Updated on July 19, 2015
Long-Term Use of Nonsteroidal Anti-inflammatory Medication for Treatment of Canine Arthritis
Just like people, many dogs develop age-related arthritis. Symptoms are far more common in larger breeds. Not only are the big dogs more predisposed to arthritis, their joint pain is intensified because of the extra weight they carry.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
As their name implies, NSAIDs are non-cortisone containing drugs. They have both anti-inflammatory and analgesic (pain fighting) properties that produce greater ease of movement resulting in muscle strengthening and decreased strain on affected joints.
Back in the 80’s when I was just a pup, the only NSAID available for dogs with arthritis was aspirin. While this drug did do a pretty good job alleviating arthritis pain, it also caused plenty of gastrointestinal side effects.
Fast-forward to 2015 and several big-name pharmaceutical companies have their own NSAID brand approved for the treatment of canine arthritis. Within the United States there’s Rimadyl, Deramaxx, Previcox, and Metacam, all of which are quite effective and associated with far fewer side effects than aspirin.
Just as in people, the specific NSAID brand that most effectively treats arthritis pain in dogs varies from individual to individual. Most veterinarians have their first choice recommendation, but certainly try other NSAIDs should the first choice fail to create significant improvement.
Potential side effects
As is true for most any drug, negative side effects can occur with NSAID use in dogs. While the actual incidence of side effects is not known, it is thought to be low. When dosed appropriately, the vast majority of dogs tolerate NSAID therapy very well.
There tends to be an unsubstantiated fear that the longer NSAIDs are used, the greater the risk of associated problems. Dr. B. Duncan Lascelles, a professor of surgery and pain management at North Carolina State University College of Veterinary Medicine dispels this notion in a paper titled, “Risk-Benefit Decision Making in the Long-Term Use of NSAIDs for Canine Osteoarthritis.” Lascelles states,
We found that this was not true, there was no association between the longer you give a non-steroidal and the risk of side effects. As far as we can tell, we don’t find any relationship between those two things- length of non-steroidal use and incidence of side effects. Often, the clinical approach to a young or middle-aged dog with osteoarthritis associated pain is to avoid the use of NSAIDs. The rationale often quoted for this approach is that the practitioner wants to leave the use of NSAIDs for later, and not have a dog on NSAIDs for the whole of its life. This is a flawed and rather naïve approach.
Lascelles goes on to say that, when NSAID side effects do occur, they are most likely to appear within the first two to four weeks after beginning therapy. Furthermore, when side effects do occur, they vary from dog to dog.
Gastrointestinal upset, gastrointestinal ulcers, liver toxicity, and kidney toxicity are all possible NSAID associated problems. Symptoms may include:
- vomiting
- diarrhea
- loss of appetite
- lethargy
- increased thirst
Proper screening of the dog by a veterinarian prior to starting NSAID therapy as well as appropriate follow up after medication has started lessens the potential for adverse reactions. For example, an older arthritic dog discovered to have kidney failure would be ruled out as a good candidate for NSAID therapy. Observation of any side effects warrants immediate discontinuation of the NSAID and discussion with the prescribing veterinarian.
NSAIDs: One of several treatment options
While NSAIDs work well in many dogs, they are not the end-all and be-all treatment for arthritis. As a stand-alone therapy, they are inadequate for some dogs with chronic arthritis pain. Such animals are more likely to benefit from multimodal therapy in which an NSAID is combined with one or more of the following:
- Weight management
- Exercise modification
- Physical rehabilitation
– passive stretching
– range of motion exercises
– swimming
– under water treadmill therapy
- Supplements/nutraceuticals
– omega-3 fatty acids
– glucosamine
– hyaluronic acid
– chondroitin sulfate
– polysulfated glycosaminoglycans
- Acupuncture
- Massage therapy
- Stem cell therapy
- Surgery, such as a total hip replacement
- Pain medications
– tramadol
– gabapentin
– narcotics
- Steroids
Don’t skimp on therapy
Arthritis pain robs dogs of their ability to do many of the things they most love in life such as going for walks, wrestling with their favorite dog park buddy, going hunting, or playing a good game of fetch. Think about the exuberant Labrador who loves nothing more than chasing tennis balls and eating. Add arthritis to the mix and the game of chase must be curtailed. This means fewer calories burned which translates into fewer treats and smaller meals. What a drag for everyone involved!
