Category Archives: Medication

Pain Management for Your Dog

Pain Medication and Pets: Management of Pain was not always the Norm

Most people who take their pets in for a surgical procedure are sent home with pain medication of some sort to assure their pet’s comfort. This, surprisingly, was not always the norm. For years, veterinarians believed that pets did not experience pain the same way people do, because dogs (and cats, sometimes even more so) hide their pain. This is a left over protective mechanism from wild dogs, as weak, injured animals are much more of a target for predators. While the assumption previously was that dogs don’t feel pain like we do, the assumption now is that if it would hurt you, it will hurt your dog (https://vcahospitals.com/know-your-pet/pain-management-for-dogs).

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It is important to control pain that your pet may be experiencing, not only for humane reasons, but also to help your pet heal faster, as pain slows healing.

Pain slows healing:

It is important to control our pet’s pain because no one should have to needlessly suffer. Still, some people believe that a little pain is good, because if an animal is feeling sore, she may be less likely to over-exert herself and reinjure a sprained leg or tear out stitches from surgery. The thought process here seems to be logical and would lead one to believe that some pain will help the pet heal faster. This isn’t the case (http://www.caberfeidh.com/Pain1.htm).

Other than being uncomfortable by definition, pain also slows healing. It can also cause the animal to experience unnecessary anxiety and depression. Not only is pain after surgery detrimental, but pain caused from other sources can also severely hurt your pet’s health. For example, a disease such as arthritis makes movement hurt for your pet. This in turn causes your pet to move less, which causes deterioration of the muscles, which in turn puts more stress on the already diseased joints (https://wheatlandanimalclinic.com/services/veterinary-surgery.php).

If a dog needs to rest because of surgery or injury but she wants to move around too much, crates and leashes can help keep the dog from hurting herself. If absolutely necessary, a vet can always prescribe a mild sedative to calm a dog the needs to rest.

Signs of pain in dogs:

While your dog may try to hide his pain, he may also make his pain obvious, whether obviously or subtly. Always be aware of signs of pain, as they can be evidence of an underlying disease. Some signs, such as whimpering and limping are very obvious. Others that are not as evident are holding the ears back, odd reactions to being touched, and loss of appetite. Any change in personality can also indicate something is wrong with your pet, making it important to be aware of what is normal and what is abnormal for your dog (https://vcahospitals.com/know-your-pet/pain-management-for-dogs).

What pain medications are suitable for dogs:

There are a wide range of pain medications available for dogs that provide relief from acute or chronic pain. These include opioids, corticosteroids, and NSAIDs. Some drugs, such as opioids, may be used after a major medical procedure or in end of life pain relief. Medications such as NSAIDs are many times used for conditions such as arthritis.

As can be seen from the previous paragraphs, it is important to recognize and treat pain in dogs, but this does not mean that it is safe to give your dog the same pain medications that you take yourself. Only use pain medications that your vet prescribes. Also, never give medications intended for a cat to a dog, and vise versa. Many things that are safe for dogs are deadly to cats, and many medicines for cats were never meant to be given to dogs.

Even when giving your pet over-the-counter medications, veterinary consultation is needed. Doses for pets are very different from doses for humans. Drugs that seem as safe and common as Tylenol (acetaminophen) need to be carefully administered. While this drug may be a good choice of pain relief for a dog with kidney disease, it can be deadly for a dog with liver problems. Only blood work done be your veterinarian can show what medications are appropriate for your pet, and your vet is the best person to give information on the correct amount to give and how frequently to give it.

Another note:

If you are confused at all about how to administer your pet’s medication, don’t hesitate to contact your vet. Once, our one dog was sent home with a prescription that we picked up from the pharmacy. The instructions on the bottle were different from the instructions that our veterinarian had given us. We found out after a phone call to the vet that the pharmacy had printed the wrong information on the label. Such a mishap could be fatal with certain medications. It never hurts to be extra cautious when caring for your pet.

Galliprant: Will it Help my Dog?

IMG_0154Why Galliprant:

Arthritis is an unfortunate disease that many pets develop in their golden years of life. Nutrition can play a big role in improving a dog’s mobility who has arthritis. First hand, I have seen the amazing effects that a low carb, high protein diet can have to improve the life of a dog with arthritis. But what happens when the diet can’t be tailored to reduce joint pain? This is the predicament I am in with my elderly dog, Lady.

Lady was diagnosed with kidney disease a few years ago. As the disease has progressed, so has her joint pain. For a long time, glucosamine and fish oil kept her joint pain under control, but eventually, I realized she needed additional relief. Anyone who has or has had a dog with kidney disease knows that your diet options are limited. Low phosphorus carbohydrates are a must. These include white rice, couscous, pearled barley, white potatoes, sweet potatoes, and butternut squash. Only the last two are arthritis friendly, and Lady happens to hate those foods ☹. Managing Lady’s arthritis with diet and nutritional supplementation alone became impossible, and many pain killers are hard on the kidneys, making them bad for kidney patients.

