NSAIDs, Inflammation, And A Cautionary Tale
When I went through vet school, there was not much if anything mentioned about inflammation being a natural thing. Or a good thing. It might have been paid lip service, but in the same sentence it was implied that we are here to control it, as it so often acts like a bull in a china shop, causing untold mayhem, pain and suffering.
“Luckily, young man, we have Powerful Drugs to tame this beast and help the unlucky ones on the planet who are plagued by it.”
Ever notice how long the aisle of pain killers is in the grocery store? Yeah, we live in an inflamed society.
Those Powerful Drugs that tame inflammation typically fall into one of two categories:
- Non-steroidal anti-inflammatory drugs (NSAIDs)
I’ll focus on the latter today, one of the most overused drugs in the kingdom. And surprisingly quite dangerous.
Who Is This Lout Called Inflammation?
Before we plunge into these drugs, I think it only fair to put inflammation into its proper perspective, to pick her up, straighten her tousled hair and set her back on her righted chair with a bit of respect. After all, inflammation was created by a masterful, wonderful friend of mine, Mother Nature.
Does Nature make huge blunders? Well, there are those “Acts Of” that we read about, but they are the exceptions, and probably more man made than we’d like to admit. Nature, in the animal kingdom (of which we are a part), has made some exceedingly well tuned specimens who, given half a chance, will stay healthy and running for many long years. Those Vital Animals we love to touch and smell and have fun with are vital because we’ve largely supported Nature in her intelligent workings, after all.
Or we’ve at least gotten out of her way.
Inflammation is noted for its four striking signs:
- Rubor (redness)
- Calor (heat)
- Tumor (swelling)
- Dolor (pain)
We could probably look the other way on the first three, but the last one really makes us sit up and pay attention. Our animal friends are pretty good at demonstrating it too: limping, being slow to rise or lie down, no longer jumping into the car, not climbing the scratching post to the highest condo any more, or pinning ears when the saddle’s girth is snugged up.
Inflammation: Mostly, Not the Enemy.
Inflammation is one of two major strategies of healing that most bodies will show when necessary. It’s there for a reason, along with its partner, discharge. If you watch carefully, you’ll see both at some point in someone who’s trying to get well, or fight the good fight against an invader.
If you’ve ever had the flu, your body has fought it by using both of these healing strategies.
Inflammation is that achy pain that seems to affect your whole body, sometimes even your eyes. And there’s fever, the calor.
Discharge in the flu battle is usually a runny nose or maybe a diarrhea stool.
After fighting the good fight with both inflammation and discharge, the flu is conquered and you’re ready to resume normal activity once more.
Acute Inflammation: Brilliant. Chronic Inflammation: Not So Much.
So, Nature has armed us with inflammation (and discharge, a subject for another post) to get us well in tight straits. Infectious disease, trauma, bites and stings, lacerations, all of these heal with inflammation.
These acute diseases are the ones that come on suddenly and resolve rather quickly, like the flu. Even a broken limb is expected to heal in a couple of months, not a couple of years, right? Inflammation comes, does brilliant work, your animal rests the affected part or licks the wound, and resolution comes in good time.
It’s when chronic, lingering disease sets in that inflammation can be a real pain, no pun intended. Arthritis, allergic itchy skin or inflamed ears, inflammatory bowel disease, asthma, gum disease, cancer, the list is quite lengthy.
It’s here that Dr. WhiteCoat often reaches for those Powerful Drugs to turn it off. The NSAIDs and antibiotics frequently top the list.
The Dangers of Turning Off Inflammation
These non-steroidal anti-inflammatory drugs pose several problems for your animal, while purportedly “helping.”
- They mask pain, an important check on over exertion.
- They have toxic side effects.
- They wreak havoc on the stomach and digestive system.
- They can damage, sometimes irreparably, liver and kidneys.
- They actually damage joints (for which they are often given!).
- Rimadyl, one of the most popular, has purportedly caused deaths!
