Pet Health: Arthritis Medications Rimadyl and EtoGesic

We’re examining medications recommended for arthritis in dogs. The “Systematic review of clinical trials of treatments for osteoarthritis in dogs” published in the Feb 15th, 2007, Journal of the American Veterinary Medical Association (JAVMA) recommended three nonsteroidal anti-inflammatory drugs (NSAIDs) as most effective: Metacam, Rimadyl, and EtoGesic. We previously looked at what the Review said and did not say about Metacam. Now, let’s see what this study said about Rimadyl and EtoGesic

Rimadyl (Carprofen) according to the Systemic Review
Three studies conforming to rigid scientific standards as determined by authors of the “Systematic review of clinical trials of treatments for osteoarthritis in dogs” found Rimadyl to be effective in controlling arthritis symptoms. Thus, Rimadyl appears to be a good medication to prescribe for pet arthritis.

What the Systemic Review did not say about Rimadyl
No information was given on side effects caused by Rimadyl (Carprofen). Rimadyl is an NSAID with potential problems that include stomach ulcers, kidney failure, and liver failure. Unfortunately, problems caused by Rimadyl are so common that the federal government created a website: http://www.fda.gov/cvm/CVM_Updates/NSAIDpage.htm
to discuss precautions when using the medication. The FDA recommends that veterinarians discuss the potential for ulcers, kidney and liver failure, and death with their clients. General recommendations on NSAIDs are posted by the FDA at: http://www.fda.gov/cvm/nsaids.htm.
Let’s look at the third NSAID promoted as effective against arthritis, EtoGesic.

EtoGesic (Etodolac) according to the Systemic Review
One study, which conformed to rigid scientific standards determined by authors of the “Systematic review of clinical trials of treatments for osteoarthritis in dogs” found EtoGesic to be at least somewhat effective in controlling pain.

What the Systemic Review did not say about EtoGesic
Unfortunately, no information was given on side effects of EtoGesic. As with Rimadyl and Metacam, EtoGesic is an NSAID with potential problems that include stomach ulcers, kidney failure, and liver failure. Reports of these problems are not uncommon. In addition, EtoGesic causes dry eye (keratoconjunctivitis sicca or KCS). Dry eye occurs when there are insufficient tears to flush the eye. Dry eye occurs in some pets with a genetic predisposition to it and in some pets as a result of drug use.In addition to EtoGesic, drugs in the following categories can cause dry eye:

Decongestants
Diuretics
Antibiotics (sulfa)
Antihistamines
Beta blockers
Antidepressants

With dry eye, the tears thicken and a mucoid discharge collects in the inner corner of the eye. The sensitive clear layer over the eye, the cornea, is more easily irritated by dust and debris because it is not constantly bathed with a thin layer of tears. When pets develop dry eye or other side effects due to a medication, these medical problems may improve if the medication is stopped. And, they may not. For some pets with dry eye following EtoGesic use, the condition is permanent and requires treatment for life. To make matters worse, the medication used to treat dry eye is expensive. Thus, it would appear that EtoGesic is not a wise first choice of medication for treating arthritis symptoms in many dogs, especially those with a tendency to develop dry eye: Cocker Spaniels, Bulldogs, Westies, Lhaso Apsos, and Shih Tzus.

If NSAIDS cause serious side effects, what medications should be used for arthritis?
No dog should live with arthritis pain, and no dog should develop liver failure, kidney failure, dry eye, or other health problems because they received medication to control pain. So, what should we do for pets with arthritis? In subsequent blogs, we’ll look at chondroprotective medications, including three covered in the Systemic Review and published in JAVMA:
· Cosequin,
· Perna, and
· Glyco-Flex.