Steroids Or Nsaid?

[Guest suzye]

I was telling an old colleague of mine the story of Jazz's passing tonight and it got me thinking about how the whole mess started -- with that broken toe and Deramaxx. That drug is a NSAID, or non-steroidal anti-inflammatory, and it put her into chronic kidney failure, a documented side effect. I have a new greyhound Popo, and I just got to thinking -- what do I do if something like this happens again? I am very against the use of NSAIDs now. My current philosophy is only to use NSAIDs when I have almost nothing to lose.

 

I am a believer in acupuncture, so I hope that will be an option for long-term problems. NSAIDs scare me even for short-term. It took about a week for this stuff to hurt Jazz.

 

I guess what I want is some insight on what to discuss with the vet should my dog have an injury/condition that would call for pain meds and anti-inflammatory meds. My current vet knows my history with Deramaxx, but if I end up at the e-vet I need to discuss it rationally and not just cave in because they say my dog has to have NSAID. I worry that I would leave with the bottle and chicken out giving the meds later and make my dog suffer. I haven't read up on steroids, but I would definitely ask the vet if those would be appropriate, particularly with a short-term problem. I wonder how bad off Jazz would have been with her broken toe and only Tramadol.

 

And.... go!

Edited January 31, 2009 by suzye

[ahicks51]

I know very little about pain control in hounds, but I do know that tramadol is available OTC in some countries- not the US, obviously. It seems to be a relatively safe drug, albeit a bit strong for the management of relatively minor pain. However, I don't believe it offers the inflammation-fighting power of NSAIDs, so it doesn't really get to the root of some problems that could otherwise be managed in that fashion.

[lothianjavert]

NSAIDs-- non-steroidal anti-inflammatories do help relieve pain, but they also help reduce inflammation. Many NSAIDs can damage the kidneys and/or liver-- it's the same with human NSAIDS. Most dogs handle them well, but there are some that just don't. Unfortunately, you don't know until you find out the hard way. (same thing can happen in people too) The most common side effects in both people and animals are either gastric disturbances (upset stomach, ulcers, bleeding) and kidney impairment

 

Tramadol is not an NSAID. It does relieve pain, but won't do squat for inflammation. It's often combined with an NSAID.

 

Steroids such as prednisone are the most powerful drugs when it comes to inflammation. However, they have nasty side effects and you don't want to use them casually. You also cannot just start and stop steroids, you must gradually taper the dose. If they are truly needed, go for it--they are lifesavers, especially for auto-immune problems. But for a minor injury like a broken toe, steroids would not be the way to go. Keep in mind that they can also delay healing.

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[Hawthorn]

I've been thinking about this subject recently too, as my Sunny can't have NSAIDs as he had a bad reaction (staggering around, loss of coordination) from just one injection.

 

When Sunny had a recent problem with limping, instead of a NSAID we had Tramadol for pain relief on an as-needed basis but as others have said this does not have the anti-inflammatory properties of the NSAIDs.

 

There are also herbal anti-inflammatories that can be given to dogs, such as Devils Claw. I've recently bought one for Sunny that's a combination of Devils Claw and Yucca but have yet to use it so don't know how effective it is. You also have to bear in mind that herbal remedies can also have side effects, such as gastric disturbance.

 

Re steroids, because of the serious side effects, I think I would want to reserve these for very serious conditions only.

[Guest KennelMom]

I would choose an NSAID over steroids, esp in greyhounds. We've given NSAIDs and tramadol safely to many greyhounds. Though, we have one now that can't have them because of kidney issues.

[CaliforniaGreys]

Maybe I missed something here, but vets will usually do blood work before giving the NSAID which will tell them if it's safe to use

[lothianjavert]

The bloodwork can screen for -existing- kidney or liver issues, but it can't tell the vet if that dog will have an unusual reaction. Now, if the nsaids are to be used long term, then periodic testing is done to monitor the effects. However, some react very badly very quickly, and there's no way to predict that.

[CaliforniaGreys]

The bloodwork can screen for -existing- kidney or liver issues, but it can't tell the vet if that dog will have an unusual reaction. Now, if the nsaids are to be used long term, then periodic testing is done to monitor the effects. However, some react very badly very quickly, and there's no way to predict that.

That's scary!! I have a boy on Rimadyl and we do the blood work every 6 months and he had bloodwork done before we even started it. I never realized it wasn't a sure thing.

[Guest suzye]

Thanks for the responses. It sounds like NSAIDs are something I will have to get over, and just hope this doesn't happen again. If I have to use them and heaven forbid something does happen, I will catch it sooner.

