Pain meds

this is an excellent article written by a contributing vet on another site. I have his permission to post it, it is a great explanation

Deramaxx, Rimadyl, Metacam, Previcox, Zubrin, Ketoprofen are all part of
a drug class called NSAIDs (Non Steroidal Anti Inflammatory Drugs).
There are many examples in human medicine (>30) which include:
aspirin, tylenol, advil, celebrex etc... NSAIDs interact with two
receptors: Cox 1 and Cox2. Cox 2 is related to pain and inflammation.
This is why the medications help relieve these symptoms. Cox 1 receptors
are involved with homeostasis (keeping the good things running in your
body) such as kidney blood flow, stomach mucous production and stomach
acidity. The goal of all companies is to create a NSAID that does not
touch Cox1 - so far the companies have made ones that are more 'Cox-1'
sparing than before but there are none that are completely without Cox-1
effects.

Why do we care about Cox-1? For a variety of reasons, but in this case
it is important to realize that the 'pain' effects (Cox-2) are affected
by the NSAIDs for 12-24 hours. The medication however can have lasting
effects on Cox-1 for up to two weeks (this is a common period accepted
by most specialists). When you combine any two NSAIDs - their negative
effects on Cox-1 can be anywhere up to TEN TIMES worse than if you just
doubled the dose of one of the drugs by itself. While each combination
is different, the take home point is that there can be interaction which
is worse when combined. When switching from one NSAID to another it is
generally recommended to have a two week 'wash out' period. Obviously
for reasons of patient comfort, this is not always done. Usually you can
switch from one to another with little problem. So, if a vet does not
do this, it is not necessarily wrong. Immediate switching can cause some
problems and the most common is stomach upset. For mild problems, this
can often be treated with pepcid (famotidine). For schroder I assume he
is approximately 50lbs? For a 50lb dog, a dose of famotidine is 20mg by
mouth every 24 hours. Please check with your veterinarian prior to
administering this however!

Now, which NSAID is the BEST??! If there was one which worked best,
there would not be so many on the market. There are some that have
higher safety ranges and may be more Cox 1 sparing. But importantly, one
may work great in one dog and poorly in another. Just like people -
most people like advil for one thing, aspirin or pamprin for another.
Also some come in various forms (chewable, non chewable, honey flavored
liquid or dissolving tablet). So the big question is which one is best
for you and your pet. This will be determined on three factors: 1) one
that makes the pet feel better, 2) a form that the owner finds
compliance easy, 3) one that does not negatively interact with the pet
(this should be determined by blood testing with your veterinarian).

FWIW - there was a head to head test on Deramaxx, Rimadyl, Metacam and
Previcox. Please note that the test was paid for by the makers of
Previcox however usually when the data does not add up to what the
makers like - they just do not release the information (as opposed to
'tampering' with data). Thus previcox came out with highest safety
ranges. Also the oral tablet takes faster action than Rimadyl
injectable. Metacam was the next safest, then Rimadyl and last Deramaxx.
Safeness was determined by lowest number of side effects add a higher
than normal dosing along with range of safety. As far as pain relief
they all had similar effects with metacam and previcox as slightly
higher. What was interesting was that the previcox longer term (over 2
months) had better pain effects than all the others. With that said,
because of higher cost and it being a newer medication - it is not seen
widely. I carry it but honestly prescribe Metacam the most. I like it
because the liquid form is highly palatable and easy to dose with
weight. I also have patients on Rimadyl (one of my own dogs - didn't
switch her from it because she has always responded so well to it) and
also patients on Deramaxx.

Final thought on human NSAIDs - please do NOT use these alone or
especially in conjunction with the dog NSAIDs. Aspirin has long been
used in dogs - I wish it was not used at all for pain. The dose we use
to interfere with platelet function (where we want to help stop clot
formation) is TEN times LESS than the dose needed for relief of pain.
There was a study done that suggests that all dogs on pain doses of
aspirin have some form of intestinal bleeding regardless of how 'normal'
they are acting. As I am sure the other members here will also
recommend is that to use the concurrent use of glucosamine, chondroitin,
MSM and Omega 3 fatty acid (especially those that have high levels of
EPA in them). If all of these are not enough and no surgery is indicated
by your veterinarian, then tramadol is a great, safe, inexpensive pain
medication that CAN be given with NSAIDs.

great info to know. thank you for sharing this with us. I wouldn't ever give my dog human medicine..but I have heard of people doing so before and it's terrible! they dont work the same in all bodies and animals. going to save this.