Special Report (June
9, 2006)
Opinion
Do’s and don’ts of NSAIDs
By Melissa Burden
Special to The Press
Non-Steroidal Anti-Inflammatory
Drugs (NSAIDS) are considered safer than aspirin for reducing
pain in pets. But for some animals, NSAIDs can cause injury and
death. Here are some cautionary tips to consider before giving
these commonly prescribed pain killers to your pets, according
to Dr. Bob Rogers, of Critter Fixer Pet Hospital, in Texas.
“There is risk
of liver failure with all NSAIDs,” said Rogers. “Liver
necrosis in Labrador Retrievers caused by Rimadyl has been reported
in largest numbers.”
Pfizer Animal Health,
which manufactures Rimadyl, believes labs are most affected because
it is the most common breed, he said, “and Rimadyl was the
first and most commonly prescribed NSAID.”
Blood tests before
administration of NSAIDs cannot predict this liver reaction, said
Rogers. “Until more information is available, the staff
at Critter Fixer Pet Hospital prefers to exercise caution, and
not use Rimadyl.”
NSAIDs are relatively
new to veterinary medicine, he said. “Veterinarians have
little clinical experience with these drugs. Although every manufacturer
has data that alleges their drug is safer than others, no credible
non-manufacturer sponsored data exists which accurately compares
the safety or effectiveness of these drugs.”
NSAID Do’s
Pet owners should pay
careful attention to the following before administering NSAIDs,
said Rogers:
Ask veterinarian
for a written warning about side effects and the manufacturers’
package insert;
Test for kidney and
liver problems, especially in older pets, which are prone to
kidney failure. A urinalysis and blood test are essential;
Watch for signs of
Kerititis secca, or dry eye, in patients receiving the NSAID
EtoGesic (Etodolac);
Monitor kidney and
liver functions in pets on prolonged NSAID use. Monitoring is
recommended annually, and if the dosage is increased;
Give with food and
Zantac or other antacid medication daily to prevent duodenal
ulcers, a common side effect of NSAIDs, though it won’t
prevent gastric ulcers;
Give Polysulfated
Glucosamines, PSGAs, (Adequan, Glycoflex, or Cosequin) with
prolonged use of NSAIDs for arthritis and degenerative joint
disease. NSAIDs can contribute to cartilage degeneration over
a long period of time. PSGAs help cartilage heal, and protect
kidneys;
Stop NSAIDs when
gastric upset, nausea, lack of appetite, vomiting or diarrhea
first appear.
NSAID Don’t’s
Don’t mix with
steroids like dextamethazone, prednisone, vetalog or depomedrol.
Gastrointestinal bleeding can result;
Don’t give
to patients with known impaired gastrointestinal, kidney, cardiovascular,
or coagulation fuctions. Tramadol, a pain medication, can be
used instead. If liver enzymes are elevated, use a lower dose,
and with liver treatment medication;
Don’t give
with Enalapril or other ACE inhibitors, Lasix, or with drugs
like aminoglycoside antibiotics or psychotropic drugs (Prozac,
Clomiclam);
Don’t give
to dogs with Cushing’s disease, or other diseases where
pets are predisposed to blood clots;
Don’t use in
trauma or critical care patients due to potential clotting and
kidney problems.
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