Common members of this class of drugs called NSAIDs include:
- Rimadyl (carprofen)
- Metacam (meloxicam)
- Deramaxx (deracoxib)
- Previcox (firocoxib)
- EtoGesic (etodolac)
- Aspirin (yep, you read that right, probably the original NSAID)
- Ibuprofen (again, very common, primarily for human use)
Here’s a list of the common side effects seen in this class of anti-inflammatories:
- Decrease or increase in appetite.
- Change in bowel movements (such as diarrhea, or black, tarry or bloody stools).
- Change in behavior (such as decreased or increased activity level, incoordination, seizure, or aggression).
- Yellowing of gums, skin, or whites of the eyes (jaundice).
- Change in drinking habits (frequency or amount consumed).
- Change in urination habits (frequency, color, or smell).
- Change in skin (redness, scabs, or scratching).
- Unexpected weight loss.
If you see any of these, you are urged to stop using the drug immediately and report it to your vet or physician.
Pre-Vet Student as Lab Rat
While I was waiting to get into veterinary school as a poor lab assistant, I volunteered to be a guinea pig at one of the big hospitals in Columbia, Missouri. They were looking for young folks willing to swallow an endoscope to study various things. The pay was quite attractive, so I signed up.
One particular study will remain etched in my memory. The research was on aspirin, and I was given about 4-8 aspirins prior to being scoped. After some rest time, they numbed my throat and I swallowed the endoscope. The researchers let me see what they saw, live: about a dozen blood spots on the inside lining of my stomach! Whoa.
I’d grown up being given aspirin by my mom when ever I ran a fever (still thankful I grew up before antibiotic use was so prevalent). I hated it, couldn’t take it without crushing and mixing with sugar, but I had no idea it had the potential to cause GI bleeds.
Joints and NSAIDs: A Marriage Made in Hell
Most of these drugs are given for joint problems, so let’s take a deeper look at their effects on joints. This was a revelation to me early on in my career as a newly minted holistic vet in the late 80’s.
First and foremost, they are given for pain. Acute or chronic pain, these are often the drugs of choice to “manage” pain, especially in the dog.
Why might that be a bad idea?
Pain, especially after an accident or trauma, is a strong signal to rest that damaged limb. A classic example where these drugs are used is cranial cruciate ligament rupture, the “football knee” of the dog world.
NSAIDs and painkillers (like Tramadol, currently in vogue) are telling your injured animal, in essence, “Hey, no worries. You’re good to go!” That valuable signal of hurting on motion is lost to his consciousness, much like a black piece of electrical tape could hide the oil warning light on your dashboard. What’s the end result?
He’ll want to get frisky and active! And now, instead of rest and repair, as Mother Nature had in mind, Jeb is out running and jumping and further injuring his already injured joint!
Healing Slowed by NSAIDs
It’s been known for years that NSAIDs interfere with the healing of a joint. They block the regeneration of connective tissue, which is everything in the joint aside from the bone: ligaments, tendons, muscle, and cartilage. A joint needs connective tissue to function normally, and it’s a big part of repair.
Here’s a page citing research that shows the strength of tendons was actually decreased after ibuprofen use.
Not exactly an outcome you’d want, let alone one you’d want to pay for!
Better Options for Healing Joints
Remember my posting about cranial cruciate ligament damage a few weeks back? Well, I promised a homeopathic protocol for repair that works incredibly well, and that report is available now, via Dogs Naturally Magazine (click to get your report for free). The cost of the treatment is minuscule and the outcome far better than the surgical outcome (which is quite poor, as pointed out in the earlier post).
Of course, the deeper work in homeopathy is what most of us full timers do: constitutional prescribing. That’s where we find the remedy that fits the totality of your animal’s state, and initiate whole patient healing. Sore joints yield nicely to a cure like this. In my mind, homeopathy is the go-to modality for chronic conditions of all sorts, including chronic pain. When you heal the Whole Animal, the need to keep recreating pain goes away.
TCM practitioners can help you get healing sped up as well. There’s a list of them on my Resources page. (Note: choose one or the other, acupuncture and homeopathy should not be done together.)
A qualified veterinary herbalist can select and combine herbs that help heal joints. You can find veterinarians trained in herbal use here. Here’s a Certified Herbalist’s list of favorites for joints in dogs.
