Can I Give My Dog Rimadyl And CBD Oil

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Overall, CBD use in dogs appears to have a good safety profile and is at low risk for side effects. But “Appears” is the key word here. What is Carprofen? Carprofen is a type of nonsteroidal anti-inflammatory drug (NSAID) that is used to treat pain and inflammation in dogs.

Which Dogs Should Not Receive CBD?

Continued research is essential to furthering our understanding of how CBD affects the canine body.

Cannabidiol (CBD) is one of over 90 cannabinoids produced by the Cannabis sativa plant and has great potential for therapeutic application in veterinary medicine. The 2018 Farm Bill legalized the regulated production and use of hemp and hemp products that contain less than 0.3% tetrahydrocannabinol (THC) in the United States, and since then, CBD products have become widely available and interest in using CBD to treat our pets is increasing. This is due to not only anecdotal reports, but also scientific evidence of beneficial behavioral and health effects, especially for such conditions as pain (particularly with arthritis), inflammation, anxiety, seizures, and immune system modulation in companion animals.

Overall, CBD use in dogs appears to have a good safety profile and is at low risk for side effects. “Appears” is the key word here, however. Because cannabidiol and other hemp products were federally illegal until 2018, we are only now beginning to see the results of recent scientific studies conducted on these products.

It is known that dogs, like humans, have an endocannabinoid system (a complex cell signaling system); however, experts haven’t yet determined how it all works. Because we are in only the very early stages of understanding just how cannabinoid-based medications affect the canine body, we need to be cautious in administering CBD to our dogs. While we wait for the results of new and ongoing research, here are some key points to be aware of when considering CBD:

  • Currently, there are no veterinary drugs containing CBD that are approved by the United States Food & Drug Administration (FDA). CBD products are currently sold as nutritional supplements and “drug claims” about their use are strictly illegal.
  • There is little documented research, control, or regulation over CBD products. This can result in highly varying compositions, concentrations, and quality, even from one batch to the other of the same product. Because of this, consumers may not know what any individual product contains.
  • A recent study (“Cannabinoid, Terpene, and Heavy Metal Analysis of 29 Over-the-Counter Commercial Veterinary Hemp Supplements”, Vet Med (Auckl). 2020;11:45-55) by Cornell College of Veterinary Medicine and ElleVet Sciences, a manufacturer of pet CBD products, tested 29 CBD pet products. Label guarantees to the cannabinoid concentration contained in the supplement were present on 27 of the 29 products, however, only 10 of the 27 “were within 10% of the total cannabinoid concentrations of their label claim.” Several tested below their label claims of cannabinoid concentration, and two products were found not to contain any CBD at all. Heavy metal contamination was found in four of the products, with lead being the most prevalent contaminant (three products).
  • Owners and veterinarians considering the use of CBD need to be aware of the prevalence of low concentration products. Obtaining a certificate of analysis (COA) from a third party laboratory will enable correct calculation of dosage.
  • There is not yet any data available as to the effects of long-term administration of CBD to dogs. It is also not known if there is any cumulative effect.
  • Of particular concern is any potential interaction between CBD and other medications. Because CBD is metabolized by the cytochrome P450 family of enzymes, it can affect the metabolizing of the other medications in the system. In turn, this can alter the efficacy of these other drugs, either by enhancing their activity or inhibiting the desired activity. Studies with humans have demonstrated that this interaction has impacted drug concentrations in the blood. It has been determined that there is the potential for interaction in humans with the drugs warfarin, tacrolimus, theophylline, ketoconazole, and zonisamide. As these drugs are also used in dogs, it is possible that that there may be interactions in the canine body as well. Other medications that CBD may interfere with include antibiotics, antipsychotics, antidepressants, blood thinners, and any other drugs metabolized by P450 enzymes.
  • Scientific studies have shown that CBD can cause an increase in the liver enzyme alkaline phosphatase (ALP), but the significance of this is not yet known. CBD is thought to be able to enhance the effects of certain drugs. This may present an opportunity or need to reduce the dose of certain medications that are administered to a patient who is also being given CBD.
  • As NSAIDs, Tramadol, Gabapentin, and anti-anxiety drugs rely on P450 enzymes for metabolizing, approach the addition of CBD carefully.
  • When given with trazadone, CBD was found to inhibit the ability of trazodone to lower blood cortisol in a recent study by Morris et al (The Impact of Feeding Cannabidiol [CBD] Containing Treats on Canine Response to a Noise-Induced Fear Response Test, Front. Vet. Sci., 22 September 2020). This highlights the potential drug interactions associated with CBD and may support previous work that shows CBD to be a potent inhibitor of the cytochrome P450 family of enzymes.

