NSAIDs - Side Effects / Dangers

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Definition / Overview	Types of NSAIDs	Side Effects / Dangers
Safety Concerns

Dangers and Side Effects of NSAIDs

There are risks and benefits with all commonly prescribed veterinary drugs, including NSAIDs. Veterinarians and pet owners should be aware of the following facts:

All dogs should undergo a thorough history and physical examination before beginning NSAID therapy.
Appropriate blood and urine tests should be performed to establish baseline data prior to administration of any NSAID, as well as periodically during treatment.
Veterinary NSAIDs may be associated with gastrointestinal ulcers and perforations as well as liver and kidney toxicity.
Use with other anti-inflammatory drugs, such as other NSAIDs and corticosteroids, should be avoided.
Patients at greatest risk for kidney problems are those that are dehydrated, are on diuretic treatment, or have pre-existing kidney, heart, and/or liver problems.
NSAIDs can cause stomach or intestinal bleeding.

Since dogs have shown greater toxicity with most NSAID medications, it is actually questionable if they should be used in dogs for any reason. As a result of this increased sensitivity towards NSAID side effects, pharmaceutical companies are currently developing products which are safer for canine patients.

A common side effect is gastrointestinal bleeding, which occurs because of prostaglandin inhibition. Other side effects include kidney disease (also due to prostaglandin inhibition), liver disease (mild cases display elevated liver enzymes, whereas more serious cases can show liver failure), immune diseases (anemia, low platelet count, skin diseases,) neurologic signs (seizures, paralysis, unsteadiness), behavioral problems (hyperactivity, aggression, depression, or sedation), drug interactions (NSAIDs normally should not be used in combination with corticosteroids, as the potential for side effects increases), and even death. Finally, and perhaps most importantly, as with steroids, many NSAIDs destroy cartilage, although the popular Rimadyl and EtoGesic appear to cause less cartilage destruction than other NSAIDs.

The Drug Companies

Drug manufacturers conjecture that these side effects are observed most often in older dogs. Of course, as joint disorders are most common in older dogs, these are the dogs that need the drugs and use them most often. They also argue that many veterinarians do not test liver and kidney function before subscribing these drugs, or that they do not monitor the blood and urine as frequently as recommended.

History of Usage

NSAIDs have been controversial all along. In 2006, the Food and Drug Administration reported that over 22,000 dogs had gotten sick, while almost 3,000 had died, following use of NSAIDs. Most of their owners said they never would have begun treatment if they had been warned of the potentially severe or fatal side effects. Drug companies generally passed the buck to veterinarians, claiming that information sheets are always provided and it is the veterinarian’s responsibility to pass those along to pet owners when prescribing an NSAID.

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