Sunday, May 04, 2008

Rimadyl: Relief From a Swollen Wallet

A reader of this blog has a dog with limber tail, a rare problem in some hard-working field dogs (mostly bird dogs such as labs and pointers).

Basically, the muscle at the base of the tail seems to inflame, and the tail is pulled down and held close to the body, rather than standing proud and held high, as is normal. It's unclear why this condition occurs.

Apparently this condition has happened to this dog before, and the owner has been advised to keep Rimadyl on hand and dose the dog for a day or two to ease the inflammation. Normally, the problem is self-correcting in a few days.

The question: Did I know a cheaper source of Rimadyl other than going to a vet? Rimadyl is pretty expensive, and a vet visit is an additional charge as well.

First of all, what is Rimadyl? Rimadyl is a non steroidal anti inflammatory drug (NSAID) called Carprophen.

Car-prophen. Look at that name closely. It it reminds you of the name of another drug -- Ibu-profen -- that is not an accident.

In fact, Ibuprofen (aka Motrin, Advil, Nuprin) is also a non steroidal anti inflammatory (NSAID), and Ibuprofen and Carprophen are chemically very similar. One is is Cox-1 drug (Ibuprofen), and the other is a Cox-2 drug (Rimadyl).

What's the difference between a Cox-1 and a Cox-2 drug? In the real world, not a damn thing unless you are taking the drug daily and for a very long period of time (i.e., more than 3 weeks of daily dosing).

Cox-2 drugs, such as Rimadyl, have NOT been shown to be more effective at alleviating pain than Cox-1 drugs such as Aspirin and Ibuprofen.

So, to put a point on it, almost all Rimadyl sales by veterinarians for short-term use are a rip-off; you could be using buffered children's Apirin or a low-dosage of Ibuprofen for a lot less money.

At the core of the scam you have drug company that has created a "me too" version of Ibuprofen that they sell through veterinarians. Veterinarians sell the drug at a big profit (more than 100 percent markup) and also create client dependency as folks have to come back in those cases where a recurring condition (like limber tail) might arise. The drug company makes a lot money, the veterinarian makes a lot of money, and you, the customer, are out of money.

Some veterinarians trying to protect the profit-and-dependency business model will protest that dogs "do not process Ibuprofen as well as Rimadyl."

Which is barely true. All NSAIDs are a little bit hard on the stomach (including Rimadyl), and while Cox-2 drugs are a little bit easier on the stomach than Cox-1 drugs (like Ibuprofen or Aspirin) the differences are minimal, and are essentially zero for short-term use (i.e. anything less than three weeks).

Nor are Cox-2 drugs completely safe. Cox-2 drugs like Vioxx, Celebrex and Bextra have all been implicated in heart attacks and strokes in humans, and Vioxx was pulled after it was implicated in killing perhaps as many as 20,000 people. Bextra too has been pulled from the market, and Rimadyl, once sold to humans, is now only sold for veterinary use, under the theory that dogs do not typically suffer from hypertension.

Will your veterinarian tell you all this? Not likely! You see, there is too much money to be made selling Rimadyl.

There is, of course, another factor at work. I call this the "Witch Doctor's burden."

If you've taken a dog to the vet, no matter what the reason, you are going to billed for an office visit, which is only fair: time is time. Around here, that office visit alone is going to cost you about $80.

Now, if the vet glances at your dog's ass, shrugs her shoulders, and says "Ibuprofen might help," you are really going to wonder what you have paid your money for.

Yet, if this same vet looks carefully at the tail, scrunches up her face, and says "What we seem to have here is a rare condition, found only in certain working dog breeds, and only in very active dogs. This is a temporal, breed-specific, idiopathic, neuro-muscular condition, and not the kind most vets see every day. But I have good news: I know what it is, and I have a prescription for a medicine. The medicine is not cheap, but I am pretty sure it will work."

Well! After that kind of stem-winding (what's it all mean?) , most patients are eager to write a check for another $50.00 ("is that all?"), and the vet is only too happy to oblige knowing that a dog with limber tail is likely to be in again for a prescription refill -- at which time perhaps a round of unnecessary vaccines, unnecessary blood work, and unnecessary teeth cleaning can be sold.

Now, if you simply "google" (this is now a verb) Ibuprofen and dogs, you will not find out what I have told you here unless you do a lot of reading and read very carefully. Instead, what you will find are a bunch of ninnies (some of who are vets trying to protect their price-gouging-and-dependency business plan), who say that short-term Ibuprofen use will rip up a dog's stomach and is even poisonous to dogs because it is so easy to overdose a dog.

Which is, of course, complete nonsense. Here are the facts:

  1. Ibuprofen will NOT damage your dog's stomach if given daily for any period under three weeks duration. In addition, Rimadyl may damage your dog's stomach if given for over three weeks duration. For long-term daily use (such as arthritis in an aged dog), Rimadyl may be better than Ibuprofen, but if money is a big issue, buffered children's aspirin is the way to go.