Continued research is essential to furthering our understanding of how CBD affects the canine body. As with any medication, consult your veterinarian before treating your dog with CBD.

Carprofen for Dogs – August 2022

Carprofen is a type of nonsteroidal anti-inflammatory drug (NSAID) that is used to treat pain and inflammation in dogs. It is also classified under the propionic acid class, which includes other medications like ibuprofen, naproxen, and ketoprofen (13 ).

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The use of Carprofen in dogs has not been approved by the United States Food and Drug Administration (FDA). According to the U.S. FDA, NSAIDs manage symptoms of arthritis such as inflammation, swelling, stiffness, and joint pain (14 ) .

NSAIDs are also used to treat osteoarthritis in dogs and even post-surgical pain, particularly pain from orthopedic surgeries and soft tissue procedures (15 ) .

Carprofen is an active ingredient that is marketed under various brand names, including Rimadyl , Zinecarp, Canidryl, Aventicarp, Rycarfa, Rimifin, Carpox, Tergive, Carprodyl, Carprieve, Norocarp, Novox, Quellin, Rovera, Vetprofen, and Levafen. (16 )

How Does Carprofen Work?

According to Dr. Wendy Brooks, DVM, DABVP, an enzyme called cyclooxygenase (COX) 2 produces prostaglandins that cause pain and inflammation (17 ) . Its counterpart cyclooxygenase (COX) 1 meanwhile makes prostaglandins that are essential to the gastrointestinal and renal functions of mammals (18 ) .

Most NSAIDs, such as aspirin , inhibit both COX enzymes; but in animals, it is ideal that the drug administered to them inhibits COX-2 but not COX-1 (19 ) . Carprofen has been dubbed as a COX-preferential NSAID because it can manage pain and inflammation without affecting the COX-1 enzyme and its benefits.

A study in 1998 was conducted on canines to evaluate which NSAID was more selective in inhibiting COX-2. The study found that Carprofen was the most potent inhibitor of the enzyme (20 ) , therefore more effective and beneficial to dogs.

Why was Carprofen Developed?

In 1983, Carprofen was initially launched in the market for human use; but due to commercial reasons, it was withdrawn 10 years later (21 ) .

Carprofen was relaunched in 1993 as an anti-arthritic medication for dogs.

It has been used since, because compared to other NSAIDs, Carprofen has proven to be one of the safer alternatives. A study in 1997 concluded that Carprofen was safer to use in dogs. The study also outlined its anti-inflammatory, analgesic, and antipyretic properties (22 ) .

Meloxicam is another medication that is as effective in treating pain in dogs post-surgery sans the more severe side effects (23 ) .

Dr. Wendy Brooks, DVM, DABVP wrote about NSAIDs and their side effects that could be detrimental to animal health. Possible side effects that can escalate and become adverse reactions include the following (24 ) :

  • Stomach ulceration – this can sometimes lead to perforation and rupture of the stomach, which can be fatal.
  • Platelet deactivation – if the pet experiences bleeding disorders, the bleeding may become uncontrollable as platelets are responsible for blood clotting.
  • Decreased kidney blood supply – this could result in kidney problems or even kidney failure.

Veterinary medicine needed an NSAID that could relieve pain and inflammation sans the adverse effects; hence, Carprofen use was recommended. It was ideal for long-term use in dogs that require pain relief.

It is important to note that the U.S. FDA has approved Carprofen use in dogs, but not in other animals. Brooks advises against administering Carprofen to cats, as felines are more sensitive to the side effects of NSAIDs compared to canines.

Carprofen Dosage for Dogs

The recommended dosage of Carprofen for dogs is 4.4 mg per kilogram of the dog’s body weight daily (25 ) .

Carprofen has different dosage forms. In the United States (U.S.), Carprofen caplets and chewable tablet formulations are available. Injectable solutions are also an option in the U.S. and European markets.

The usual practice is oral administration of Carprofen in tablet form to dogs. It is recommended that pet owners should administer the drug to their pets with food to lessen the risks of a stomach upset (26 ) .