There are loads of supplements out there for helping joints, the commonest using variations of GAGs (glycosaminoglycans). My old standby for years was GlycoFlex, and it’s still widely sold.
There’s also Adequan, a safe though expensive injectable of hyaluronic acid available from your vet.
I had a client once who had great results getting her chronically arthritic dog sound by feeding lots of tendon rich foods, like raw chicken necks and feet.
But, the bottom line is, like anything else in raising Vital Animals, it pays to respect Mother Nature rather than turn her off (what woman likes a turn off, after all?). Working to support her efforts and recognizing that inflammation is an important part of her kit will get us the greatest results long term.
Let us know in the comments if you have a favorite something for helping with joint pain, or if you’ve had a bad experience with the pain drugs. Please name names with both.
Photo by Ray Larabie
I called the vet today with a suspect UTI in my Raw fed, intact male italian greyhound. He has only had his puppy series of shots and one rabies – no heartworm meds or flea and tick. Mostly indoors except for walks. He is 3 years old and 15.5 lbs.
They have not called back and I’m sure they will want to see him. I’m trying to get a clean urine sample for them. Pretty certain they will prescribe an antibiotic because finding a true holistic healer is near impossible here. What should I do? My dog seems pretty quiet.. not too fussy, yet I know he is not 100%. I found some small urine spots and one had a tiny tinge of pink. Can I treat with Mercurius? Any advice is so appreciated!!!
Thank you for your time & expertise.
You can, but it won’t work unless it’s the best match for your dog and his disease symptoms. Best is to hire a homeopathic vet to help you if you’ve not learned this method.
I tell you how in my free Apoquel Alternatives Report, in your Member Home.
All the best with him, and bravo for not just giving antibiotics (which cause untoward side effects).
Hello Doctor! Thanks for your information. I am looking for some more information about cartrophen and possible side effects. My little Italian Greyhound has arthritis in one of her front legs that was previously broken. She was on metacam for quite awhile, but still limping quite a bit. Our vet prescribed cartrophen injections. Since we began cartrophen (once a month) our little dog has had THREE episodes of fibrocartilaginous embolism. The first one was quite severe, causing her to lose the use of her back legs for a couple of weeks. They slowly came back and she returned to about 95% mobility, which we were very happy about. The second episode was milder, and caused her to lose her back legs again only for a few hours. After that she dragged her legs a bit for a few days, and then again returned pretty much normal. The last one was the mildest, and she only lost mobility for an afternoon, and then returned to normal again.
Each of these attacks has followed a cartrophen injection by about a week. Our vet assures us that these things are not related, just a coincidence, and encourages us to continue the cartrophen. However, we are suspicious there is a connection.
Do you know anything about this, and are you able to shed any light on this question?
Thanks for your help,
I just did a quick Google search and there are some concerns out there. But, I think you’ve witnessed three scary events after its use! I think that’d be enough for me to chuck it and start something more natural. “Fibrocartilaginous embolism???” In what universe is that considered an okay condition?
Here’s my thoughts, w/o a deep investigation:
Sure sounds like a connection to me! I’d dump that drug and run for something natural. Raw bones with lots of cartilage on the joints, at the very least.
Dear Dr. Falconer;
My 9 year old Lab is currently on Transfer Factor and Krill Oil. I was giving her Dr. Wysong’s multivitamin used with raw food and was told that if using Transfer Factor there is no need for additional vitamins, do you agree? I am also not familiar with your Raw Support, what exactly are its benefits. I am very happy to say that she is my last baby out of 4. She is also the only one that only had her Core Vaccines and Rabies at 1 year. I understand that the LAW states otherwise but I will indeed take on that responsibility to keep them healthy.