In order to prevent arthritis from negatively impacting a dog’s quality of life, it is important to treat this disease aggressively. This means treating daily rather than just on the day after a vigorous hike or when severe symptoms become apparent. Treatment should be started well before indicators of advanced arthritis pain such as limping or whining are observed.
Dr. Jennifer Johnson, owner of Stoney Creek Veterinary Hospital in Morton, Pennsylvania states,
From a pain-management perspective, I believe that my patients that are on chronic, daily NSAID use fare much better than the patients whose owners try to chase pain by giving NSAIDs as needed, or on tough days. It’s difficult for clients to judge definitively how much pain their pet is in, which makes it impossible to accurately dose the pain with an NSAID as needed.
In summary, maximizing the benefit of long-term NSAID use for treatment of canine arthritis requires the following:
- Early treatment: use NSAIDs early on in the disease process. Once arthritis pain is “ramped up” it becomes much more difficult to control.
- Multimodal therapy: use NSAIDs in combination with other therapies
- Long-term therapy: use NSAIDs consistently for a period of time rather than on an as needed basis.
Questions for your veterinarian
- Are my dog’s symptoms caused by arthritis?
- Is my dog a suitable candidate for NSAID therapy?
- What other treatments for arthritis should we be considering?
- When should my dog be reevaluated?
Do you have a pain prevention strategy for your pets?
Best wishes,
Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook
Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.
In general, increased size and weight is always a predisposer of joint problems. So the poster children for both developmental and degenerative problems are going to be the bigger dogs.
We have had two dogs on long-term NSAID treatment using Metacam.
Our diabetic dog had some arthritis and he took it daily for a few years.
After he passed, we adopted a border collie who turned out to have some mystery problem in his back / right hip. It’s been totally worked up – MRI, extensive x-rays, ortho exam, neurologist exam – and remains a mystery. We found that he feels better on Metacam for whatever it is and he has been taking it daily for five years now. As long as he tolerates it, we plan to keep him on it because of his visibly happier demeanor when using it.
Both dogs have tolerated Metacam (liquid form) beautifully and never had any problems with it. We are grateful for the relief it provides.
I have been using a product for years now along with a group of us that do agility with our dogs. I have turned so many people onto it and all of them love it. It is called Joint Strong. I had my vet go over all the info listed on it and he approved. Here is what I gave to my vet.
Put Out The Fire and Make Real Joint Pain Progress! Animal Naturals K9 Joint Strong joint support formula is designed to “Put Out the Fire” of dog joint inflammation. Dog joint pain and inflammation fighting K9 Joint Strong helps produce results even for dogs that are “non responders” to ordinary formulas.
The truth is all the Glucosamine in the world does little good if your dog has chronically inflamed joints and many do. Glucosamine barely penetrates inflamed joints. This is why many dogs are non-responders to Glucosamine.
Gram for Gram, More Complete, More Powerful! K9 Joint Strong puts out the fire of inflammation with ORAC* antioxidants, as found in wolf diets. Reducing inflammation enables glucosamine, chondroitin, Omega 3s and more to work even better.
Putting Out the Fire is the First Step! K9 Joint Strong helps establish an anti-inflammatory foundation, and provides the functional nutrients essential for building toward real joint progress:
First: Reduce dog joint inflammation & discomfort, ease muscle soreness, increases movement, mobility and quality of life. Omega 3, flavonoids, polyphenols, ellagic acid, elevated SAMe levels & MSM fight inflammation.
Next: Guard cartilage from chemical attack. Green Tea extract, acetyl-cysteine & curcumin inhibit cartilage destroying enzymes.
Finally: Support repair & growth, Glucosamine, Chondroitin, CMO help “turn on” anabolic processes to support cartilage repair & growth. Animal Naturals Joint Strong is concentrated, so only small amounts are used. Whatever the activity or joint status, K9 Joint Strong fights inflammation so glucosamine and other joint builders work better.