The medication usually takes effect in one to two hours.

Carprofen should be stored at room temperature, between 59°F and 86°F (15°C and 30°C).

Carprofen Drug Interactions

Carprofen should not be taken with other NSAIDs. These include aspirin, deracoxib, etodolac, firocoxib, meloxicam, and tepoxalin. It should also not be administered with steroids, such as cortisone, dexamethasone, prednisone, and triamcinolone (27 ) .

Carprofen should be used with caution if the dog is also taking the following (28 ) :

  • Anticoagulants
  • ACE inhibitors (for heart and blood pressure conditions)
  • Nephrotoxic medications (kidney-damaging drugs like cyclosporine)
  • Dacarbazine
  • Dactinomycin
  • Desmopressin
  • Digoxin
  • Dinoprost
  • Highly protein-bound medications
  • Insulin
  • Oral antidiabetics
  • Loop diuretics
  • Methotrexate
  • Tricyclic antidepressants

Side Effects of Carprofen in Dogs

Potential side effects of Carprofen are usually related to the gastrointestinal tract, such as (29 ) :

  • Vomiting
  • Diarrhea
  • Ulcers
  • Constipation (30 )
  • Temporary lack of appetite
  • Tiredness

In the rare situation that liver and kidney side effects are observed on dogs, veterinarians highly recommend that these dogs should undergo blood work. Senior dogs and pets that are taking Carprofen long-term should also take blood tests so that experts can monitor their liver enzymes and kidney values.

More serious side effects include the following (31 ) :

  • Changes in appetite
  • Severe vomiting
  • Diarrhea
  • Black, bloody, or tarry stool (melena)
  • Behavioral changes (increased or decreased activity, sudden aggression, or restlessness)
  • Neurological symptoms (incoordination, paralysis, seizures, or disorientation) (32 )
  • Increased or decreased drinking
  • Urinary symptoms (increased urination and changes in color or smell of urine)
  • Dermatologic symptoms (scabs, itchiness, or redness)
  • Jaundice (yellowing of gums, skin, or whites of the eyes)
  • Allergic reactions (facial swelling or hives)
  • Hair loss

Other precautions before administering this pain medication to dogs (33 ) :

  • Do not administer Carprofen to dogs with low platelet counts or with bleeding disorders like Von Willebrand disease.
  • Carprofen should not be used on dogs allergic to the drug or NSAIDs from the same class. Dogs taking other NSAIDs or corticosteroids like prednisone should not use Carprofen, too.
  • Carprofen should be used with caution in puppies younger than six weeks of age, more senior, pregnant, or lactating dogs, dehydrated pets, or dogs with preexisting conditions like liver, heart, gastrointestinal, and kidney diseases.
  • The drug also affects bone healing, so it should be used with caution in pets that have undergone bone surgery or have bone injuries.
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The Pfizer Lawsuit

Rimadyl (Carprofen’s brand name) has had many controversies since Pfizer launched it in 1997.

According to The Wall Street Journal (34 ) , Rimadyl’s launch campaign was accompanied by television commercials promoting the use of the drug in dogs. These T.V. spots were removed because of several complaints, including the death of Montana, a Siberian husky.

Upon the prescription of a veterinarian, Angela Giglio gave her dog Montana Rimadyl, to alleviate her pet’s stiff back legs. Initially, the drug worked, but Montana started going limp, wobbling, vomiting, and experiencing seizures. Eventually, Montana had to be put to sleep.

Giglio filed a complaint against Pfizer. As compensation, Pfizer offered Giglio $440 “as a gesture of goodwill.” Giglio flatly refused.

Pet parents Christopher Cooper and Shelley Smith had also filed a lawsuit against Pfizer when their golden retriever Sophie died because of Rimadyl use (35 ) .

According to the lawsuit, Sophie had undergone surgery for a ruptured cranial cruciate ligament and was prescribed several medications, including Rimadyl. After 11 days, the dog started “experiencing symptoms described by two Pfizer veterinarians as Rimadyl toxicity.”

Sophie was hospitalized for 13 days. Even when the dog was released, she continued to suffer. On July 26, 2009, Sophie died from severe liver degradation. These events propelled the couple to file a lawsuit against Pfizer.

The lawsuit accused the pharmaceutical giant of negligence because they had not informed pet owners of the risks that come with Rimadyl use.

In 2013, Pfizer settled the lawsuit.