P.S.: Are you familiar with any articles written about over-vaccinating horses. I am especially interested in the WNV risks. My two horses were vaccinated in 2006 and had a booster in 2007. Six months later they BOTH were diagnosed with respiratory issues/COPD. My beautiful quarter horse passed last year after a 6 year battle. My Arab continues to have minor issues but am now treating her with Acupuncture, Chinese Herbs, Transfer Factor and blue green algae. I am convinced that the WNV vaccine was the trigger, this is not a coincidence as my traditional vet likes to call it. My Quarter Horse passed due to hepatitis from all the steroids she was given and my lack of knowledge but her death has not gone in vain. I will be treating her sister with Whole Foods and Supplements and allowing her body to heal her. Thank you for your time. You are a blessing
Hi Betsy, and thanks for being on the Natural Path with us.
I think as long as raw food is made intelligently and rotated periodically (I like a new protein monthly, with a cycle of three different recipes), additional vitamins shouldn’t be necessary. The Transfer Factor Canine Complete (and Feline Complete) were formulated by a vet nutritionist to be complementary to any diet, even a vitamin fortified one. Another product would be redundant.
My hat is off to you on your stance on more rabies vaccinations. My thoughts to a T.
The closest piece I’ve written on horses and vaccinations makes it clear that to me, horses are the most over vaccinated species in the world. Certainly COPD or allergic asthma (heaves) is due to immune confusion. There’s no larger confusion cause than vaccination, the injection of foreign organisms right into the blood, bypassing all the natural defenses.
I’m so sorry you lost you QH to this, and I’m inspired that she’s sent you down a better path for her sister and all future horses you have a say over.
I have given my dog subcutaneous Cartrophen Vet injections, as prescribed by his elbow surgeon. Have to get it sent down from Canada, where he got his surgery but I’m back in the US where it is not sold. He also sees a physical therapist regularly and does plenty of swimming most of the year. I recommended homeopathic Zeel as a pain reliever for another person’s little dog who couldn’t jump up on the bed and he’s done well on it.
One modality that has worked well for my female who suffered an F.C.E.
A few years back, is cold laser therapy along with acupuncture.
Years ago, I had used Metacam, but had seen a clear drop in appetite, and realized it offered more of a cover up then true benefit, so I took her off it.
Instead, preferring, Turmeric along with a good glucosamine product.
I am very interested in Raw Support, Dr. Falconer, would I be able to purchase this from you?
I love the idea of a whole foods based supplement.
Would this be a replacement for her current glucosamine supplement?
Sure, Joyce, I can send this. Just contact my through the Contact page and use the subject line Order and I’ll get you the info.
I’d use it concurrently with your current glucosamine product until that runs out, and then you should be able to use less to start with. Like most of this class of product, there’s benefit to a 2x or “loading dose” to get started, followed by a maintenance dose. You could bypass that if you do it this way.
Also, for me and others, what’s FCE? Farcical Comic Epidemic? Fractured Creamed Elbow? I guess I’m supposed to know, being a doctor and all, but I stopped keeping up with this stuff years ago.
Excellent! Thank you Dr. Falconer, I will contact you.
Lol, on the aforementioned definitions!
I am having troubles with my ipad. Not sure what happened.
Here are two links that somehow did not get added.
It is sad to see how “we” pet owners have been brainwashed into thinking that any symptom our dogs show need to be stopped IMMEDIATELY. When in reality our bodies and theirs are wiser then any of us.
Lately, I’ve had a number of pet owners come to me with different acute issues, my response in most cases: If the dog is not suffering let “it” run its course. So many times we stop our bodies from healing us.
Thanks to people like you, those of us that are open to the truth will change the way we see things and at the end this will help our dogs and ourselves tremendously!!!!
Sorry, Dr. Falconer — I had not checked the link you provided that took me to the same site to which I copied a link!
Great minds think alike, Barbara. Won’t hurt to have it here twice. Thanks.
Thanks for this terrific article, Dr. Falconer. Here’s a link to an article about the detrimental effects of NSAIDs found in human studies, from blog by a sports clinic in Chicago.
[Removed Broken Link From Comment]
Hi Dr. Falconer
You said acupuncture and homeopathy should not be used together.
Can you tell me more about that?
Sure, Shari, it’s just that both work on the same level. A homeopath’s aim is to nudge the patient towards cure with the best fitting remedy, most similar to the state of illness. As we often have an incomplete picture of that state, not being able to interview our patient (talking of animals here), we are likely to be close at times, but not completely on the mark. As such, we always need to see the full response of the patient to what we’ve given.
