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dwerten · 08-28-2009, 10:20 PM

FDA Consumer magazine
September-October 2006

Pain Drugs for Dogs: Be an Informed Pet Owner
By Linda Bren
A decade ago, few drugs were available to treat pets in pain at home. Pups were spayed or neutered at the animal hospital, stitched up, and sent home without pain medication. And dogs with painful arthritis limped along without drugs that were safe and effective for long-term use.
Today, a new generation of nonsteroidal anti-inflammatory drugs (NSAIDs) is bringing relief to millions of dogs with joint problems or with pain after surgery.
"NSAIDs are extremely effective for controlling pain and inflammation in dogs," says Stephen F. Sundlof, D.V.M., Ph.D., director of the Food and Drug Administration's Center for Veterinary Medicine (CVM). "These are very valuable drugs that help many pets live to a ripe old age."
But like any drugs, NSAIDs carry a risk of side effects, or adverse reactions. Most adverse reactions are mild, but some may be serious, especially if the drugs are not used according to labeled directions. Some reactions result in permanent damage or even death.
"It's important for pet owners to be aware of the risks and benefits of all drugs, including NSAIDs, so that they can make informed decisions about their pets' health care," says Sundlof. "Owners who give their dog NSAIDs need to know the side effects to watch for that indicate their pet needs medical attention."
The most common side effects from NSAIDs include vomiting, loss of appetite, depression, lethargy, and diarrhea. Serious side effects include gastrointestinal bleeding, ulcers, perforations, kidney damage, and liver problems.
"The side effects of NSAIDs are very well known and very well documented," says Michele Sharkey, D.V.M., in the CVM's Office of New Animal Drug Evaluation. But this information is not always getting to the pet owner, she says. "If the pet owner can recognize a possible reaction, stop the medication, and get veterinary help, it could mean the difference between a good outcome and a disaster."
Safety and Effectiveness
The CVM, which regulates drugs for use in animals, has approved some NSAIDs for use in dogs with pain from degenerative joint disease (osteoarthritis) or with pain after surgery. These include Etogesic (etodolac), Rimadyl (carprofen), Metacam (meloxicam), Zubrin (tepoxalin), Deramaxx (deracoxib), Previcox (firocoxib), and Novox (generic carprofen).
NSAIDs help 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.
The FDA considers approved NSAIDs to be safe and effective when used according to the label and when dog owners are informed about common NSAID adverse reactions.
And veterinarians are becoming increasingly aware of the advantages of recognizing and controlling pain, says Charles Lemme, D.V.M., a member of the American Veterinary Medical Association (AVMA), Clinical Practitioners Advisory Committee. "We recognize that pets are healing better and faster with pain control."
Lemme says that the emphasis on pain management may be partly because of the availability of the newer NSAIDs. "The NSAIDs we have available now are a lot safer than what we've had before and we're seeing far fewer side effects than before."
Before the newer generation of NSAIDs came along, "people were using NSAIDs such as aspirin in an attempt to mitigate arthritic pain," says Michael Andrews, D.V.M., president of the American Animal Hospital Association (AAHA). "We saw the consequence of their use," adds Andrews, who recalls seeing a client who gave her dog aspirin for six weeks, two times a day. "The dog had a bleeding nose that wouldn't stop."
"NSAIDs are used in many, many dogs and the frequency of problems is quite low," says Andrews. "The duration of use makes a difference in safety. If used for a day or two, the risks often are much lower than when used over long periods of time for a chronic arthritic condition."
Drugs used to control pain should be given only when necessary, and in the smallest dose that is effective, says Sharkey. "Arthritis waxes and wanes. Some animals get worse in cold weather. 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."
An owner should never give an NSAID to a pet, or increase the dose or frequency of a drug, without the veterinarian's instructions, adds Sharkey. "Just like different people respond differently to a drug, the way each dog responds to an NSAID varies." Because of this individual response, no one NSAID is considered more effective than another, and because every NSAID can cause adverse reactions, none is considered safer than others.
If a pet is prescribed an NSAID, the CVM recommends that pet owners take the following steps to make sure they are fully informed about the drug and can make the best decision for their pet's health.
Ask Questions and Tell All
Ask your veterinarian about the benefits, risks, and side effects of any medication, including NSAIDs. "An informed dog owner is the best defense against serious side effects from NSAIDs," says Sharkey. "Owners should not hesitate to ask questions and inquire about possible side effects or signs to watch for when treating a dog."
Tell your veterinarian your pet's symptoms and current medications, including prescriptions, over-the-counter drugs, vitamins, herbal supplements, and flea control products. Giving NSAIDS and other medications together could harm your pet. Aspirin, for instance, may be in a supplement you're giving to your pet, says Sharkey, and should not be used in conjunction with an NSAID.