Natural Alternatives to Carprofen for Dogs

Instead of taking their chances on NSAID therapy and its risks, some dog owners are resorting to natural alternatives to reduce their pet’s osteoarthritis and postoperative pain.

Natural Herbs and Dogs

According to an extensive report on veterinary herbal medicine (36 ) , some plants have anti-inflammatory properties that are beneficial in treating osteoarthritis. These include Boswellia and Arnica.

When applied topically, Capsicum (known as pepper) helps treat osteoarthritis and other illnesses like rheumatoid arthritis, peripheral neuropathies, and fibromyalgia.

Another herb called Guggul helps in reducing pain and stiffness and improves function in patients with osteoarthritis of the knee.

Acupuncture and Dogs

Veterinarians are also prescribing acupuncture as a possible alternative for control of postoperative pain and alleviation of the clinical signs of osteoarthritis.

Acupuncture originates from ancient Chinese practices. It helps the body heal by correcting its energy imbalances. The practice involves inserting fine needles into “acupuncture points” in a dog’s body where nerves and blood vessels converge (37 ) .

Dr. Lynn Buzhardt, DVM says acupuncture improves blood flow and relaxes the muscles where the needles have been inserted as well as other muscles in the dog’s body. She adds that acupuncture stimulates the release of pain-relieving and anti-inflammatory substances that are innate in the body.

Buzhardt believes that acupuncture’s most significant advantage is that it does not have systemic side effects, unlike most anti-inflammatory and pain medications.

CBD Oil and Dogs

CBD’s Therapeutic Effects

Another alternative worth exploring for the relief of pain from dog osteoarthritis and surgery is cannabidiol (CBD).

CBD, the nonpsychoactive component of cannabis plants, has anti-inflammatory properties that may benefit dogs that have osteoarthritis and other painful conditions.

A study in 2018 conducted on dogs with osteoarthritis found that CBD oil helps increase comfort and activity level in the test subjects. Long-term studies have yet to be conducted, but the researchers reported that “short-term effects appear to be positive” (38 ) .

Colorado State University’s Dr. Stephanie McGrath, DVM, Ph.D., together with her team, has also conducted clinical trials on CBD’s effectiveness in treating dog osteoarthritis; the report has not been published yet.

Several studies conducted on rats have likewise proven CBD’s anti-arthritic properties. A study in 2000 outlines CBD’s immunosuppressive and anti-inflammatory actions that have helped treat arthritis in the mice test subjects (39 ) .

A 2016 study, also on rats, reported that topically administered CBD helped relieve arthritis, pain-related behaviors, and inflammation sans observable side effects (40 ) .

Researchers have also found that CBD may help prevent further development of osteoarthritis pain and joint neuropathy (41 ) .

A 2017 study has also shown that CBD has promising therapeutic effects on postoperative pain, another condition that Carprofen relieves. CBD helps in pain suppression by reducing the distress that comes with pain (42 ) .

Even if the studies cited were conducted on rats, all animals except insects have an endocannabinoid system (ECS) that works the same way (43 ) . Therefore, if CBD is found to be beneficial on rats, it is suggested that it can be as effective on dogs and humans, too.

The ECS is the system that regulates the functions of cannabinoids in the body, particularly those that affect mood, pain reception, and the immune system.

Choosing the Right CBD Products for Dogs

CBD comes in many forms. It may be administered to dogs as a pet tincture (drops) through massages or by combining the oil with pet food or treats . Topical CBD is also available (CBD hemp oil, creams, salve, or balms).

The American Kennel Club (AKC) says that the best CBD format to administer to dogs is CBD in liquid form (44 ) , so pet owners can adjust the dose by drops.

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A study in 2018 (45 ) compared the effects of CBD given in different formats to healthy dogs. The researchers administered the CBD products as oral microencapsulated oil beads, oral CBD-infused oil, and CBD-infused transdermal cream.

Among the three CBD formulations, the researchers recommended oral CBD-infused oil because they found that it had the most favorable pharmacokinetic profile.

Pharmacokinetics is the movement of a drug into, through, and out of the body. It is influenced by patient-related factors and the drug’s chemical composition (46 ) .

CBD for veterinary use has not been approved by the U.S. Food and Drug Administration, but in the 2018 study on dogs with osteoarthritis, a full-spectrum CBD product was used (47 ) .

