NSAID use in dogs with Cushings

RE: NSAID use in dogs with Cushings

John Flynn — Sat, 30 Jan 2016 13:45:30 GMT

I have seen lots of dogs receiving mixes of glucocorticoids and NSAIDs at appropriate doses for the combination without problems over the years. I don't think there is any reason not to?

Also I'm not sure that the cohort of dogs with "treated" cushings I have seen have outperformed the untreated cohort - indeed the opposite has been my experience...

RE: NSAID use in dogs with Cushings

Hannah Wynne Richards — Sat, 30 Jan 2016 13:08:34 GMT

Equine veterinary surgeons happily use corticosteroids and NSAIDs concurrently, but with dogs I'd sooner try to avoid NSAIDs if it has Cushings. Having said that, if no other pain killer appropriate, then our oath is "My constant endevour will be to ensure the WELFARE of animals committed to my care" so I'd rather take a risk than deprive an animal of analgesia if it needed it.

Wynne

RE: NSAID use in dogs with Cushings

Virginia Campbell — Sat, 30 Jan 2016 10:26:16 GMT

[quote user="Kate Richardson"]Given that there it tends to a progressive disease, many dogs may have early Cushings but have no apparent symptoms, and I bet a lot of these receive NSAIDs for one reason or another with no problems at all.[/quote]

I bet you're right - all those wee middle aged Bichons and terriers with manky teeth that have no or only mild elevation in liver enzymes (or bloods not done for financial reasons) and get some NSAID post extraction; all the arthritics who are starting to feel it a bit despite self medicating with steroid and cheer up on NSAIDs.

RE: NSAID use in dogs with Cushings

Kate Richardson — Sat, 30 Jan 2016 10:18:34 GMT

Given that there it tends to a progressive disease, many dogs may have early Cushings but have no apparent symptoms, and I bet a lot of these receive NSAIDs for one reason or another with no problems at all.

RE: NSAID use in dogs with Cushings

Julian Earl — Sat, 30 Jan 2016 09:43:50 GMT

My experience is that I had no apparent complications in this situation. I'veonly used carprofen in this situation as far as I can remember but have pursued the evidence for the steroid/non-steroidal contra-indication without great success. The risks are theoretical I believe and extrapolated from human medicine. I know downer cows have been given huge dexamethasone doses, and NSAIDs tend to be used now as well without reported effects.At BCVA, 50ml of soluble dexamethasone iv that is 100mg or say 0.2mg/kg for down cows plus Ketofen and when I queried the risk, I received blank looks from thirty or so cattle vets.

RE: NSAID use in dogs with Cushings

Clive Ansell — Thu, 28 Jan 2016 21:41:32 GMT

[quote user="Virginia Campbell"]For a procedure I'd probably stick to opiates with maybe a cautious dose of Pardale to go home if necessary (10mg/kg q 12 hours, not the licensed dose q 8 hrs). Although I don't think one shot of NSAID would make its liver fall apart or its guts dissolve. [/quote]

Tend to agree, but if one does give a single shot of a nsaid and things go mammaries up (whether caused by the nsaid or not), could be on thin ice defending it.

RE: NSAID use in dogs with Cushings

Clive Ansell — Thu, 28 Jan 2016 21:37:54 GMT

There are no analgesic drugs, nsaid or otherwise, specifically licenced for use in untreated cushingoid dogs, so all/any use is technically off label, and appropriate written consent should be obtained.

Depending upon the procedure I would try and avoid nsaid and use an opiate instead.

RE: NSAID use in dogs with Cushings

Virginia Campbell — Thu, 28 Jan 2016 20:35:04 GMT

For a procedure I'd probably stick to opiates with maybe a cautious dose of Pardale to go home if necessary (10mg/kg q 12 hours, not the licensed dose q 8 hrs). Although I don't think one shot of NSAID would make its liver fall apart or its guts dissolve.

For longer term use - can't think of any rickety Cushingoid dogs we have at the moment- I might use a low dose long term in a dog who needed NSAIDs for happiness as long as the owner understood that this might hasten the liver's Cushing-induced demise.

RE: NSAID use in dogs with Cushings

Michael Woodhouse — Thu, 28 Jan 2016 20:28:46 GMT

If the dog needs NSAIDs, give it NSAIDs. I've used loads in dogs on steroids and had zero problems (with owners aware of risks).

Vets seem so scared of steroids. There is increasing use in people peri-operatively in combination with NSAIDs etc.

Interesting article - attached

RE: NSAID use in dogs with Cushings

Nicola Cole — Thu, 28 Jan 2016 20:27:06 GMT

Thinking about it I'm sure I had a poorly controlled Cushings (didn't tolerate vetoryl well but a low dose took the edge off clinical signs) on metacam for a while as he had a ruptured cruciate-no adverts effects on that one (but was probably going on for 8years ago so can't actually remember what pain relief he was on!)

RE: NSAID use in dogs with Cushings

Robin Grimmer — Thu, 28 Jan 2016 20:22:52 GMT

Probably not recommended. I would also be concerned about poor wound healing and possible breakdown in untreated cushings.

RE: NSAID use in dogs with Cushings

Linda Filshie — Thu, 28 Jan 2016 20:19:27 GMT

Not directly the same but I do have a dog on long term metacam and pred. Been on it for going on 2 years now without keeling over or any noticeable adverse effects.