K9 Joint Strong is designed to provide dual benefits, joint factors and antioxidants. Joint factors include USP-standardized glucosamine, MSM and others to help maintain normal joint function. In addition, natural antioxidants he DESCRIPTION
Animal Naturals Joint Strong Joint Supplement for Dogs
Animal Naturals Joint Strong™ is the first dog joint support formula designed to “Put Out the Fire” of dog joint inflammation. Dog joint pain and inflammation fighting Joint Strong™ helps produce results even for dogs that are “non responders” to ordinary formulas. Joint Strong Puts out the fire of inflammation with ORAC antioxidants, as found in wolf diets. Reducing inflammation enables Joint Strong™ glucosamine, chondroitin, Omega 3’s and more to work even better. Putting out the fire is the first step… Joint Strong™ helps establish an anti-inflammatory foundation, and provides the functional nutrients essential for building toward real joint progress. First it reduces dog joint inflammation and discomfort, eases muscle soreness, increases movement, mobility and quality of life. Next it guards cartilage from chemical attack. Green Tea extract, acetyl-cysteine and curcumin inhibit cartilage destroying enzymes. Finally it supports repair and growth. Glucosamine, Chondroitin, CMO help “turn on” anabolic processes to support cartilage repair and growth. Joint Strong™ is concentrated, so only small amounts are used. Whatever the activity or joint status, Joint Strong™ fights inflammation so glucosamine and other joint builders work better. Sugar free, human grade, zero trans fats. Includes clear plastic scooper for easy use.
lp protect cells (including joint) from free radical damage. This two-way joint support health strategy is meant to help maintain joint mobility.
Performance Dogs: Strengthens joints and soft tissues. Finally, joints can keep up with exercise!
Older Dogs: Shifts metabolism toward greater cartilage buildup than breakdown.
Large Breeds: Create biochemical environment favoring cartilage formation better able to keep pace with growth.
• 1,150 mg Glucosamine Per Scoop
• Antioxidant Protection
• 600 mg chondroitin sulfate + MSM
• Supports Healthy Joints and Flexibility
• Helps Maintain Joint Mobility
• Supports Connective Tissue
• Supports Joint Tissue Health
• Ultra Concentrated
• Inflammation Fighting ORAC
• Natural Anti-Inflammatories
• Human Grade Ingredients
*ORAC (Oxygen Radical Absorbance Capacity) measures total antioxidant power of foods, supplements and extracts. High ORAC intake is associated with reduced inflammation, and enhanced brain, heart and eye health.
I’ve always wondered what was meant by long term, since dogs don’t really live long term. Most arthritis treatments I don’t start until later in their lives.
I do much of what you listed; weight management, swimming, acupuncture, Glucosamine/Chondroitin/MSM combo, massage. I’ve given my boy Fish Oil (omega 3) since he was little. When he needs it I’ll start all you mentioned plus Turmeric. I’ve found that works wonders.
I’ll have to do all of this because I doubt I’ll be able to afford a hip replacement and he is a Lab, so he’ll probably have hip problems. He’s only 9 right now and still going strong.
Thanks for all your helpful tips!
I’m so torn on this. My guy had a gastric reaction to Rimadyl a few years back and I was so nervous to give him any NSAIDs. But he had knee issues (and TPLOs), along with hip and elbow issues.
I’ve been using supplements, Adequan injections, acupuncture and cold laser, and finally, after doing blood work, I started him on a half daily dose of Previcox. That was nearly two years ago. He’s 12 now and he needs a full dose of Previcox, in addition to maintaining the other things I’m doing.
He is so much happier on Previcox than off it, and I’ve added Denamarin to his daily supplement list. I maintain his blood work and I worry constantly, but it’s good to see him so much more functional and happy and I cross my fingers that he’ll be okay. (Especially in light of what the latest studies say about NSAIDs and human bodies.)
I have read about dogs dying from NSAIDs (liver and kidney failure), just like from the comments here, so I know I need to be vigilant. Very vigilant. So far, I’m glad we’re okay and I hope we stay that way until he has to leave me.
I’ll always follow the NSAID research because it is rather controversial and it’s heartbreaking to read about dogs who have a reaction and die from taking them.
We had a Border Collie/Aussie Shepherd mix whose greatest joy in life was mid-air Frisbee catches. It caught up with him in the form of arthritis in his hips. A few days after starting Rimadyl my husband said “Sammy’s back!” We hadn’t realized how impaired he was until he was better.
I don’t blame you one little bit Judith.
12 years ago, my very healthy 10 YO lab was prescribed Deramaxx as a routine protocal after ACL surgery. 2 Months later we had to put her down due to liver failure. I’ll never know if the Deramaxx caused it (how could I?) but I look squinty eyed at Nsaids.