Anti-inflammatories - should you be afraid of them?

When is it appropriate to use anti-inflammatories?

Common NSAID types

In a modern society with great access to great health care one of our main goals is to prevent or treat pain in our beloved patients and family members. A lot of our treatments involve helping with either chronic (long term) pain or acute (sudden) pain.

• Acute pain 

This is a common cause for presentation such as trauma - car accidents, fights, falls, injuries etc. Treatment clearly depends on the cause, however it is frequent that we use anti-inflammatories to help with swelling and pain.

Anti-inflammatories (NSAIDS or non-steroidal anti-inflammatories), relief pain effectively and also decrease swelling and  inflammation.

So anti-inflammatories are PAIN KILLERS and ANTI-INFLAMMATORIES!

In an acute situation, they are used for short periods. We have to be cautious using them only in healthy well hydrated animals otherwise side effects occur at a slightly greater risk.

• Chronic Pain

The most common cause is osteoarthritis or joint breakdown. this is a long term, low to medium to high level of pain. Often we use anti-inflammatories on an as needed to every day dosage, often at lower doses than the acute pain situations. They are very effective, and quite safe. However! For chronic usage we recommend the following precautions

1. Never use with cortisones such as prednisolone together - DISASTER
2. Never use in a patient with kidney or liver issues
3. If on long term usage, test kidney and liver function before, after 2 weeks then every 6 months via blood and urine tests
4. Use lowest effective dose
5. Don't ever give as a "pick me up" when the dog/cat is sick
6. They are not safe if you pet is vomiting or unwell - don't give it! Seek advice
7. Use exactly as prescribed, don't go over the dose amount or frequency
8. Don't use human anti-inflammatories, they are not safe

So with all this DANGER DANGER talk why use them?

All in all they are actually quite safe, especially when used sensibly and as prescribed. The risks are there, but are extremely low, especially for the huge benefits they derive. Many of our patients on long term anti-inflammatories for years and would not be alive without them as the pain of arthritis would be too much to bear. Simply in many cases they provide quality of life.

Take home messages

• Don't be afraid of anti-inflammatories, they are of tremendous benefit when used sensibly 
• Ask us, or your vet about the risks for YOUR pet as an individual
• Weigh up the benefits versus this risk
• Consider what alternatives you have to relieve the pain
• Use any medication as prescribed, DON'T alter it without asking us!
• Consider blood and urine tests routinely to reduce the risk of the drugs and their potential impacts
• Ask for alternative forms of the drug if you are having trouble medicating, there are tablets, liquids, injections available
• Seek advice if you are unsure about anything or if the animal becomes unwell, goes off their food, changes behaviour or is just "off".

Have a great day.

Dr Steve Rose