At the London Vet Clinic we use non-steroid anti-inflammatory drugs (NSAIDS) to manage acute or chronic pain, to reduce inflammation and to lower high fevers. (Rather surprisingly, we also use them to slow the growth of certain forms of cancer such as bladder cancer.)
NSAIDs are divided into three ‘generations’. Broadly speaking, aspirin is first generation, carprofen (Rimadyl) and meloxicam (Metacam) are second generation and firocoxib (Previcox), and robenacoxib (Onsior) are third generation.
NSAIDs can produce unwanted side-effects, specifically stomach irritation, even ulceration. The second and third generation NSAIDs were developed to reduce gastric toxicity in humans. They did so but were also associated with fatal heart complications in people, due to atherosclerosis. This condition is virtually unknown in dogs and cats so it is not a major problem.
Onsior may have a longer duration of action and fewer side effects than second generation NSAIDs. Its high safety index applies to cats as well as dogs. Meloxicam (Metacam) and robenacoxib (Onsior) are the only NSAIDs licenced for use in cats.
We select NSAIDs for their safety , efficacy, ease of giving and cost. The most common side effects are gastrointestinal although kidney and liver problems are also possible. Unwanted side effects are most commonly associated with:
Too great a dose for the dog or cat’s body weight
Used together with another NSAID
Used together with corticosteroids
Accumulation of the drug in the body because or dehydration, kidney or liver dysfunction or other health issues.
We routinely use NSAIDs both during and after surgery to reduce pain. This is one reason we always give intravenous fluids to any surgical individual who may become dehydrated.
We routinely use NSAIDs (together with weight management, joint nutrients and controlled exercise) for dogs and cats with osteoarthritis. We are happy to provide repeat prescriptions but need to see your dog or cat at least once every six months, often for a blood test for liver and kidney function and signs of dehydration, before providing further medication.
Kidney disease is much more common in cats than in dogs. Osteoarthritis, on the other hand, is equally common in both species. This means that very accurate dosing is vital as is routine monitoring of kidney function.
However, for cats with osteoarthritis a safer alternative is to use Solensia, a monthly injectable monoclonal antibody therapy that is very effective to control osteoarthritis pain.
For long term management of osteoarthritic pain in dogs we use a ‘multi-mode’ approach. In addition to weight control, nutritional supplements and controlled exercise we initially use NSAIDs. If however the NSAID causes side effects we give monthly injections of ‘Librela’.
Librela is an injectable monoclonal antibody therapy administered monthly to control osteoarthritic pain in dogs. It has proven to be very effective and no more expensive than monthly NSAIDS for large dogs. Once we know that your dog is responding to Librela the repeat monthly injections are given by our nurses.
Other drugs may be used to control pain. We use tramadol when pain affects your dog’s mood or behaviour. Lameness may not diminish but your dog seems happier even though it still limps. The most common side effect from tramadol is mild sedation.
We use gabapentin if we suspect neurological pain. Because it is metabolized by the liver and eliminated by the kidneys we usually run a routine blood sample before starting a course. As with tramadol, the most common side effect is mild sedation. NSAIDs, tramadol and gabapentin appear safe to use alongside each other.
Paracetemol is generally safe for dogs BUT HIGHLY TOXIC TO CATS. On its own it is not a very potent analgesic but when combined with an NSAID or tramadol it can be an effective pain killer. Paracetemol should be avoided in any dog with liver problems.
The best vet I have ever been. The staff are so nice and attentive. My dog loves going there, whichever of the doctors or the nurses are on duty the atmosphere is always so welcoming and nice. Next year will be my 10th year as a client.
Jenny P
Best nurses, best Vets, and they are I always so helpful on the phone
Deanna Wisbey
I have been with London Vet Clinic for many years and all the dogs I have had have been looked after 100% from the nurses to the vets they are absolutely excellent and always look after my dogs
Julie-Ann
Such a friendly reception team, and everyone happy to help. Thank you!
Maja Redfern
Best vets in London! Super friendly and knowledgeable, our dog always loves going even when she’s unwell, which I take as a good sign!
Christina Rhodes
Always a super helpful and attentive team to assist you – if you’re looking for 5* service from your vet along with top quality healthcare for your pet – look no further…
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