Nonsteroidal anti-inflammatory (NSAID) drugs are used in a variety of animals. They are used for their analgesic, anti-inflammatory, and anti-fever effect. The majority of NSAIDs work by inhibiting cyclooxygenase (COX). Some are selective for COX-2 and others are non-specific and block both COX-1 and -2. Examples of NSAIDs include carprofen, dercoxib, firocoxib, meloxicam, and piroxicam. Galliprant® is a newer atypical NSAID that works but blocking prostaglandin E4 which is down stream from COX-2.
NSAIDs have several documented side effects which include increased risk for bleeding, gastrointestinal effects (vomiting, diarrhea), and liver or kidney damage. Labrador retrievers may have an increased risk for liver toxicity from NSAIDs. Piroxicam is a mixed COX-1 and COX-2 inhibitor that has been shown to have an anti-cancer effect in transitional cell carcinoma and squamous cell carcinoma in dogs. Because piroxicam is an older generation, non-selective COX inhibitor gastrointestinal upset (including ulceration) is more likely to occur. While on any NSAID, the patient should be monitored for decreased appetite, vomiting, dark/black tarry stool and if any of these signs are noticed the NSAID should be discontinued and a veterinarian contacted.
There are many types of cancer in dogs and cats that cause pain. Some of these cancers include:
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- Osteosarcoma or other tumors of bone
- Oral tumors
- Inflammatory mammary carcinoma
- Prostate tumors
- Nasal tumors
The long-term use of NSAIDs in cats is controversial. The primary concern is that they can negatively affect kidney function and contribute to kidney failure and death. No NSAIDs are approved in the United States for long term use in cats. Meloxicam is approved for long term use in several other countries. Robenacoxib (Onsior®) is licensed for use in cats for up to 6 days. For cats with cancer, a careful evaluation of risk vs. benefit must be performed. In my opinion, if the cat is experiencing significant pain due to a tumor it is reasonable to consider using an NSAID. Newer guidelines by the American Association of Feline Practitioners recommend careful patient selection and monitoring while using the lowest effective dose.
Over-the-counter pain relievers for humans should not be used in pets. These include: ibuprofen, naproxen, aspirin, and acetaminophen.