NSAIDs:  For Dogs with Osteoarthritis and Chronic Pain

Non-steroidal anti-inflammatory drugs (NSAIDs) remain the cornerstone of pain management for dogs with osteoarthritis (OA) and other chronic pain conditions. They help reduce pain, stiffness, and inflammation, and when used correctly, they can greatly improve a dog’s comfort and mobility.

I often rely on NSAIDs as part of a multimodal plan for managing pain. While they are powerful tools, they must be used carefully, as side effects can occur. Let’s walk through the common NSAIDs available for dogs, what makes them different, and other medications we sometimes consider.

Commonly Used NSAIDs in Dogs

Carprofen (Rimadyl® and generics)

One of the most widely prescribed NSAIDs for dogs. It has decades of use behind it, comes in multiple formulations (chewable, caplet, injectable), and is generally well-tolerated.

Meloxicam (Metacam®)

Often available as a liquid, which makes it helpful for dosing smaller dogs. Interestingly, meloxicam is also used in people, and for extra-large dogs the tablet form can be a cost-saving option.

Deracoxib (Deramaxx®)

A COX-2 selective NSAID often used after orthopedic surgery or for long-term OA management.

Firocoxib (Previcox®, Equioxx®)

Another COX-2 selective option that is palatable and effective for OA pain.

Robenacoxib (Onsior®)

FDA-approved for short-term use in dogs and cats. It has a rapid onset and shorter half-life, which may make it better suited for short-term use.

Grapiprant (Galliprant®)

Works differently from traditional NSAIDs by blocking the EP4 receptor, which is a key pain pathway in OA. It’s generally considered gentler on the GI tract, but unlike the other NSAIDs, it cannot be used “as needed”; it must be given daily and consistently to be effective.

Other Oral Medications

• Aspirin: Once commonly used, it is no longer recommended for dogs because of its high risk of gastrointestinal ulceration and bleeding.
• Acetaminophen (Tylenol): Can be used in dogs only, at 10–20 mg/kg up to three times daily. It is sometimes added for multimodal pain management but must never be used in cats due to toxicity.

Safety Considerations with NSAIDs

All NSAIDs share potential risks, and safe use is critical:

1. Blood Monitoring
   • All dogs on NSAIDs should have baseline and follow-up bloodwork (typically liver and kidney values) to monitor for adverse effects.
2. Two Main Groups of Side Effects
   • Acute toxicity (overdose): Because most NSAIDs are made to be very palatable (flavored chewables), accidental overdoses can happen if a dog gets into the bottle. Overdosing can be life threatening, so it’s crucial to store all NSAIDs out of reach of pets and never on counters or tables where a dog might knock them over.
   • Idiosyncratic reactions: These are unpredictable and not dose related. Even at correct doses, some dogs may develop GI ulcers, liver toxicity, or kidney issues. These reactions are rare but serious, which is why close monitoring is always recommended.

Comparison Table of NSAIDs in Dogs

Drug	Brand(s)	Use Pattern	Notes
Carprofen	Rimadyl®, generics	As needed or daily	Well-tolerated, long history of use
Meloxicam	Metacam®	As needed or daily	Liquid form good for small dogs; tablet form can help reduce cost in XL dogs
Deracoxib	Deramaxx®	As needed or daily	COX-2 selective, often post-op or chronic OA
Firocoxib	Previcox®	As needed or daily	COX-2 selective, palatable chewable
Robenacoxib	Onsior®	As needed (short-term)	Short half-life; FDA-approved for cats
Grapiprant	Galliprant®	Daily only	Not “as needed”; EP4 antagonist, different from other NSAIDs

Take-Home Message

NSAIDs are powerful allies in the management of osteoarthritis and chronic pain in dogs. Used carefully, with proper monitoring, they can provide tremendous relief and improve quality of life. Every dog is different, and the choice of NSAID (or whether to use one at all) depends on your pet’s health history, lifestyle, and concurrent conditions.

Always work closely with your veterinarian to determine the safest and most effective plan, and remember to keep all medications stored securely away from curious noses.