How safe is long-term Rimadyl use?
In the last week I have received several questions about the safety of Rimadyl. Since it seems to be a hot topic, I will devote this post to issues surrounding Rimadyl and related medicines.
Rimadyl is a pain killer and anti-inflammatory medication. It is a class of medicines called prescription non-steroidal anti-inflammatories (prescription NSAIDs). Other commonly used medicines in this class include Deramaxx, Previcox, Metacam and EtoGesic.
In veterinary medicine, prescription NSAIDs commonly are used to treat pain and inflammation from arthritis, trauma, surgery, strains, sprains and pulled muscles. Prescription NSAIDs are used frequently in dogs. They are used less often in cats.
All of the prescription NSAIDs have similar side effects (gastrointestinal upset is most common). All of the prescription NSAIDs are metabolized by the liver and excreted by the kidneys. This means that all of them have the potential to damage the liver, and all of them must be used cautiously in animals that have impaired liver or kidney function.
Extreme reactions to prescription NSAIDs occur very rarely. However, when they occur they can be fatal. If you google any of the medicines that I listed above, you will find web pages in which people have written about their bad experiences with each of them. These cases are very sad. However, they are the exception, not the rule.
Rimadyl, in particular, has received some bad press for being linked to liver failure in some Labrador retrievers. However, in my experience adverse reactions to prescription NSAIDs are unpredicable, and Rimadyl does not seem to cause more adverse reactions than the others. One dog may react badly to Rimadyl and tolerate Deramaxx. For another dog, it could be the other way around.
I have said many times on this blog that in veterinary medicine one must weigh the benefits of a treatment against its risks. Prescription NSAIDs may cause side effects or, very rarely, severe adverse reactions. However, they are potent pain killers, and they give some arthritic dogs new leases on life. For most dogs, the benefits outweigh the risks.
Long-term use of prescription NSAIDs is safe for most dogs. However, regardless of which one you use, your vet should check your pet’s liver and kidney function periodically to make sure that no damage has occurred.
You have questions. 
Dr. Barchas,
Thank you for your very good summation of an NSAID drug and its descriptive use. Overall your comments are right on. Although I am not a vet by profession ( I am an engineer), I have spent the last five years dedicating my spare time to research specific to NSAID use in dogs, have worked with vets and scientists all over the world familiar with the NSAID process, and the FDA CVM, in an effort to understand how and why I lost a perferctly otherwise healthy dog after three days on Deramaxx. I think I’ve pretty much found the answer why. More importantly, I have come to the conclusion after the years of research that two important processes are being skirted which, in my estimate, if performed, could save perhaps as many as 50% of the dog’s lives now being lost to the current unsafe manner NSAID drugs are being used. These FDA and drug manufacturer recommended processes are routinely not being performed by client’s vets per their clients for reasons that are unclear. It is important here to note that these two processes are endorsed and strongly recommended by the drug manufacturer themselves, the FDA, and numerous professional vet associations on a number of published consumer sheets and website links.
1. Pre-testing the patient’s blood work prior to introduction of an NSAID to review current liver and kidney finction for impairment, and to what extreeme. In your summation you state the liver and kidney play key rolls in NSAID use. Agreed. Compromised conditions of these organs can certainly elevate the chances of adverse reactions, which all too many times include and end in death of the patient.
2. Giving to the client the manufacturer’s written and FDA approved Client Information Sheet, or CIS, which written in plain english is an important tool for helping the client understand the risks and benefits of safe NSAID use. No one knows their dog better than the owner. Changes in habits, which are more then clearly outlined on the CIS, are the most important tool in watching for the beginning signs of NSAID adverse reactions. And since these drugs are given at home with the owner acting in place of the vet, it is more than important that the client recognize these common adverse reactions signs and know what to do. These reactions, if not caught within an acceptable time, can quickly escalate to irreversable damage, incluing death, or neccesitate euthanization. We’ve seen this all too many times.
Recommended Solution as submitted to the NSAID drug manufacturers, the FDA CVM, and state vet boards across the United States.
1.The vet, in conjunction with the drug manufacturers and FDA CVM, work up a simple minimal blood test program for use with NSAID drugs to include the 5 or 6 basic blood level indicators that NSAID use routinely elevate. The client’s vet not proceed with NSAID use until a full blood panel is done and returned to the vet. Pain in dogs has been happening a lot longer than NSAID’s have been around. Rarely has it been documented that dogs died of pain. Surely the day or two that blood work would take to come back to the vet from the lab will not kill the dog. In the meantime, the vet can send home with the client the CIS sheet to be reviewed and allow time for the client to prepare questions for the next vet appointment. The cost for the basic blood work and lab testing should be reasonsble and realized as part of a safe system of NSAID use. It should be paid for by the vet’s client. Any dog owner that will not pay for this testing once briefed on its importance in the safe use of an NSAID should be required to sign off on a release to release the vet from any future claims.
I have found that NSAID drugs are not for all dogs. And you are correct that clients need to be made aware of the risks vs. benefits, and that not all drugs are 100% safe, and adverse reactions should be expected. It is the vets responsibility within the vet/client relationship to properly prepare his client for the above. Safe treatment with NSAID drugs is a partnership between a vet, his client, and the patient. ALL parties must participate in order for NSAID use to be safe and successful.
Thank you.
Dermitry Herman
www.DogsAdverseReactions.com
My very elderly dog was prescribed Rimadyl for an inflammation in her gum. The blood results were not available until the following day. The results indicated my dog had renal disease (which I was not told) and the Vet wanted to continue the Rimadyl. At this point, I had learned of the problems associated with Rimadyl from the internet. The Vet gave me no verbal warnings of side effects to watch for, no written information. I lost my dog.
It should be required that blood tests are done prior to administration of Rimadyl and owners warned of side effects. The fact is many dogs are suffering the ill effects of this drug but are passing under the radar screen. Our Vet didn’t report our dogs death until we complained a couple months later. How many deaths actually go unreported? How many dogs suffer side effects from this drug? Too many.
Judy, I am terribly sorry for your loss. As to how many dogs may be dieing from unsafe NSAID use, the FDA CVM had posted the following comment: they estimated in 2005 based on cumlative Adverse Reaction Reports that approx. 3,000 dogs died from unsafe NSAID use. By their own admittance they also estimated that this 3,000 count number represented less than 1% of the actual number of dogs that died from unsafe, unprepared NSAID use. By unprepared I mean no blood testing was done to prior approve or eliminate a dog from NSAID use, and the owner was never fully made aware of the risk vs. benefits to NSAID use.
My colleagues and I have been working non-stop in a world wide awareness campaign to bring vets and dog owners together, with each doing their part; vets coming forward to follow the drug manufacturers recommended safe use NSAID method, and their clients understanding that it is their job to ask questions in order to foster save NSAID use. Vets can’t do it alone. And without the necessary info, their clients can not use a drug in a safe manner if they don’t know what they are doing. The patient will loose everytime.
I suggest ALL dog owners that are considering an NSAID for pain management, or their dogs are currently on NSAID drugs for pain management, to visit our website for additional safe use information.
Thank you.
Demitry Herman
www.DogsAdverseReactions.com
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Gave my 8 year old mix breed named Polar Rimadyl at 10:30 p.m. Saturday May 3, 2008. Sunday 6:00 a.m.all fine. Sunday May 4, 2008 2:30 p.m. my beloved Polar was dead. Please beware.
I have had my Shepherd-Akita mix on Rimadyl for the past 3 years. He has regular liver function tests and has done very well on the drug. Fortunately, I have a vet who is well aware of the side effects, made them very clear to me and continues to keep up with testing every 6 months. My boy would not be running around today were it not for Rimadyl. Please, if you put your dog on this medication, get a full blood panel done before starting on the drug and continue to keep up w/liver testing, at the least, every 6 months, and have a full blood panel at least yearly.
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I will start off by saying I do work for a Vet. I will not defend Vets who do not make clients informed. I personally think that is the biggest problem NSAIDs.
I had put my 8yr Golden on Rimadyl when he just kept falling down. I tried everything, I had paths of rubber-backed rugs around my house, installed carpeting on the stairs for him, etc. I couldn’t put it off any longer. I do believe you should put it off as long as you can.
Then you wake up one day & see that your boy or girl is not enjoying life. He would get so upset & frustrated. I thought about how I would feel.
NO MATTER WHAT! A dog should have liver & kidney tests done before being put on any NSAID. We do the tests in-house for about $75-$100, depending on how many & history. He still suggest a full lab work up in addition. He also goes over all side affects & what to look out for. He also suggest that even if everything goes great, a 3month re-check & than every 6 months if OK. ANY signs of stomach or bowel upsets, check.
My boy lived for over 5yrs on Rimadyl, he would not have made it until 10yrs. Has anyone considered how much longer large breed dogs are living because of NSAIDs? My guy never would have lived long enough to get cancer at the age of 10, made it through the surgery & lived on to be 13+ years. He died because the cancer came back, real quick, real fast. It was best for him because it was quick & he didn’t suffer. It was not the NSAID. He was playing happily weeks before.
I have recently had to start my Border Collie on an NSAID. She has 3 completely shot discs in her back. She is on a low dose (1/4) but manages, she still limps but has learned over the years to tolerate pain. I had ber blood test re-done after 6 weeks. I will repeat them in another 6-8 weeks.
If your Vet doesn’t tell you, ask him/her. Ask what pharmacutical Co the drug comes from, they all have great web-sites to find info on.
I took my 1 year old Boykin Spaniel to the vet yesterday because he had injured his tail and I was afraid it was broken. It wasn’t but the vet prescribed Rimadyl for him to take and didn’t mention any side effects. He’s already better but I did NOT give him the Rimadyl after doing a search and reading the WSJ article on it. Why would a vet prescribe a drug like that for just a sore tail. I realize it’s an anti-inflammatory but as dire as the adverse reactions could be, why in the world would he put a young dog on an NSAID for this problem? It worries me very much and I’m just thankful I threw them out.
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Two weeks ago, our beloved 8year old black lab haf minor surgery to have a small growth removed. We were sent home with 14 Rimadyl tablets. Taz did have blood work done prior to the surgery. We gave Taz 2 tablets a day as directed, in all we gave her 10 tablets. The surgery was Tuesday. Friday Taz had an accident on my floor; but due to another puppy in the house. I did not think anything of it. Sad to say this was my first sign that something was wrong Saturday night Taz was acting a little strange, I gave her another Rimadyl. Sunday we had to take her to the emergency hospital. She was in critical condition. Two days later she passed away. Our family is devastated. I do not understand why this drug was prescribed for Taz.
My sons lost their best friend, Taz, due to Rimadyl. I cannot understand how a drug like Rimadyl can be on the market when it poses such a danger. I was not sent home with any information regarding Rimadyl. I will fight in Taz’s name to inform dog owners to research whatever drug that is prescribed. Do not take it for granted that your vet is doing the right thing for your beloved pet. I would not want any family to go through what we endured as we watched Taz in her final days. She was never sick a day in her life. Rimadyl cut short her life for no reason. Pet owners need to be made aware of the adverse effects that drugs such as Rimadyl can impose upon their pets.
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