Dog Laying Down Next To Chair

How do NSAIDs work and how do they help my dog feel better?

An overview of NSAIDs (non-steroidal anti-inflammatory drugs)

Arthritis is the most common cause of chronic pain in dogs. Managing that pain is the foundation of treating arthritis and preserving a high quality of life for your dog. Pain management should be an integral part of your dog’s arthritis care plan.

It can be hard to know when our dogs are in pain, as the signs can be subtle. If you haven’t already, take our pain quiz (linked at right) to better understand what pain looks like for dogs so you can help them stay comfortable and active.

In this article, we’ll answer the most common questions around a very commonly prescribed pain management option, non-steroidal anti-inflammatory drugs (NSAIDs).

Which NSAID is the most effective? Safest?

There are numerous studies showing that NSAIDs decrease pain associated with arthritis. There are multiple NSAID products available for dogs, and none have been found to be superior in effectiveness or safety. Dogs, like people, respond differently to different NSAIDs, so one particular product may be more effective for your dog while another dog may respond better to a different brand. One day we will probably have a test to determine the best medication for your dog based on their genetics, but we aren’t there yet. For now, your veterinarian will recommend the NSAID they are most comfortable with to start with.

All NSAIDs have potential side effects, including vomiting, diarrhea, decreased appetite, elevated kidney values and elevated liver values. There are rare cases of severe side effects such as gastric ulceration or perforation and acute liver failure. Appropriate case selection and use of NSAIDs strongly minimizes the risks of side effects.

How soon after starting NSAIDs should I see a response?

You should see a response in your dog within 2 weeks of starting therapy (though there is often some relief after a single dose). Studies have shown that continued weekly improvement is likely for at least the first 4 weeks of daily treatment. Some dogs show continued improvement for up to a year after starting an NSAID.

If you don’t see any improvement after 2 weeks, you might want to ask your veterinarian about trying a different NSAID or ensuring that the appropriate diagnosis has been made (for example, a dog with an ACL tear in their knee might not show improvement because there is instability in the knee that is best addressed with surgery).

Should I ask my veterinarian about using NSAIDs daily?

When you first start treating your dog’s arthritis, your veterinarian will likely recommend giving them NSAIDs daily for at least several months to see how your dog responds.

Studies have found a cumulative effect in effectiveness with doses given daily for up to 1 year. In other words, dogs often keep getting better (less pain, better mobility, etc.) the longer they are on daily doses of NSAIDs!

As with any medication, side effects can occur at any time. However, according to studies, the length of time a dog is on NSAIDs doesn’t appear to increase the risk of developing side effects.

NSAIDs scare me. Are they really safe to give to my dog?

In general, the benefits of NSAIDs outweigh the risks. Adverse events can happen with any medication, but they are generally low with NSAIDs.

However, you should always be aware of potential side effects, such as vomiting, diarrhea, decreased appetite, or lethargy. Alert your veterinarian if your dog is showing any signs of side effects. Make sure they know all medications and supplements your dog takes.

Can I minimize the risk of adverse events?

There are a few things you can do:

  • Do NOT combine NSAIDs and aspirin or corticosteroids (prednisone)
  • Read nutritional supplement labels closely and avoid ones that contain aspirin or natural anti-inflammatories such as willow bark or meadowsweet
  • Make sure you follow the NSAID dose your veterinarian recommends exactly (for example, once or twice per day, half tablet vs a full tablet, etc)
  • If you are unsure if your dog’s reaction to NSAIDs is normal, contact your veterinarian! 
  • Decreased appetite is often the earliest sign of a problem- call your veterinarian if you see this!