Pain Meds for Dogs

Non-Steroidal Anti-Inflammatory Drugs

NSAIDs are the most commonly prescribed drugs for pain and inflammation in dogs, especially conditions like osteoarthritis and soft-tissue injuries. Drugs in this category work by blocking or inhibiting the production of prostaglandins, which are hormones that play a role in fever and inflammation.

NSAIDs can be highly effective at managing pain due to inflammation, but there are several potential side effects. These drugs can cause vomiting, diarrhea, loss of appetite, gastrointestinal irritation and bleeding, and liver and/or kidney toxicity. Your vet may need to run some lab tests before using an NSAID to make sure your dog does not have underlying conditions that can be worsened with NSAID use.

Over-the-counter NSAIDs include aspirin, acetaminophen (Tylenol), ibuprofen (Advil, Motrin), and naproxen (Aleve). Ibuprofen and naproxen are toxic to dogs and should never be used. Acetaminophen has a narrow safety margin and is usually not recommended for dogs.

Aspirin may be safe for some dogs when used under the direct supervision of a veterinarian. Non-enteric coated aspirin should be used because the coating can alter the way the aspirin is absorbed in the stomach. It can slow absorption in some situations and then allow regular absorption in others. This can lead to over or under-dosing. The absorption in non-buffered aspirin is more predictable and therefore preferred. The generally recommended dose range for dogs is 10-15mg/kg, but be sure to ask your vet about the safest dosage for your particular dog. It is absolutely critical that you do not give aspirin unless directed by your veterinarian. Giving aspirin may limit or prevent the use of other medications your veterinarian would want to use, medications that may be more effective and safer for your pet.

Most NSAIDs appropriate for dogs are available by prescription only. All of the following NSAIDs are available in an oral form (tablet, capsule, chewable, or suspension). Some also have injectable forms for in-hospital administration.

• carprofen (Rimadyl, Novox)
• deracoxib (Deramaxx)
• firocoxib (Previcox): less effective for pain than other NSAIDs; more often used in dogs to treat certain cancers
• grapiprant (Galliprant): works differently from some other NSAIDs and may be safer for some dogs
• meloxicam (Metacam)
• piroxicam (Feldene)
• obenacoxib (Onsior): can only be used once daily for three days at a time

Corticosteroids

Corticosteroids are highly effective at reducing inflammation in the body and may be used to relieve pain in some cases. In addition to reducing inflammation, steroids also suppress the immune system, so long-term use is rarely recommended for pain management alone. These drugs are more likely to be used on dogs with concurrent pain and immune-mediated diseases.

Corticosteroids cause side effects such as increased thirst and urination, increased appetite, weight gain, gastrointestinal upset, and restlessness. These drugs may also have a negative impact on organs and bodily function, especially when used frequently or for long periods of time. This is why vets prefer to use NSAIDs and other pain medications instead of corticosteroids.

The most common steroids prescribed by veterinarians include prednisone, prednisolone, methylprednisolone, and dexamethasone.

Opioid Analgesics

Opioids are considered to be the most powerful analgesics available. There are numerous opioid analgesics on the market, some of which are used in dogs. In short, they relieve pain by affecting certain pain receptors in the body.

Veterinarians often use injectable opioid analgesics to manage pain before, during, and immediately after surgery. They may also be used to treat acute pain from serious injuries. Vets don't often prescribe oral opioids for dogs to take at home becuse of the potential side effects.

The side effects of opioids in dogs include sedation, dysphoria, dizziness, nausea, vomiting. Dogs may also experience slowed heartrate and breathing. Long-term use can increase a dog's tolerance to opioids, making them less effective.

The most common opioid analgesics used by veterinarians include the following:

• buprenorphine
• butorphanol
• codeine
• diazepam
• fentanyl
• hydromorphone
• morphine
• oxymorphone

Tramadol

Tramadol is a synthetic opioid analgesic. It is not technically an opioid, but is considered an opioid-like analgesic because it has a very similar structure and method of action.

Tramadol is often used to treat mild to moderate pain and can be used in conjuction with certain other pain medications (like NSAIDS or gabapentin) to manage moderate to severe pain.

The side effects of tramadol are similar to those of opoids but may be milder.

Tramadol is typically prescribed as a tablet or capsule to be given by mouth every 8-12 hours.

Gabapentin

Gabapentin is an anti-convulsant that has analgesic properties. It has shown to be effective at relieving nerve pain and many types of chronic pain.

Experts do not fully understand how gabapentin works to reduce pain. It has an impact on the brain's electrical activity and the body's neurotransmitters (chemicals that send messages between nerve cells). 

Gabapentin is typically given orally once or twice daily. It is available as a tablet, or capsule but can be compounded into a suspension for small dogs.

Herbs and Supplements

Many dog owners have showed interest in natural pain management for themselves and their dogs. There are numerous herbs and supplements that seem to relieve pain and inflammation. Be aware that not all of these are safe for dogs, so be sure to consult your veterinarian for advice. You may be referred to a holistic veterinarian who specializes in alternative veterinary medicine (such as homeopathy and traditional chinese veterinary medicine).

The use of cannabidiol, or CBD, has become popular in both humans and dogs to manage pain with few or no side effects. However, caution must be used with these products. CBD for dogs must be THC-free and sourced from a reputable company. Your veterinarian can help guide you through choosing a CBD supplement for your dog.

Pain Management Alternatives

If you are looking for a way to manage your dog's pain without medications (or in addition), there are some alternative treatments that can help. These include acupuncture, cold laser therapy, and physical therapy. Some vets already offer these services. If not, your vet can refer you to a professional that specializes in these treatments.

It is never good for your pet to be in pain. The signs of pain can be as subtle as skipping a meal, growling or being more grumpy, and not wanting to get on the couch, or as dramatic as limping daily and yelping or whining. If you note any changes of movement or behavior in your pet, reach out to your vet and see if pain may be a reason. The good news is that there are several safe and effective ways to control pain and your dog should be on the mend soon.