On February 22, the Food and Drug Administration (FDA) held an FDA Basics Webinar entitled, "Advice to Dog Owners Whose Pets Take NSAIDs." I didn’t hear about it soon enough to give you a heads up in time to attend the live event, but the FDA has an archived version available on its website if you want to take a look.
It contains some good information, and I recommend it for any owner who has not had an in depth discussion with their veterinarian about the benefits and risks associated with the use of NSAIDs for pain relief for their dogs.
In case you don’t have the time or inclination to listen to the entire webinar (it’s 20-30 minutes long), I’ll present a few of the highlights here.
The presentation starts with an overview of FDA responsibilities and procedures. Sounds dry, I know, but I did learn something new. I was aware that drug testing for animals isn’t as rigorous as it is for human medications, but didn’t know the details. It turns out that for companion animals, preapproval safety studies are generally conducted on only 32 young, healthy animals, and preapproval effectiveness studies are usually performed on healthy, client-owned pets.
With this information, I’m even less likely than I have been in the past to prescribe the “latest and greatest” new drug when there is a tried and true old standby available. I always tell my clients, "Let someone else’s pet be the guinea pig."
OK, now on to NSAIDs. The webinar tidily sums up what NSAIDs are and what they do. To paraphrase:
Nonsteroidal anti-inflammatory drugs (NSAIDs) work by decreasing prostaglandin levels in the body. They do this by inhibiting the enzyme cyclooxygenase (COX), which in turn is responsible for turning arachidonic acid (a fatty acid) into prostaglandins.
Inhibiting prostaglandin formation has widespread consequences for the patient because of the many physiological roles they play, including:
- Promoting inflammation, pain and fever
- Supporting platelet function (i.e., helping blood clots form)
- Protecting the stomach lining from stomach acid
- Maintaining normal kidney function
The primary uses for NSAIDs in veterinary medicine are reducing inflammation, pain, and fever in dogs and horses. No veterinary NSAIDs are approved for long-term use in cats in the United States. Cats can’t break down NSAIDs very well and are at very high risk for developing potentially serious side effects when given these drugs over extended periods of time.
Like all forms of medical intervention, NSAIDs carry with them potential benefits and risks. Anybody who has taken a human-approved NSAID to treat joint pain, fever, etc. can attest to the upsides: less pain, greater mobility, and an improved quality of life. And the same is true for our pets. The most common adverse events associated with NSAID use in veterinary patients are vomiting, loss of appetite, depression, and diarrhea that resolve with discontinuation of the drug and appropriate treatment. Rarer but more serious side effects include stomach/intestinal ulcers with possible perforation, kidney and liver failure, and death.
The best way to determine whether the benefits of NSAID use outweigh the potential risks for your pet is to talk to your veterinarian — every case is unique — and make sure you get a client information sheet with your pet’s NSAID prescription. These are part of the labeling for FDA-approved oral NSAIDs and should be included with the medication, although they may not be passed along when the drugs aren’t dispensed in their original packaging. You can also look up NSAID client information sheets here.
If your dog has an adverse reaction to an NSAID, stop giving the drug and call your veterinarian immediately. Adverse reactions need to be reported so drug safety can be monitored. Directions on how to do this is available at the FDA’s Report a Problem website.
For more information from the FDA on NSAIDs, take a look at the brochure "Keeping Your Best Friend Active, Safe, and Pain Free."
Dr. Jennifer Coates