Table of Contents:
non-steroidal anti-inflammatory drugs or NSAIDS are prescribed
for inflammation. With a
disc episode it may take 7-30 days to resolve the painful spinal
They all have been marketed and advertised as safe. However,
they ALL can cause adverse reactions which include vomiting,
diarrhea, weight loss, nausea, gastrointestinal ulceration and
perforation, lethargy, weakness, seizure, aggression, tremor,
glazed eyes, urinary tract infection, urinary incontinence,
renal failure, coughing, fever, facial/muzzle edema and moist
dermatitis. People are advised to watch closely for vomiting,
loss of appetite, change in urination habits, change in urine
odor or color, diarrhea, or red blood or black or tarry blood in
the stool. If you suspect a possible side effect to an NSAID,
STOP giving the drug to
your dog and call your veterinarian immediately! Never
give aspirin or corticosteroids along with an NSAID to your
dog. It is also recommended that dogs should
receive a thorough examination and blood test before receiving
these medications to verify health of organs.
In general there should be a 4-7
days washout before the start
of a different brand NSAID
or the start of a steroid
or switching from a
steroid to a NSAID.
What are NSAIDs: What to know and watch for
Points about NSAIDs your vet should go over with you
Manufacturer's package Inserts for NSAID brands
Pfizer recommends a complete history and physical examination before starting Rimadyl®, including blood tests to determine hematological and serum biochemistry prior to and periodically during administration. If your dog is taking Phenobarbital, it is especially important that appropriate liver monitoring be performed. ACE inhibitors used in the treatment of heart failure such as Enalapril or Captopril may not be as evocative in the presence of Rimadyl®. Generic Rimadyl: Novox Imadyl, Novox, Imafen and Rovera, Vetprofen.
Safety information: As a class, NSAIDS may be associated with
gastrointestinal, kidney and liver side effects. These are usually mild, but may be serious. Pet owners should discontinue therapy and contact their veterinarian immediately if side effects occur. Evaluation for pre-existing conditions and regular monitoring are recommended for pets on any medication, including RIMADYL. Use with other NSAIDS or corticosteroids should be avoided
If you suspect
an adverse reaction, Pfizer can be contacted at 800 366-5288
Previcox is one of the newest NSAIDS and is manufactured by
Merial. Merial recommends that all dogs should undergo a
thorough history and physical examination before the beginning
NSAID therapy. Appropriate laboratory testing to establish
hematological and serum baseline date is recommended prior to
and periodically during use. Should not be used with dogs less
than 12.5 pounds. Possible side effects include vomiting,
diarrhea, decreased appetite, lethargy, increased thirst and
increased urination. As
a class, cyclooxygenase inhibitory NSAIDs may be associated with
gastrointestinal, kidney or liver side effects. These are
usually mild, but may be serious. Pet owners should discontinue
therapy and contact their veterinarian immediately if side
effects occur. Evaluation for pre-existing conditions and
regular monitoring are recommended for pets on any medication,
including PREVICOX. Use with other NSAIDs, corticosteroids or
nephrotoxic medication should be avoided. http://www.previcox.com
Novartis recommends veterinarians conduct appropriate laboratory tests in dogs that may be at risk including seniors, pets with a history of liver disease, inflammatory bowel disease, renal disease or any chronic conditions. Owners are advised to watch for vomiting, diarrhea, lack of appetite, and should contact vet and discontinue use immediately. Veterinarians are encouraged to provide owners with Deramaxx® Owner Information Sheet and discuss potential benefits and risks. Deramaxx® should not be used with patients sensitive to sulfa-containing drugs. Caution should be used if Deramaxx® is used with antibiotics of the sulfa class.
Important Safety Information
As with all drugs in this class, side effects involving the
digestive system, kidneys or liver may occur. These are normally
mild, but may be serious. Pet owners should discontinue therapy
and contact their veterinarian immediately if side effects occur.
Evaluation for pre-existing conditions and regular monitoring are
recommended for pets on any medication, including DERAMAXX
(deracoxib). Use with other NSAIDs or corticosteroids should be
Important Safety Information As with all drugs in this class, side effects involving the digestive system, kidneys or liver may occur. These are normally mild, but may be serious. Pet owners should discontinue therapy and contact their veterinarian immediately if side effects occur. Evaluation for pre-existing conditions and regular monitoring are recommended for pets on any medication, including DERAMAXX (deracoxib). Use with other NSAIDs or corticosteroids should be avoided.
EtoGesic® (Etodolac) Manufactured by Fort Dodge
Due to tablet size and scoring, dogs weighing less then eleven pounds cannot be accurately dosed. Vets are asked to conduct appropriate physical examinations of all dogs before administering or prescribing and obtaining appropriate diagnostic support, laboratory tests, for animals that may be at a higher risk. This would include geriatric dogs, dogs with a history of liver disease, inflammatory bowel disease, renal disease, or other chronic conditions. Owners should discontinue if they see unusual or unexpected changes in their dog.