Full-spectrum CBD products make use of the whole cannabis plant to achieve an “entourage effect.” This phenomenon happens when all the active ingredients synergize to get the maximum therapeutic benefits from the plant.

Other CBD types are broad-spectrum and CBD isolate. Unlike full-spectrum CBD, these two other types do not make use of tetrahydrocannabinol (THC), the psychoactive component of the cannabis plant.

Broad-spectrum CBD is made of cannabidiol and terpenes, the compounds that provide the plant its distinctive aromas and flavors.

CBD isolate is derived from pure cannabidiol.

Before purchasing a CBD product, dog owners should check if the product’s batch reports are accessible. These are lab analyses (certificate of analysis) from third-party sources verifying the contents of a product.

A study conducted in 2018 revealed that in the 84 CBD products that the researchers reviewed, 26% contained less CBD than labeled, 43% contained more CBD than what the label declared, and 21% had THC concentrations high enough to intoxicate children (48 ) .

Pet owners should be cautious when purchasing CBD products.

Dog owners should also ensure that the product they are looking to buy is certified organic and has undergone Current Good Manufacturing Process (CGMP) regulations.

Pet parents should also ascertain that the CBD product has no contaminants like heavy metals or pesticides.

CBD Dosage for Dogs

There is no standard CBD dosing chart for dogs, but the recommendation is to begin dosing pets with small amounts of CBD; if there are no adverse effects, the dosage may be gradually increased.

The researchers of the 2018 study gave a CBD dosage of 2 mg per kilogram of the dog’s body weight to help increase comfort and activity levels in dogs with osteoarthritis. CBD oil was administered to the test subjects twice daily for one month (49 ) .

CBD also has side effects on canines; these include dry mouth, lowered blood pressure, and drowsiness (50 ) .

Before using CBD for pain management in dogs, pet owners should inform their veterinarian first.

U.S. veterinarians cannot prescribe CBD to their patients. They are also not allowed to instruct or encourage the usage of CBD products; however, they can be consulted by pet owners if the pet parents have devised their treatment for their dog (51 ) .

It is best to consult with veterinarians who have experience with CBD.

Conclusion

Carprofen is a nonsteroidal anti-inflammatory drug (NSAID). Its use in dogs has been approved by the U.S. Food and Drug Administration (FDA), particularly in treating canine osteoarthritis and post-surgical pain.

Initially, it was developed for humans but was discontinued because of commercial reasons. It was relaunched and marketed to treat arthritis in canines.

The U.S. FDA has not approved its use in other animals. Its use in cats is not advised because they are more sensitive to the side effects of NSAIDs compared to dogs.

Among the other NSAIDs, Carprofen is one of the safer ones. Typical side effects are usually related to gastrointestinal conditions, including vomiting, diarrhea, ulcers, constipation, temporary lack of appetite, and tiredness.

Carprofen is in the market under several brand names, one of which is Pfizer’s Rimadyl. Launched in 1997, the Rimadyl brand became controversial as several dog owners have complained of its effects that have led to the death of some dogs who have taken the drug.

Some of Carprofen’s potential side effects can be detrimental to a dog’s health. The most adverse reactions include black, bloody, or tarry stool, behavioral changes such as sudden aggression, neurological conditions like seizures, changes in a dog’s urinary pattern, dermatologic symptoms, and allergic reactions like itchiness and hives.

In treating pain-related dog conditions like osteoarthritis, pet owners are turning to natural alternatives. Herbs such as Boswellia, Arnica, Capsicum (more known as pepper), and Guggul have anti-inflammatory properties and other benefits that aid in the treatment of pain conditions in canines.

Veterinarians also recommend acupuncture as a natural remedy to osteoarthritis.

CBD oil is a natural alternative to Carprofen that is safer than the drug and other NSAIDs, and useful in treating the clinical signs of osteoarthritis.

Several studies conducted mostly on rats have proven that CBD has potential therapeutic and anti-arthritic benefits. However, the U.S. FDA has not approved its use in pets.

CBD’s anti-inflammatory and immunosuppressive properties make it a natural alternative worth exploring. It is available in different formats, but a liquid formulation in the oil or tincture form is more recommended for dogs.

Liquid CBD makes it easier for pet owners to adjust their dog’s dosage.

Before adding CBD to their canine’s osteoarthritis or postoperative pain medication regimen, pet owners should always consult with their veterinarian first.

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