Ask for the Client Information Sheet
Pet owners should receive a "Client Information Sheet" with every NSAID prescription. Client Information Sheets, also called "Information for Dog Owner Sheets," are user-friendly summaries that explain the results to expect from using the drug, what to discuss with your veterinarian before giving the drug, possible side effects to look for, and other important information. The FDA has helped the pharmaceutical companies who make NSAIDs for dogs develop these sheets for the owners, and the companies provide them with each NSAID they ship.
Ask your veterinarian for the sheet if you do not receive one, and read the information carefully before giving the medication to your dog. If your veterinarian can't provide the Client Information Sheet, you can get one by printing it from the CVM's Web site or by calling the toll-free number of the drug company.
Bernadette Dunham, D.V.M., Ph.D., deputy director in the CVM's Office of New Animal Drug Evaluation, explains why some veterinarians may be unable to locate the Client Information Sheet. "They often have the role of veterinarian and the role of pharmacist," she says. Veterinary hospitals get shipments of drugs from the pharmaceutical companies or distributors. Then they may repackage the drug in their hospitals' bottles, often in smaller quantities for distributing to clients. In the repackaging process, the Client Information Sheet, which is often printed on the package insert for the veterinarian, may be tossed out inadvertently.
The FDA, the veterinary community, and the pharmaceutical companies are working together to ensure that NSAIDs are used safely and responsibly and that owners are given the Client Information Sheets.
"The pharmaceutical companies are trying to come up with creative ideas to make it easier for busy veterinarians," says Dunham. Many companies are making the Consumer Information Sheet a tear-off sheet that can be easily separated from the drug labeling.
Some companies also are packaging drugs in smaller quantities with the Consumer Information Sheet sealed inside the package. Therefore, the veterinarian can just attach the hospital label and dosing instructions on the drug container without repackaging the drug and inadvertently discarding the sheet.
Through published journal articles, electronic newsletters, and information posted on their Web sites, both the AVMA and the AAHA are reinforcing the importance of client communication regarding NSAIDs, including handing out the Client Information Sheets, to their veterinary members.
Get the Recommended Tests
NSAIDs approved for use in dogs contain the following information on their labels:

08-28-2009, 10:20 PM	#8
dwerten BANNED! Join Date: May 2007 Location: USA Posts: 11,073	FDA Consumer magazine September-October 2006 Pain Drugs for Dogs: Be an Informed Pet Owner By Linda Bren A decade ago, few drugs were available to treat pets in pain at home. Pups were spayed or neutered at the animal hospital, stitched up, and sent home without pain medication. And dogs with painful arthritis limped along without drugs that were safe and effective for long-term use. Today, a new generation of nonsteroidal anti-inflammatory drugs (NSAIDs) is bringing relief to millions of dogs with joint problems or with pain after surgery. "NSAIDs are extremely effective for controlling pain and inflammation in dogs," says Stephen F. Sundlof, D.V.M., Ph.D., director of the Food and Drug Administration's Center for Veterinary Medicine (CVM). "These are very valuable drugs that help many pets live to a ripe old age." But like any drugs, NSAIDs carry a risk of side effects, or adverse reactions. Most adverse reactions are mild, but some may be serious, especially if the drugs are not used according to labeled directions. Some reactions result in permanent damage or even death. "It's important for pet owners to be aware of the risks and benefits of all drugs, including NSAIDs, so that they can make informed decisions about their pets' health care," says Sundlof. "Owners who give their dog NSAIDs need to know the side effects to watch for that indicate their pet needs medical attention." The most common side effects from NSAIDs include vomiting, loss of appetite, depression, lethargy, and diarrhea. Serious side effects include gastrointestinal bleeding, ulcers, perforations, kidney damage, and liver problems. "The side effects of NSAIDs are very well known and very well documented," says Michele Sharkey, D.V.M., in the CVM's Office of New Animal Drug Evaluation. But this information is not always getting to the pet owner, she says. "If the pet owner can recognize a possible reaction, stop the medication, and get veterinary help, it could mean the difference between a good outcome and a disaster." Safety and Effectiveness The CVM, which regulates drugs for use in animals, has approved some NSAIDs for use in dogs with pain from degenerative joint disease (osteoarthritis) or with pain after surgery. These include Etogesic (etodolac), Rimadyl (carprofen), Metacam (meloxicam), Zubrin (tepoxalin), Deramaxx (deracoxib), Previcox (firocoxib), and Novox (generic carprofen). NSAIDs help 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. The FDA considers approved NSAIDs to be safe and effective when used according to the label and when dog owners are informed about common NSAID adverse reactions. And veterinarians are becoming increasingly aware of the advantages of