If you suspect an adverse reaction Fort Dodge Animal Health can be reached at 800 477-1365
Metacam® (Meloxicam) Manufactured by Boehringer
There are several less commonly used NSAIDS that have a greater risk of adverse reactions. The information below includes a few.
COX-2 selective NSAIDS have made drugs like Piroxicam® less popular. Piroxicam® has anecdotally been shown to inhibit the growth of some cancers in dogs. It is used primarily now for the treatment of Transitional Cell Carcinoma of the urinary bladder, mammary Aden carcinoma, and squamous cell carcinoma. Piroxicam should not be used in combination with other NSAIDs nor with steroids. Evidence from observational studies suggests that piroxicam may be associated with a high risk of serious GI toxicity, relative to other NSAIDs.
General information: http://marvistavet.com/piroxicam.pml
Although not approved for dogs, it was used frequently prior to the new generation of NSAIDS. Ketoprofen® has a higher occurrence of bleeding problems.
are treated for IVDD with Glucocorticords, more commonly know as
steroids, a group of drugs that are anti-inflammatory but do not
control pain. Steroids can be given orally, by injection or IV.
Methylprednisolone administered by IV can be very effective at
controlling spinal inflammation and swelling, but needs to be
started as quickly as possible and requires a stay at the vets.
must be tapered to signal the
body to again produce
own steroid hormone, cortisol.
taper is also a window
assess if all the painful spinal
cord swelling has been resolved. Veterinarians
may choose to guess at the 7 or 14
pain might be resolved. At
of the steroid taper,
will also either stop or
back of pain-masking pain
meds to quickly determine if
another course of steroid
would be needed. At
the vet ASAP
if pain should
Azium®, Voren® (Dexamethason)
Dexamethasone is considered to be a long acting steroid, meaning that a dose can last up to 2 and a half days. Dexamethasone is roughly ten times stronger then Prednisone. Excessive thirst and urination are usually less pronounced then seen with Prednisone. Because of the retention of salt, Dexamethasone® may not be suitable for patients with heart disease. Dexamethasone may change liver enzyme blood testing and interfere with testing for thyroid disease. Dexamethasone should not be used by diabetic patients.
General information: http://marvistavet.com/dexamethasone.pml
Good information on the use of steroids http://www.peteducation.com/article.cfm?articleid=1422
Tramadol acts like an opiod, controlling pain by stimulating
opiate receptors in the brain. Tramadol may be an
especially good option for a dog who is experiencing an IVDD
episode since it can be used with steroids such as prednisone or
with NSAIDs. Reactions and side effects with Tramadol are
generally considered rare and are usually mild. It is important
to notify your vet immediately of any unusual behavior. If your
dog appears sedated or demonstrates bizarre behavior the dose
should be reduced. Panting and constipation can occur in
some dogs and will resolve when the drug is discontinued.
Tramadol does not cause gastric bleeding, but a few dogs have
experienced nausea. Dogs being treated with L-Deprenyl for
Cushings Disease or cognitive disorders should not take
Tramadol. Not for use with dogs taking serotonin reuptake
inhibitors, ononamine oxidase inhibitors or certain
antidepressant drugs. Tramadol may decrease seizure threshold,
so make sure your veterinarian is aware if your dog has a
history of seizures.
Methocarbamol is a muscle relaxant that is FDA approved for veterinary medicine. It is very effective for treatment of muscle spasms associated with IVDD. Methocarbamol should be used with caution in animals with kidney disease. Methocarbamol may cause a darkening of urine, but this is not a cause for concern. Methocarbamol may interact with other medications such as sedatives, barbiturates and other muscle relaxants.The sedative side effect of Methocarbamol is exaggerated when using other medications with sedative properties.
The response to the patch can vary, so animals should be closely monitored. Use with caution in animals with liver, kidney, or heart/lung disease. Do not use in patients allergic to other opiad medications. The patch should not be near a heating source such as a heating pad, electric blanket, heating vent or heated water bed. The application of heat to a Fentanyl Patch may increase the uptake of Fentanyl to dangerous levels.
If a rash is seen where the patch is located, contact your vet immediately. The most serious side effect is slowed breathing and heart rate. Remove the patch immediately and contact your veterinarian. Fentanyl is not a sedative, but some sedation such as a wobbly gait may occur. The patch should be used cautiously in combination with medications that have sedative properties. Contact your veterinarian at the first sign of unusual behavior.
Mar Vista Veterinary "Fentanyl Patch" http://marvistavet.com/fentanyl-patch.pml
Torbutrol®, Torbugesic® (Butorphanol Tartrate)
Torbutrol® is an opioid pain reliever. It is FDA approved for pain relief in cats and for chronic coughing in dogs. It is common and accepted to use off label for pain in dogs.
