Canis ISSN: 2398-2942

Analgesia: NSAID

Contributor(s): Cheryl Blaze, Prof Stephen Greene, B D X Lascelles, Jo Murrell

Overview

  • Practically all non steroid anti-inflammatory drugs (NSAIDs) produce analgesia by inhibitory action on cyclooxygenase (COX) family of enzymes preventing production of prostaglandins and thromboxanes.
  • Because of effect on prostaglandin production, reduce inflammation, fever and endotoxemia and may inhibit aggregation of platelets.
  • Can be used in the treatment of chronic pain.
  • Although many effects of NSAIDs are beneficial in inflammatory conditions, also have some undesirable effects.
  • Toxic effects caused mostly by inhibition of production of the types of prostaglandins that protect homeostasis of kidneys and gastrointestinal tract.
  • Toxic side-effects include:
    • Gastric irritation, progressing to vomiting, ulceration and hemorrhage.
    • Enteritis leading to diarrhea and melena.
    • Blood dyscrasias.
    • Hepatotoxicity or nephrotoxicity Nephrotoxicosis.
  • Nephrotoxicity much more likely to occur in dogs that are dehydrated, hypotensive or hypovolemic. Adequate fluid therapy Fluid therapy should be provided before NSAIDs are administered in these cases.
    Use NSAIDs with care in dogs undergoing anesthesia because hypotension frequently occurs. However, if IV fluids are administered and blood pressure is monitored, NSAIDs are safe to use during the peri-operative period.Do not give NSAIDs and corticosteroids Therapeutics: glucocorticoids simultaneously because side-effects much more likely to occur. Particularly the case for gut ulceration Gastric ulceration.Do not use more than one NSAID at the same time because of increased risk of toxic effects. If one NSAID is not effective and veterinarian chooses to use a different one, there should be a washout period of 48 h - 2 weeks, depending on the type of NSAID used initially.

Cyclooxygenase enzymes

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NSAIDs frequently given to dogs include:

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NSAIDs best avoided in dogs include:

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • King J N, Dawson J, Esser R E et al (2009) Preclinical pharmacology of robenacoxib: a novel selective inhibitor of cyclooxygenase-2. J Vet Pharmacol Ther 32 (1), 1-17 PubMed.
  • Sanderson R O, Beata C, Flipo R M et al (2009) Systematic review of the management of canine osteoarthritis. Vet Rec 164 (14), 418-424 PubMed.
  • Ryan W G, Moldave K, Carithers D (2007) Switching NSAIDs in practice: insights form the Previcox (firocoxib) Experience Trial. Vet Ther (4), 263-271 PubMed.
  • Jones C J, Streppa H K, Harmon B G et al (2002) In vivo effects of meloxicam and aspirin on blood, gastric mucosal, and synovial fluid prostanoid synthesis in dogs. Am J Vet Res 63 (11), 1527-1531 PubMed.
  • Millis D L, Weigel J P, Moyers T et al (2002) Effect of deracoxib, a new COX-2 inhibitor, on the prevention of lameness induced by chemical synovitis in dogs. Vet Ther (4), 453-464 PubMed.
  • Capner C A, Lascelles B D & Waterman-Pearson A E (1999) Current British veterinary attitudes to perioperative analgesia for dogs.​ Vet Rec 145 (4), 95-99 PubMed.
  • Johnson C (1999) Chemical restraint in the dog and cat. In Practice 21 (3), 111-118 VetMedResource.
  • Forsyth S F, Guilford W G, Haslett S J et al (1998) Endoscopy of the gastroduodenal mucosa after carprofen, meloxicam and ketoprofen administration in dogs. JSAP 39 (9), 421-424 PubMed.
  • Knight E V, Kimball J P, Keenan C M et al (1996) Preclinical toxicity evaluation of tepoxalin, a dual inhibitor of cyclooxygenase and 5-lipoxygenase, in Sprague-Dawley rats and beagle dogs. Fundam Appl Toxicol 33 (1), 38-48 PubMed.


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