Dear Dr. Shawn: "Can you tell me something about a new drug for arthritis called Deramaxx? My nine-year-old lab Max has been taking Rimadyl for over a year, but this new product sounds like it might be better for him. He's doing okay, but I worry about long-term problems that can occur with this drug. What are your thoughts?"--iVillager sallying
Dr. Messonnier says: "First, I would strongly recommend against using Rimadyl in Labs (and I try to avoid it in Golden Retrievers as well) since Labs have an idiosyncratic reaction that can involve fatal liver failure. I would prefer, if an NSAID (Nonsteroidal anti-inflammatory drug) needs to be used in these breeds, to use EtoGesic or Deramaxx, which so far have not caused these idiosyncratic reactions. Second, I am totally opposed to using NSAIDS for long-term control of arthritis. There are many safer and less expensive alternative therapies. To date, I have never had to treat any dog with arthritis with chronic NSAID therapy. Deramaxx belongs to a new class of NSAIDS that preferentially inhibit activity of the COX-2 enzyme (the bad enzyme that causes pain, inflammation and cartilage damage) while minimizing inhibition of the COX-1 enzyme (the good enzyme which maintains normal function of the kidneys and gastrointestinal system.) However, there is still some COX-1 inhibition. In people, the new COX-2 products (Vioxx, Celebrex) are usually incorrectly prescribed for anyone with mild joint pain. These more expensive products do not work any better than less expensive generic NSAIDS and are best used for pets requiring chronic NSAID therapy who are also predisposed to side effects from other NSAIDS. Deramaxx product literature reveals erosions of the intestines at 2.5 times label dose, and as doses increase so does kidney damage. To quote the company's own literature, "All dogs should undergo a thorough history and physical examination before the initiation of NSAID therapy. Appropriate laboratory tests to establish hematological and serum biochemical baseline data prior to administration of any NSAID is recommended." Sadly, few dogs have this extensive and regular testing prior to chronic administration of NSAIDS, which is why I see their owners bringing them in for second opinions for treatment of serious side effects. (Fortunately, I have been able to help all of these pets with aggressive integrative therapies.) My best recommendation is to use NSAIDS as needed for control of severe pain in dogs with arthritis (or in the immediate post-operative period following any surgery in which pain is possible, such as spaying and neutering) and rely on more natural therapies (acupuncture, herbs, homeopathy, joint supplements, etc.) for long term relief.
Shawn Messonnier, D.V.M., is a holistic veterinarian and nationally recognized expert on integrative medicine for animals. He is the author of several books, including the award-winning Natural Health Bible for Dogs and Cats, The Allergy Solution for Dogs and The Arthritis Solution for Dogs.