Torbutrol® is not for use in patients with heartworm disease. Use with caution in patients with liver or kidney disease. Contact your veterinarian if you see vomiting, diarrhea, seizures or signs of sedation. Signs of overdose or toxicity include decreased heart rate or decreased respiratory rate. Naloxone is used to treat overdoses. Use with caution when combining with medications that have sedative properties.
http://www.peteducation.com enter Torbutrol in search
Mar Vista Veterinary "Torbutrol" http://marvistavet.com/butorphanol-tartrate.pml
Diazepam is used as a sedative, to treat convulsions, and as a muscle relaxant. It can be used to treat muscle spasms associated with inter-vertebral disc disease. Diazepam is not FDA approved for use in veterinary medicine, but can be prescribed by a veterinarian as an extra-label drug. Common side effects include weakness, drowsiness, and loss of coordination. Rarely aggression or unusual behavior can occur.
Diazepam should be used with caution with geriatric animals, animals with decreased kidney or liver function or animals with respiratory depression.
Diazepam has sedative properties, and combining with other drugs that have sedative characteristics should be done only with extreme caution. Diazepam may interact with other drugs such as certain antibiotics, narcotics, propranol, digoxin and barbiturates.
The effects of Diazepam may be much stronger then expected if used with Cimetidine (Tagamet®). If antacids must be used, separate the medications by at least two hours.
Mar Vista Veterianary "Diazepam" http://marvistavet.com/diazepam.pml
CAUTION: The commercially available human liquid product contains xylitol which can be toxic to dogs. It is possible to have a special formulation made at a pharmacy that does drug compounding so that it does not contain xylitol. Specifically ask/confirm with the pharmacist as the label will not likely list xylitol.
Like many other human drugs, Gabapentin started to be used in veterinary medicine to control seizures and in helping to control neuropathic pain (the burning and tingling sensations that come from damaged nerves) associated with spinal cord damage such as IVDD disc herniations. For pain control, Gabapentin is usually used in conjunction with other pain relievers which may later be tapered away. Gabapentin is also used preoperatively to minimize pain experienced after surgery.
Gabapentin should be used with
caution in animals with decreased kidney,
liver or renal function. It should only be used during
pregnancy or lactation when the benefits outweigh the potential
risks. The most common side effects are sedation, drowsiness,
loss of balance, and rarely vomiting and diarrhea. Gabapentin
can also cause a false positive reading on urine dipstick tests
for urinary protein.
Gabapentin should NOT be discontinued abruptly because withdrawal may precipitate seizures or rebound pain. The dosage should be decreased over the course of two to three weeks.
Oral Bioavailability. Gabapentin bioavailability is not dose proportional; i.e., as dose is increased, bioavailability decreases. Bioavailability of Gabapentin is approximately 60%, 47%, 34%, 33%, and 27% following 900, 1200, 2400, 3600, and 4800 mg/day given in 3 divided doses, respectively.
Amantadine a drug to add an extra dimension of pain relief.when gabapentin, tramadol and methocarbamol combo is not fully controlling pain. It is in an arsenal of pain meds to consider when trying to manage pain.
Vista Veterinary "Amantadine" explains how this med works:
Famotidine is a newer generation antihistamine used to suppress stomach acid production with fewer drug interactions and longer lasting than previous generations such as cimetidine (Tagment) and ranitidine (Zantac). There have been some reports of exacerbating heart rhythm problems in patients who already have heart rhythm problems, so it may be prudent to choose another means of stomach acid control in heart patients.The dose of famotidine may require reduction in patients with liver or kidney disease as these diseases tend to prolong drug activities.
Mar Vista Veterianry "Famotidine" http://marvistavet.com/famotidine.pml
Sucralfate is best used on an empty stomach and given 30 minutes before administering an acid suppressor such as Pepcid AC.. Sucralfate may interact with other drugs including cimetidine and digoxin. Advise your veterinarian of any other medications or nutritional supplements your dog is taking. Sucralfate can cause mild constipation
Vista Veterinary "Sucralfate"
Ranitidine should be avoided in animals with liver or kidney disease. Ranitidine may interact with other medications such as Theophylline and certain antacids. Advise your veterinarian of all medications and nutritional supplements your dog is taking .
Mar Vista Veterinary "Rantidine" http://marvistavet.com/ranitidine.pml
Tagamet® is used in the treatment and prevention of stomach and gastric ulcers. This drug is not FDA approved for use in animals. Tagamet® is available over the counter but should not be administered without first consulting a veterinarian. Tagamet® is contraindicated with a great number of medications such as Sucralfate, Digoxin and Diazepam, dexamethasone, prednisone, fentanyl, . Use with caution in animals with kidney or liver disease.
Vista Veterinary "Cimetidine"
Prilosec® is a potent inhibitor of gastric acid production. Available over the counter, Prilosec® is not FDA approved for use in animals. Do not administer without consulting your veterinarian. Side effects could include anorexia, nausea, vomiting and diarrhea. Adverse effects on the bone marrow are possible as has rarely been seen in human patients treated. Prilosec® may cause increased liver enzymes. Prilosec takes 3-5 days to reach 65% bioavailability. Until Prilosec reaches a more optimal effect another anti-acid such as Pepcid AC should be considered..
Vista Veterinary "Omeprazole" http://marvistavet.com/omeprazole.pml
Vista Veterinary: http://marvistavet.com/pharmacy-center.pml
1. Keep your
dog fit and in good weight.
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