In that response, we’ll learn more about the patient’s state of illness, and our next prescriptions are closer, more similar. The goal is high similarity between remedy and disease, and that results in cure: whole animal better, not just bereft of symptoms.
So, imagine trying to interpret a response when another modality comes along and also moves things at the level of the vital force. It makes interpretation muddy. Say the needles caused a symptom to disappear. Did it disappear because the whole animal was headed towards cure, or was it gone because of palliation, or worse, suppression?
So, best to keep one of the two modalities to itself, and so be able to clearly gauge what’s working best for the patient to move towards cure.
Thanks for asking.
Thank you for answering this question (I was going to ask it if it was not already asked).
Hi Dr. Falconer,
I’m new to you and your website.. oh how I wished I new about it a few years ago.. We went through rotator cuff surgery.. artificial tendon, hobbles for 6 weeks.. etc. Not sure if it was really worth it…. the $$ is one thing .. but the rehab was long road..
I too am usually *silent fan*.. but like other poster .. realized I better send feedback so we don’t lose you ! : )
I will look at your recommendation of the Raw Support.. I started on Glycoflex.. then went to the GLC…. now am on Natures Pharmacy Phyto-flex.. cost is a concern these days..
How do you feel about Wobenzym protocol for agility dogs and myself? Its supposed to be work long term?
Thank you for sharing your knowledge for us out here…! Will share *you* with others..
Hi Sherry, and thanks for stopping by the comments.
Oh, I’m so sorry you had to go through so much prolonged trouble. I’m assuming this is you, not your dog, right (rotator cuff doesn’t sound canine, or I missed that lecture in vet school!).
In general, the best I know is “Get thee to a good homeopathic doctor!” You shouldn’t have to rely on supplements for the rest of your life. This should still be curable. On my Resources page, you’ll see a link for the NCH, which lists human practitioners of homeopathy. Look for one whose practice is close to 100% homeopathy, and maybe just me, but I feel more comfortable with an MD than a lay homeopath. They, like me, understand the body better, have studied pathology, physiology, etc, AND homeopathy. If you care to tell me where you live, I might be able to help you choose someone.
The rest, enzymes, joint support, etc. is all fine, but won’t likely get you all the way to cure.
Best of luck, and welcome to the Natural Path. We’re glad you’re on it with us.
Hi Dr. F.
Great post. I struggle personally with Chronic Inflammatory illness so this article hits close to home. In the article you mention a product called Raw Support that you recommend, but I don’t see a link or manufacturer. I would love to read more. Is this something you like better than the WAG you recommended in a previous post?
Thanks so much for all you do.
Have a wonderful week.
Lori, Millie and Jordan 🙂
Yes, I’m really impressed and have a good stock of Raw Support in my office, so let me know if you want one shipped, Lori.
Dr. Falconer: The last time you suggested WAG, I bought this product, and my dogs are currently on it. My three dogs are taking this as a preventative. Two of my dogs do agility. Can you take Raw Support as preventative? I do not see arthritis in my dogs, except for forearm muscle tightness, and a problem with his right flexor in my male Also, he rotates his pelvis quite often. I am working with a chiropractor. Would Raw Support be better than WAG? One more thing is this supplement only for dogs? or can people take too.
Thanks for a great article!
Any supplement that is 100% food based, and whole food at that, wins in my book, other things being equal. As this Raw Support is a single ingredient pure green lipped mussel, suitable for any species to eat (yes, people, though it’s not labeled that way, but I asked) I was keen to try it on my patients, and got good feedback. So yes, I think it far superior to Wag, and have a shelf full of it as a result of early results.
I think you have a credit card on file here, so I’m happy to send you a jar to try if you wish. Just email me and let me know. I think you’ll like it, both for preventative and treatment.
Hi Dr Will,
My dog has a partial/full tear CCL. My husband and I have decided No to TPLO. Maxwell is on restricted movement now, acupuncture, glucosamine and bone broth. Where ca i buy the Raw support. I want to help my Max in any way I can!
