Pet Talk-Dec. 16, 2004

By: Dr. Daniel Eubanks
   Sooner or later, almost every pet owner perceives his pal as being in pain — back pain, joint pain, post-surgical pain, etc.
   The first temptation is to reach for one of our OTC pain relievers and contemplate giving it to our pet. This might not be a good idea, and I think it would be helpful to discuss the use of painkillers with our pets.
   This essay is for enlightenment only and is not intended to be a formulary for home remedy. This is as much about what not to give as it is about what to give.
   All of the drugs we are about to discuss, even aspirin, should be given to your pet only with the advice and supervision of a veterinarian or a qualified veterinary technician. A professional should determine drug choice, dosage, frequency and duration of administration.
   The reason for all of this caution is our pets can suffer severe consequences from some of our common pain relievers.
   Acute, short-term pain usually is treated with potent prescription drugs administered by injection while hospitalized. Examples would include post-surgical or auto accident pain management. Orally administered pain meds given at home generally are for chronic, long-term misery such as chronic arthritis.
   Some terminology first. Anesthesia refers to reduction of all sensations with complete loss of consciousness. Analgesia is simply lack of sensation of pain. Anti-inflammatory is exactly that — resolving inflammation.
   Pain management drugs are generally of three types: analgesic, anti-inflammatory or a combination of the two.
   Analgesics are painkillers with no anti-inflammatory property. These compounds simply numb the pain. Narcotics (morphine, Demerol) are examples of potent, prescription-only analgesics.
   Anti-inflammatory drugs are not really analgesics. If inflammation is the cause of the pain, as is frequently the case with arthritis, then resolving the inflammation indirectly relieves the pain. Steroids (cortisone) are examples of the most potent anti-inflammatory drugs.
   The third category of drugs has both analgesic and anti-inflammatory properties. These are commonly referred to as NSAIDS (nonsteroidal anti-inflammatory drugs) and comprise the largest market of prescription and OTC pain relievers for long-term use.
   Let’s take a look at some specific drugs and their uses.
   I mentioned surgery as a source of short-term pain. Anesthetics are generally poor analgesics so in addition to the anesthetic agent, we administer an injectable narcotic prior to or immediately after surgery. Narcotics are mostly for in-hospital use but occasionally are dispensed for relatively short-term oral use at home.
   Examples might include a patient with severe spinal disc pain or trying to provide relief for a patient with terminal bone cancer until euthanasia is appropriate.
   Chronic, low-grade to moderate pain prompts the need for long-term orally administered medication at home. The most frequent source of this type of pain is arthritis. There are many causes of arthritis, but all of them have an inflammatory component, and all of them are painful. We would, therefore, like to use a drug with both analgesic and anti-inflammatory properties.
   An OTC drug with solely analgesic property is acetaminophen (Tylenol, Excedrin). This drug has no anti-inflammatory activity and, therefore, would not be the best choice for arthritis. It also is contraindicated for use in both the dog and cat due to liver and blood toxicities respectively.
   Strictly anti-inflammatory drugs (a.k.a. steroids, cortisone, prednisone, etc.) are prescription drugs. They might be used in advanced, refractory cases of arthritis, but have potential for serious long-range consequences. Remember, steroids relieve pain only secondarily by resolving the inflammation that is causing the pain.
   That brings us to the largest category of long-term pain relievers, the NSAIDS. As stated before, these drugs have both analgesic and anti-inflammatory properties and are best suited for our example, arthritis.
   However, not all NSAIDS are appropriate for use in our pets.
   Aspirin is the oldest and still most commonly used NSAID in people. It also can be used in the dog and the cat, but only with the guidance and supervision of a veterinarian. This is especially true in cats, which are very sensitive to aspirin and can easily develop toxicity if given too much or too often.
   Typically, cats can tolerate one baby aspirin once, and the dose is not repeated for at least two to three days and then only if absolutely necessary.
   Ibuprofen (Advil, Motrin) is not to be used in either the dog or the cat. Giving this drug can cause fatal hemorrhagic and/or liver disorders.
   Similarly, naproxen (Aleve, Naprosyn) are not to be used in either the dog or cat.
   Recent attention has focused on a new group of NSAIDS called COX-2 inhibitors. These include Vioxx and Celebrex in the human market. Neither of these can be used in our pets, but two drugs in this class are marketed for use in dogs only (not cats). These are Deramaxx and Rimadyl. Neither is known to cause heart problems in the dog as is apparently the case of Vioxx in people.
   Deramaxx and Rimadyl are the two most often prescribed NSAIDS for canine arthritis. They are remarkably effective, are available by prescription only, and patients must be periodically monitored for liver and kidney function via a simple blood test.
   If you suspect your pet is experiencing pain, consult with your veterinarian. The likelihood is good some sort of pain management program can be selected, which will be safe and effective.