recognizing and controlling pain, says Charles Lemme, D.V.M., a member of the American Veterinary Medical Association (AVMA), Clinical Practitioners Advisory Committee. "We recognize that pets are healing better and faster with pain control." Lemme says that the emphasis on pain management may be partly because of the availability of the newer NSAIDs. "The NSAIDs we have available now are a lot safer than what we've had before and we're seeing far fewer side effects than before." Before the newer generation of NSAIDs came along, "people were using NSAIDs such as aspirin in an attempt to mitigate arthritic pain," says Michael Andrews, D.V.M., president of the American Animal Hospital Association (AAHA). "We saw the consequence of their use," adds Andrews, who recalls seeing a client who gave her dog aspirin for six weeks, two times a day. "The dog had a bleeding nose that wouldn't stop." "NSAIDs are used in many, many dogs and the frequency of problems is quite low," says Andrews. "The duration of use makes a difference in safety. If used for a day or two, the risks often are much lower than when used over long periods of time for a chronic arthritic condition." Drugs used to control pain should be given only when necessary, and in the smallest dose that is effective, says Sharkey. "Arthritis waxes and wanes. Some animals get worse in cold weather. 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." An owner should never give an NSAID to a pet, or increase the dose or frequency of a drug, without the veterinarian's instructions, adds Sharkey. "Just like different people respond differently to a drug, the way each dog responds to an NSAID varies." Because of this individual response, no one NSAID is considered more effective than another, and because every NSAID can cause adverse reactions, none is considered safer than others. If a pet is prescribed an NSAID, the CVM recommends that pet owners take the following steps to make sure they are fully informed about the drug and can make the best decision for their pet's health. Ask Questions and Tell All Ask your veterinarian about the benefits, risks, and side effects of any medication, including NSAIDs. "An informed dog owner is the best defense against serious side effects from NSAIDs," says Sharkey. "Owners should not hesitate to ask questions and inquire about possible side effects or signs to watch for when treating a dog." Tell your veterinarian your pet's symptoms and current medications, including prescriptions, over-the-counter drugs, vitamins, herbal supplements, and flea control products. Giving NSAIDS and other medications together could harm your pet. Aspirin, for instance, may be in a supplement you're giving to your pet, says Sharkey, and should not be used in conjunction with an NSAID. Ask for the Client Information Sheet Pet owners should receive a "Client Information Sheet" with every NSAID prescription. Client Information Sheets, also called "Information for Dog Owner Sheets," are user-friendly summaries that explain the results to expect from using the drug, what to discuss with your veterinarian before giving the drug, possible side effects to look for, and other important information. The FDA has helped the pharmaceutical companies who make NSAIDs for dogs develop these sheets for the owners, and the companies provide them with each NSAID they ship. Ask your veterinarian for the sheet if you do not receive one, and read the information carefully before giving the medication to your dog. If your veterinarian can't provide the Client Information Sheet, you can get one by printing it from the CVM's Web site or by calling the toll-free number of the drug company. Bernadette Dunham, D.V.M., Ph.D., deputy director in the CVM's Office of New Animal Drug Evaluation, explains why some veterinarians may be unable to locate the Client Information Sheet. "They often have the role of veterinarian and the role of pharmacist," she says. Veterinary hospitals get shipments of drugs from the pharmaceutical companies or distributors. Then they may repackage the drug in their hospitals' bottles, often in smaller quantities for distributing to clients. In the repackaging process, the Client Information Sheet, which is often printed on the package insert for the veterinarian, may be tossed out inadvertently. The FDA, the veterinary community, and the pharmaceutical companies are working together to ensure that NSAIDs are used safely and responsibly and that owners are given the Client Information Sheets. "The pharmaceutical companies are trying to come up with creative ideas to make it easier for busy veterinarians," says Dunham. Many companies are making the Consumer Information Sheet a tear-off sheet that can be easily separated from the drug labeling. Some companies also are packaging drugs in smaller quantities with the Consumer Information Sheet sealed inside the package. Therefore, the veterinarian can just attach the hospital label and dosing instructions on the drug container without repackaging the drug and inadvertently discarding the sheet. Through published journal articles, electronic newsletters, and information posted on their Web sites, both the AVMA and the AAHA are reinforcing the importance of client communication regarding NSAIDs, including handing out the Client Information Sheets, to their veterinary members. Get the Recommended Tests NSAIDs approved for use in dogs contain the following information on their labels: