Vet Blog

11/01/08

Let’s Revisit Rimadyl and Talk About Relative Risk
Dr. Eric Barchas, DVM

628px-kapseln.JPGI have been following the comments on a post from quite a while back regarding a commonly prescribed veterinary medication: Rimadyl.

Rimadyl is an anti-inflammatory drug and pain killer. It has been prescribed millions of times since its introduction several years ago.

Rimadyl, like all medications, can cause side effects. Drugs in Rimadyl’s class (called NSAIDs) may cause diarrhea, upset stomach, gastrointestinal ulcers and liver or kidney damage. In extremely rare cases they cause severe adverse reactions that may lead to death.

It is shocking, horrifying and heartbreaking when a medication that was prescribed to help a pet causes the pet to die. And it is therefore no surprise that some people whose pets have suffered serious reactions to Rimadyl have gone to great lengths to publicize the dangers of the medicine (try googling Rimadyl and you will see that some people have dedicated their lives to crusading against the drug).

I have nothing but sympathy for people whose pets have suffered adverse reactions to Rimadyl and other NSAIDs.

I also will go on the record and say that veterinarians have a duty to explain the risks and benefits of any medication fully before they prescribe it to a patient.

However, I believe that Rimadyl is getting a bad rap. First, in my experience, it is no more likely to cause severe side effects than any other NSAID. Try googling Metacam, Deramaxx or Previcox. You will see that they, too, cause severe adverse reactions.

And adverse reactions are not limited to medications. A neighbor of mine recently tried on some eyeliner at a beauty store. She suffered an adverse reaction to the eyeliner, and later passed away.

These sorts of reactions are absolutely tragic. But they are the exception, not the rule.

I have prescribed Rimadyl thousands of times. It has helped hundreds of my patients. It has caused diarrhea or upset stomach in a few of them. It has killed none of them so far (knock on wood).

So yes, veterinarians absolutely should warn clients about all of the potential risks of a medication before it is prescribed. And yes, it is proper to publicize the risks of medications so that pets can be protected from unexpected adverse reactions.

But at the same time, I am troubled by the fact that so much energy is spent demonizing Rimadyl and other drugs, when the problems they cause are relatively rare. Meanwhile, hundreds of dogs are dying every day because of a different, less publicized risk: irresponsible off-leash activity.

Off-leash dogs account for virtually 100% of those that are hit by cars. They are involved in virtually 100% of dog fights. They escape and are lost. They fall off cliffs, and they drown in lakes. Worst of all, they sometimes attack people, leading to euthanasia and anti-dog sentiment in communities.

If your dog has good recall and is properly socialized, then there is nothing wrong with allowing him to run free in areas where it is legal.

But if you really want to save dogs’ lives, focus your efforts on the people who don’t bother to socialize their pets before allowing them off leash.

See related Vet Blog entries:
02/29/08

How safe is long-term Rimadyl use?
Dr. Eric Barchas, DVM

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.

See related Vet Blog entries: