Taken From - _http://www.fda.gov/cvm/FdaVetFirst2006.htm#6058_
(http://www.fda.gov/cvm/FdaVetFirst2006.htm#6058)

See also: _http://www.fda.gov/cvm/FdaVetFirst2006.htm#6059_
(http://www.fda.gov/cvm/FdaVetFirst2006.htm#6059)
QUOTE:

What Veterinarians Should Tell Clients About Pain Control and Their Pets
by Michele Sharkey, DVM, Office of New Animal Drug Evaluation; Margarita
Brown, DVM, Office of Surveillance and Compliance; and Linda Wilmot, DVM,
Office
of New Animal Drug Evaluation
Non-steroidal anti-inflammatory drugs (NSAID) are commonly prescribed and
extremely effective pain control drugs for pets. Like most drugs, they do cause
side effects, some serious. Veterinarians are in the best position to inform
their clients about these side effects, so the clients can take better care
of their pets. And, pet owners expect veterinarians to explain all potential
risks of medications.
Dogs are living longer and healthier lives thanks to advances in veterinary
medicine and pharmaceuticals. With active lifestyles that extend into
advanced ages, dogs are often diagnosed with osteoarthritis or undergo surgical
procedures and are treated for postoperative pain. NSAIDs are among the most
common analgesics prescribed in these cases.
NSAIDs are used to control signs of arthritis, including inflammation,
swelling, stiffness, and joint pain. Inflammation—the body’s response to
irritation or injury—is characterized by redness, warmth, swelling, and pain.
NSAIDs
work by blocking the production of prostaglandins, the body chemicals that
cause inflammation.
In the United States, NSAIDs commonly used in dogs include ETOGESIC
(etodolac), RIMADYL (carprofen), METACAM (meloxicam), ZUBRIN (tepoxalin),
DERAMAXX
(deracoxib), PREVICOX (firocoxib), and NOVOX (generic carprofen). These drugs
have been approved by the Food and Drug Administration’s (FDA) Center for
Veterinary Medicine (CVM) for use in dogs. (You can get more information about
these drugs by going to CVM’s website, www.fda.gov/cvm. Once there, go to the
“
Green Book” navigational button, where you can look up the drugs by their
brand names or active ingredient.)
Other NSAIDs are available in the United States for human uses, but have
not been approved for use in dogs. (In the United States, there are no oral
NSAIDs approved for use in cats.) Sometimes there may not be an approved animal
drug available for a specific indication or dosage form. However, the Animal
Medicinal Drug Use Clarification Act of 1994 gives veterinarians the same
kind of discretionary authority available to physicians, allowing veterinarians
to prescribe drugs for “extralabel” uses, which are uses not listed on the
label.

As they should with any medication, veterinarians should discuss the
benefits as well as the risks of the drugs with their clients when prescribing
an
NSAID. Every year millions of doses of medications are prescribed for dogs with
good reason—but many adverse reactions occur. Most adverse reactions are
mild, but some result in permanent impairment or even death. If the client can
recognize a possible reaction and stop the medication while seeking veterinary
attention for the dog, the client may make the difference between a good
outcome and a disaster.

The most common side effects from NSAIDs include vomiting, loss of appetite,
depression/lethargy, and diarrhea. Some side effects can be serious,
especially if the drug is not used according to labeled directions, resulting
in the
need for medical care. Serious adverse reactions include gastric ulcers,
kidney and liver problems. Death may result in some instances.

All NSAIDs approved for oral use in dogs come with a Client Information
Sheet (also known as the Information for Dog Owner Sheet) that describes the
drug’
s side effects. Dog owners should ask veterinarians for the Client
Information Sheet when an NSAID is prescribed. These Client Information Sheets
provide
the dog owner with important information in a user-friendly manner regarding
what can be expected from use of the drug and what side effects to look for.
Not all side effects can be predicted
All approved medications indicated for pets are subject to extensive
evaluation by a drug company using stringent standards set by the CVM before
they
are marketed. Every effort is made to ensure safe and effective treatments.
However, every drug has the potential for side effects. Pre-testing by the
animal drug manufacturer and review of the data from those tests by the
government
ensure that the animal drug is safe and effective. Because of the relatively
low frequency of some adverse events, some adverse effects are recognized
only after the marketing of the product in a large population of animals.