So, what does a loving pet owner do? Luckily, a new drug recently came out on the market that appears to be very safe for dogs with kidney disease. Traditional NSAIDs are notoriously hard on the kidneys, but the new drug, Galliprant, is not a traditional NSAID.

What is arthritis and how do drugs reduce the symptoms?

Before taking a look at how Galliprant specifically works, it is helpful to understand what arthritis is and how NSAIDs usually reduce the symptoms of this disease.

Arthritis is inflammation of the joints. While there are different types of arthritis, all types result in inflammation. Lady did not have any form of joint problems in her younger years, but as she aged it became obvious she was having issues. She was stiff when getting up, less playful, and less alert and vibrant. She specifically has osteoarthritis, or degenerative joint disease. This type of arthritis is the result of the wearing down of cartilage. Many dogs, especially big dogs over 50 lbs., develop this disease as they get older. The disease creates a viscous cycle, because as the dog experiences pain, he becomes less active. With less movement the dog’s muscles become weaker, and this puts more strain on already painful joints. For many dogs, a time comes when the only solution is prescription medications that can reduce inflammation.

Some of the main contributors to inflammation anywhere in the body are prostaglandins (Prostaglandins and Inflammation). Prostaglandins are formed from a cascade of events in the body. While prostaglandins contribute to inflammation, its important to note that they are imperative for homeostatic functions in the body (Prostaglandins and Inflammation). In simple terms, they help the body work the way it is supposed to work. One of the functions of certain prostaglandins is to support the proper function of the kidneys by regulating the dilation of the blood vessels (Significant Acute Kidney Injury Due to Non-steroidal Anti-inflammatory Drugs: Inpatient Setting).

So, what do pain relieving pills such as NSAIDs have to do with any of this? Traditional NSAIDs such as carprofen are cyclooxygenase (COX) inhibitors. COX is important in the production of prostaglandins, including the prostaglandins needed by the kidneys (Prostaglandins and Inflammation). When NSAIDs inhibit cyclooxygenase, they in turn reduce the production of prostaglandins. This is not limited to the prostaglandins that contribute to joint inflammation; it includes the prostaglandins needed for regular kidney function. This is one of the ways NSAIDs can damage the kidneys.

How does Galliprant work?

Prostaglandins have to get to their proper receptor to cause their desired effect. There are many types of receptors in the body. Galliprant does not stop the production of prostaglandins; instead it blocks prostaglandins from reaching the receptors they need to in order to cause inflammation associated with arthritis (See Galliprant website: https://www.galliprantfordogs.com/vet ). This action does not prevent prostaglandins that are needed by the kidneys from being produced. This is a very simplified explanation, but I hope it helps show why Galliprant should be a safer alternative for kidney failure patients than NSAIDs.

As a note, Galliprant does have reported side effects, including vomiting and diarrhea. I suspect more adverse responses will be reported as more dogs take this medication for long periods of time. I don’t particularly like giving my dog a new drug for this reason, but the alternative is to let her be in more pain than she has to be, so I truly believe that the benefits out-way the potential risks.

Lady’s experience with Galliprant:

Galliprant has been helpful in reducing Lady’s joint pain. She is not as mobile as she was in her younger years, but Galliprant has improved her mobility. Before starting this medicine, she seemed more depressed, and was having a hard time jumping on and off furniture. She would often abruptly stop and lay down as if it hurt to continue standing. She was sleeping more as well. Since starting Galliprant, she is more alert and more willing to play. When she is feeling particularly spry, she will chase my other dogs around the yard. She can once again jump on and off the couch. She can no longer jump on the bed which is considerably higher, and I do have to watch her go up and down the staircase to make sure she doesn’t slip. We go on walks still, which is her favorite thing in the world. Our pace is slower, but for a 15-year-old dog she is doing well.

If I had any question as to whether or not Galliprant helps Lady, it was answered when I skipped a dose when I thought it was causing Lady to vomit. That day poor Lady was noticeably stiffer, and she did not want to play with her toys. I never figured out what made her vomit, but I have since continued giving her the medicine with good results and no vomiting.

A side note: I had stopped giving Lady her daily Cosequin DS during a bout of inappetence. I give her Cosequin consistently with the Galliprant now, and I feel this combo works better than Galliprant alone. I just add this to encourage you to continue giving a glucosamine and chondroitin supplement in addition to pain killers since the results seem better from my own experience with my dog.

Conclusion:

Galliprant can make a difference in the life of dogs who have arthritis and concurrent diseases that make typical NSAIDs a bad choice. I have used this medicine to help improve Lady’s mobility for over six months now. It has not returned her to where she was as a young dog, but she can still go for walks and play with the other dogs in my home. More side effects of this drug will probably pop up as more dogs are treated with it; this is the case with most new medications. Despite this, seeing Lady go for walks and play makes it worth the potential drawbacks. As always, work with your veterinarian to come up with the best treatment plan for your individual dog.

Cited articles:

Prostaglandins and Inflammation – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3081099/

Significant Acute Kidney Injury Due to Non-steroidal Anti-inflammatory Drugs: Inpatient Setting – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4034033/