Nsaids and cartilage?

Re: Nsaids and cartilage?

Julian Earl — Sat, 25 Jan 2014 09:41:47 GMT

I have also encountered this agument about harm to the articular cartilage but it is a non-issue for me. NSAIDs have well-documented amalgesic effects, improving mobility, and thereby even though osteoarthritis is progressive, regardless of treatment, the quality of life improvements via NSAIDs is an unchallengeable argument. By improving mobility, there is presumably an improvement in muscular support of the joints, a minimising of weight increase, and just make the dog feel happier. Despite the best efforts of Vetplus, I have never been convinced by their case promoting glucosamine and chondoitin, and NSAIDs are the unchallengeable first line treatment. Apart from anecdotal client feedback, i'm not too sure about pentosan either. But when all said and done, I want my dogs to be happy and able to exercise the way most dogs like to do; NSAIDs may or may not harm the articular cartilage but shortof joint replacment thta is unstoppable and QOL is all that counts in the end.

My 2p-worth.

Re: Nsaids and cartilage?

Robin Grimmer — Thu, 23 Jan 2014 13:03:16 GMT

I've heard that corticosteroids can cause cartilage damage but not NSAIDS.

Re: Nsaids and cartilage?

ChrisBVSc — Thu, 23 Jan 2014 12:30:28 GMT

Thanks everyone. I'm also of the opinion that nsaids reliably work in terms of comfort & mobility, and even if there was some theoretical issue with cartilage damage I'd rather the patient was comfortable & having a good quality of life. I was always under the impression that they were the one class of drug with the biggest evidence base supporting their use in OA, and I'd also been led to believe that at least some of them had been proven to have a protective or 'disease modifying' effect. Which is why I was slightly surprised/confused about this comment from the rep! Unfortunately I wasn't actually in the room at the time so I didn't have a chance to ask about references, but next time I will!

Chris.

Re: Nsaids and cartilage?

Laurence Webb — Thu, 23 Jan 2014 11:55:51 GMT

I used to hear 'cartilage sparing' being bandied about by reps for both neutraceuticals and NSAIDs with the inference that other NSAIDs may be 'bad'

I wouldn't be surprised if some of the older OA treatments like PBZ and PLTs have some deliterious effects but it isn't something I worry about unduly, especially as medications like that are generally only hauled out for small animals where there are few options left apart from euthanasia. Side effects of PLTs may be more related to the steroid component than enything else.

Even if there is some risk of cartilage dengeneration with some NSAIDs I would contrast that against the knowledge that NSAIDs reliably result in discomfort and improved mobility supported by numerous peer reviewed clinical trials but the same can not be said of neutraceuticals. I would ask the neutraceutical rep for references for this.

Re: Nsaids and cartilage?

Matt Hilary — Thu, 23 Jan 2014 11:39:36 GMT

Hi Chris,

All info extrapolated from equine medicine:

The underlying osteoarthritic process can cause cartilage erosion so theoretically any NSAID could be said to have a 'protective' effect on articular cartilage (a 'disease-modifying effect').

There have been studies that show a genuine improvement in articular cartilage after treatment with some NSAIDs (topical diclofenac).

It is thought phenylbutazone (bute) has deleterious effects on articular cartilage associated with long-term use, though as far as I'm aware this hasn't been proven.

I would say the importance of preventing the underlying process (as well as providing appropriate pain relief) as best as possible outweighs any risk of damage from the medication itself.

Hope that helps, can try and provide more info if needed.

Re: Nsaids and cartilage?

Bob Russell — Thu, 23 Jan 2014 11:29:11 GMT

Most of the reps know how cynical I am so tend to minimise the bulls*it.

I have not told any that I am sharing the dogs Nutraquin!! Not found much benefit for her or me but perhaps a minor placebo effect!

I would suggest they provide evidence that the NSAI's are having this effect!

Re: Nsaids and cartilage?

Neil Wheadon — Thu, 23 Jan 2014 11:23:44 GMT

My take is that dog feels better, bounces about more and so wears out it's joints faster, so the NSAID's are the evil cause in the salesmanship thoughts. It's an interesting debate as I get quite a few owners telling me that they have been advised to rest their dog with arthritis. My thoughts though is that a dog lives 13-15 years and both the dog and the owner 'live' to chase that ball, do that walk, so yes maybe the joints fail a little quicker but everyone is having a happier time in the process and this applies to NSAID use as well Neil

Re: Nsaids and cartilage?

ChrisBVSc — Thu, 23 Jan 2014 10:58:01 GMT

Anyone? Or perhaps another way to put it, am I one of the only people that hasn't heard of this possible effect of nsaids? (as far as I can remember anyway, it was never mentioned at college or by anyone else I've spoken to since, & I don't remember reading about it anywhere) I'm just interested to know, because the nutraceutical rep seemed to imply it should be common knowledge!