NSAID therapy can also unmask hidden disease, previously undiagnosed due to
the absence of apparent clinical signs. Dogs with underlying kidney disease,
for example, may experience worsening of that disease while on NSAIDs. Dogs
at greatest risk for kidney problems are those that are dehydrated, on
concomitant diuretic therapy, or have kidney, heart, and/or liver dysfunction.

Unexpected reactions to a drug are reported to the drug manufacturer, and
every reaction reported to a pharmaceutical manufacturer must by law be
reported to the FDA.
Advice given to owners
We recommend that pet owners work with their veterinarians to make
medication decisions including using over-the-counter drugs, vitamins, herbal
supplements, flea control products, and other medications. Giving medications
and
other over-the-counter products at the same time could be detrimental to a
dog’s
health.
Many reactions due to NSAIDs may be lessened if owners are aware of
potential side effects, and with appropriate use many can be minimized or
avoided.
First and foremost, if an owner suspects a reaction to an NSAID, the owner
should stop administering the drug immediately and should contact a
veterinarian.
Some reactions are mild and go away after stopping the drug.

The veterinarian is in the best position to advise the dog owner on using an
NSAID. Before administering an NSAID to a dog, the veterinarian often
recommends blood tests. The knowledge gained from these tests could be critical
in
deciding if the drug is safe to use in a dog. If a dog is prescribed an NSAID
for the control of pain associated with osteoarthritis, regular veterinarian
check-ups and blood tests are recommended to evaluate the continued use of
the drug.

When treating a dog with an NSAID, the owner should never increase the dose
or frequency of administration. The owners should follow their veterinarians’
instructions.

A pet owner should never give an NSAID to a dog unless under the direction
of a veterinarian.
Pain control in response to the use of an NSAID varies between dogs (just as
it does in people). Because the response to pain medication is
individualized, no one NSAID is considered more effective than another, and
because every
NSAID can cause adverse reactions, including stomach/intestinal ulcers and
death, none is considered safer than others.

But selecting the best NSAID is important. With advances in the recognition
and definition of animal pain and the many NSAID choices available, much
benefit can be gained from the appropriate and careful use of these drugs.

Sometimes, the process of finding the best NSAID can mean changing the
prescription. Only one brand of NSAID should be administered to a dog at any
given
time. If at some time the owner and the veterinarian decide to try a
different NSAID, a wash-out period is recommended. A wash-out period is a few
days
long, during which the dog does not receive any NSAID. Then the dog can be
switched to another NSAID. NSAIDs should not be combined with the use of a
corticosteroid, either.

The pain associated with osteoarthritis waxes and wanes, and drugs used to
control this pain should only be administered when necessary. If the dog seems
to improve to the point of not needing the drug, the owner should discuss
continued use of the NSAID with a veterinarian.
The key to making any transition or change work well is good
veterinarian-client communications.

An informed dog owner is the best defense against serious side effects from
NSAIDs. The veterinarian is the most qualified source for information
regarding NSAID use and a dog’s care. Owners should not hesitate to ask
questions
and inquire about possible side effects or signs to watch for when treating a
dog. A Client Information Sheet, which a veterinarian should give the pet
owner whenever an NSAID is prescribed, serves as a reminder of this information
for use at home.

What starts out as a minor problem can readily progress to an emergency. An
owner should be encouraged to call his or her veterinarian with any concerns
about the NSAID the dog is receiving. The veterinarian and/or owner may even
call the drug manufacturer (a toll free number appears on each label and the
Client Information Sheet). Pharmaceutical companies offer customer service
and technical support for product information and quality control. When
possible problems are experienced with a product, the manufacturer may have
specific
recommendations for the treating veterinarian regarding tests and
treatments.
END QUOTE
Jean
(Always for George - Always for the Rimadyl Dogs)
Be informed of animal drug dangers
www.DogsAdverseReactions.com
www.SrDogs.com/Pages/rimadylfr.html
http://rimadyldeath.com/
http://www.thepetguardian.com/
http://www.vetnsaids.com/
http://community-2.webtv.net/perro_blanca/VeterinaryDrug/index.html



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