[NeylasMom]

I understand your fears, totally logical given what happened. I discovered my female can't have them either, well at least one in particular (Rimadyl) as she starts bruising all over when we give it to her. Thankfully once taken off of it, it clears up. So now we just manage her pain (she has chronic toe pain) with Tramadol. In your case, I would say ask if Tramadol alone will be sufficient. If not, look into other anti-inflammatory options (natural rememdies) and use the NSAID as a last resort.

[PatricksMom]

I use tramadol for Patrick's arthritis, and supplement with buffered asprin on his really bad days (not usually more than once a month, in the winter.) He has used Deramaxx for injuries before, with no problems, but it doesn't seem to work any better than asprin and the vet said that was fine for very occasional use.

 

For what it's worth, I think any dog on long-term pain medication should have a blood panel done yearly if possible.

 

As for your fear, I understand. Patrick was given rimmadyl, under the generic name, and during the emergency crisis I didn't realize that's what he was sent home with. He had a very bad reaction, rationally I know that doesn't happen to most dogs, but I will certainly be reluctant to use it again in a dog.

[Guest LynnM]

Here's my opinion, and it's worth not a whole lot... just based on my experience.

 

You do have another class of pain meds to consider, opiates.

 

NSAIDS are generally very, very safe. Unfortunately, you had a dog that was exceptionally sensitive. I'm so sorry. NSAIDS do have some possible side effects, and generally if the meds are stopped when it's just at the "I don't want to eat and poops are runny" stage, it's not a big deal. I've only seen 2 dogs have bad reactions to NSAIDS. One was a BIG overdose and another was similar to your dog, though he did survive. Anyway, what I'm getting at, is that they are extremely safe and very effective.

 

For minor muscle/tendon injuries (dropped muscle, bowed tendon, etc), dmso with a steroid like dexamethasone mixed in, and applied topically, can offer good relief. Oftentimes, DMSO alone can give relief. Consult your vet.

 

Steroids are best used for OTHER conditions than pain, and for pain only when necessary. They impact so many of the body's systems that it's tough to justify them for pain when an NSAID will work.

 

Opiates are a good choice when the dog is on steroids for some other condition and cannot take NSAIDS (You don't give steroids and NSAIDS at the same time. Just about ever.) Opiates include everything from the relatively mild Tramadol to the Fentanyl patch. Tramadol can also be given with NSAIDS and oftentimes works well in conjunction with NSAIDS, in that the pet owner can generally decrease the dosage of NSAID. The main side effect that the pet owner needs to look out for is constipation.... opiates can stop a dog up but goood! It's not usually an issue with Tramadol, but I've seen it with propoxyphene and it's just about a sure thing with the Fenanyl patch.

 

Acupuncture and chiropractic can make a world of difference. I've seen acupuncture make a difference on both performace and elderly dogs. It can frequently reduce the dosage of medication that is needed to make the dog comfortable.

 

Best of luck.

 

Lynn

[Guest suzye]

Thanks Lynn. I saved your notes for future reference. Jazz was on a Tramadol/Deramaxx combo. The vet gave her the max dose of Deramaxx, so she certainly didn't reduce it because of the Tramadol. That's something else I can keep in mind to ask about in a future case. NSAID will be a last resort in the case of long term pain management. Jazz was getting acupuncture up until the adverse event. I went into meltdown mode over her kidneys and never got back into acupuncture. That was a mistake. I still wonder if her back problems could have been mitigated by continued acupuncture, or even if the breakdown occurred anyway, at least she would have felt better up until that happened. I think I underestimated how much her back was bothering her, and that makes me feel guilty. Obviously I did more than needed for her kidneys and not enough for her back. If I think about it I feel guilty, but I don't think I really beat myself up over it. I don't know what the right balance would have been, and I don't have endless resources. I just want to learn from it and next time not neglect 1 problem in favor of another.

 

All this said, I will be scared to DEATH the next time I have to give a dog Rimadyl, Deramaxx, or Metacam. Their scientific names are even burned into my brain.

[Guest speedoketo]

Your vet has to weigh the pros and cons of every drug they diagnose and trust me, they had 4 years of school beyond college to teach them what was the best choice. They have to know everything from how the kidney functions to the biochemistry of exactly how each drug works and the pathology of how the disease progresses. I would trust your vet - internet research can't hold a candle to formal education and experience. It is understandable to shy away from something that gave you such a bad experience though, I'm so sorry for what you had to go through. Find a vet you trust and you'll always be confident that no matter the outcome they made the right decision.