Years ago, I was having trouble finding the most fitting remedy for an arthritic dog patient. Several tries, and nothing really gave him relied.
Well, the owner took things into her own hands, decided that it made sense to feed joint-rich bones (like necks and big hip joints, covered in cartilage), and lo and behold, her dog’s lameness subsided! So, that’s a useful strategy. Some add gelation, plain old Knox gelatin, and see improvements as well.
I usually see better results now with homeopathic prescribing, but that is best done via hiring a homeopathic vet. If you want to pursue this, visit the Resources page and scroll down to the AVH list there.
All the best to you and Maxwell.
Yes! Great topic. I’ve had both a bad experience with Rx and great experience with Green Lipped Mussel Powder.
My youngster, Raylan (2.5yr old Great Dane) was given an Rx Tramadol shot when neutered. He had difficulty in waking up from anesthesia and acted drunk for 12 long hours afterwards. Too scary of a side effect. Never again.
Mona (turning 7 in June ) has done wonderfully on chicken feet and Green Lipped Mussel Powder.
Within about 3 weeks Mona showed a ton of increased movement that I hadn’t even recognized was gone. She runs and plays with 2 energetic Vizsla’s at the park. She doesn’t quite have the stamina they do but she cuts and turns in the chase just like the youngsters. Its so fun to watch.
When she did step in a hole while running one day – I thought for sure she’d torn something. The amount of limping and frantic crying made me very concerned. Arnica given within minutes stopped the crying. That gave me space to take a breath and decide to take her home instead of the emergency vet. Next day gave some doses of Ruta and on the third day she wanted to go out for a meandering walk. 3 Days! Unbelievable.
I truly feel that her body (although aging) was prepared for something like this injury due to lack of toxin interference. Her joint become inflamed when injured but the inflammation did its job keeping her immobile and cognizant of the injury. The inflammation went away when no longer needed. That seems like the way it should work.
Thanks again Doc for sharing all your knowledge. Its real world stuff.
How very cool, Tricia. You witnessed what was supposed to happen: inflammation comes in to heal an injury, then leaves when its work is finished and all’s well.
Kudos to you for getting arnica in within minutes and regaining sanity, and then moving on to ruta for the cure.
I tried to find the Raw Support joint supplement to order for my older BC/Aussie mix with some joint issues. When I go to the website (naturallynakedpetproducts.com) it doesn’t come up and says the domain name is available? Is this company still in business? Where do you buy your supplement? Thank you.
Remember my posting about cranial cruciate ligament damage a few weeks back? Well, I promised a homeopathic protocol for repair that works incredibly well, and that report is available now, via Dogs Naturally Magazine (click to get your report for free). The cost of the treatment is minuscule and the outcome far better than the surgical outcome (which is quite poor, as pointed out in the earlier post. This is what Dr. Falconer wrote above if you go there and click on Dogs Naturally Magazine you will find the place to buy Raw Support. Good Luck!
Thank you Esther. 🙂
I have been silently enjoying all of your articles but am realizing that this might mean you think nobody is reading and that would be a shame. So I’m getting bold and writing today. Mostly, I have some questions about anti-inflammatories/pain meds (not sure which is which quite often) for older dogs who have not been raised naturally and who are now suffering from moderate to severe pain with most movements without medication. Our dogs are now being raised naturally but our 150-pound 13-year-old old boy has been exposed to vaccinations, heartworm medication, flea prevention and a kibble diet for most of his life (now that we know better, we do better, but we didn’t realize during most of his life). Can we really expect that acupuncture or homeopathy would be enough to keep him mobile? As it is, he is on a strong dose of metacam and still requires help getting up occasionally. Any thoughts?
Yes, I think it’s going to be an uphill battle, but it’s certainly possible to get your old guy out of pain and on to a better plane of health. When I was an acupuncturist, early in my holistic vet career, I ended up seeing lots of old guys in pain and it definitely helped most of them. Has to be a series, though. Even better now with homeopathy, but again, no quick fixes: this is chronic disease, so it’ll move, just slowly.