  2. ANY medicine is a poison if it is not given in the proper dosage. This is as true for Rimadyl and any Cox-2 drug as it is for Ibuprofen and any Cox-1 drug (such as Aspirin). In fact, the proper per-pound of dog dosage for Rimadyl is one-fourth to one-half that of Ibuprofen. Yes, yes, you have to give a smaller dose of Ibuprofen to a 20-pound dog than you do to 200-pound human, but that is true for ALL drugs!

To repeat: proper dosage is important for ALL medicines, and Ibuprofen is the same, in this regard, as everything else.

The proper dosage for Ibuprofen in a dog is 2 to 4 mg per pound of dog, every 12 hours.

For a 10-pound dog, that means 20 to 40 mg every 12 hours. For a 20-pound dog, that means 40 to 80 mg every 12 hours.

Do the math for your dog, based on weight, and buy chewable 50 mg Ibuprofen to make it simple. Split a tablet for a 10-pound dog, and give him the whole tablet if you have a 20-pound dog. Scale up the dosage, by weight, if your dog is larger. Start with lower-dosage; it will probably be enough.

If you prefer, you can go to your neighborhood pharmacy's children's health section, and get Ibuprofen for infants (it comes in a liquid with a syringe. A 50 mg dose is typically 1.25 ml (1 cc is the same as 1 ml, and there are 5 ml or 5 cc to a teaspoon), but read the packaging. The pharmacy will also have 100 mg tablets of Ibuprofen for young children, which can be split in half for a 20-pound dog (use a pill cutter).

You do not have to go with Ibuprofen. Another fine Cox-I drug is called Aspirin, and you can either buy buffered children's Aspirin at the local pharmacy, or you can pay a little more money and order "veterinary Aspirin" (Vetrin) , which is dosed at the rate of 8-12 mg per 1 lb. of dog body weight. Dose every 12 hours, as per Ibuprofen.

Finally, an end note: Never give any NSAID (not Rimadyl, not Ibuprofen, and not even Aspirin) to a cat. Cats and NSAIDs generally do not mix, even at low doses.


dr. hypercube said...

Some time ago a friend recommended ketoprophen (non prescrip Orudis) as a preferred anti-inflamatory. I can't find Orudis any more, but just out of curiosity - is there any real diff between ibuprophen and ketoprophen for dogs?

PBurns said...

No, there is no real difference other that dosage. 1mg per pound is the dose for Ketoprofen, but Ibuprofen is 2-4 mg per pound. As a general rule, I do not like to give pain meds to dog for regular surgical stuff (spay/neuter) or sprains, etc. as pain is how the dog knows not to exert itself on the limb. That said, there are time, and when those time are short-term (a week or two), Ibuprofen doses as noted, and Aspirin, dosed as noted, are as good as Rimadyl or Ketoprofen (which has been discontinued OTC in low dose and is not available only in a higher dose by prescription).


Arfpod said...

A long time ago, my hunting dog sprained his tail during a day at the beach, swimming in the surf...I have known many dogs with long tails that have suffered this affliction after spending a long time in the water- no great mystery! Two months ago my dog (now 12 years old) was favouring a front leg, the carpus seemed swollen, unstable and sore, so I rested it and iced it and finally took him to the vet after 3 days.
The vet charged 380 dollars for xrays, and said there was nothing wrong with his Carpus,but he indeed had arthritis in his shoulder. She then tried to sell me 3 different supplements and metacam (which I bought, although I knew in my heart that Merl has never had pain in his shoulder). I read up on the side effects of metacam, and decided at twelve years old, Merl doesn't need to begin stressing his liver/kidneys,on it. I kept giving him half an asa every 12 hours and treating it as a carpal joint sprain, which by symptoms made sense, coupled with Merl's boundingly active but aging nature. The vet phoned after 10 days to advise me Merllyn needed more metacam and that they wanted to do more tests. I refused to get these, because the vet completely ignored the obvious symptoms of a sprain in favour of more expensive and dangerous treatment for arthritis which could eventually lead to Merl's untimely demise.
Two weeks later, he was completely better, in spite of the non existent arthritis in his shoulder. Some vets are not much different than crooks!

Cassandra Was Right said...

My ten-year-old hound's tail is fine, but she does have arthritis in her hips. She started with 75 mg Rimadyl twice a day with meals and began moving better by the next day. The stuff is working great, but at a cost of about $1 per pill I'm willing to try something else. She will need something she can take every day for a long time; what alternatives to Rimadyl are there in such a case? (You are addressing most of your entry to short-term injuries)

PBurns said...

Rimadly and other Cox2s are supposed to be gentler on the stomach, but in fact it is not entirely clear if that is true. That said, for a very old dog, a $1 a day will not change your life. If I am wrong on that, you might look at buffered children's aspirin as I note, above.


kmp275 said...

I also want to point out that Rimadyl can be fatal to dogs. Many vets do not know the do a liver panel prior to dosing, and if my former vet had known this, my Sheltie would not have suffered a premature death from complete renal failure following Rimadyl therapy.

Anonymous said...

I have been telling my friends for years that for simple pain you can give your dog ibuprofen. Thanks for explaining it so well. I will forward your posting in future.
I also give them Pepto-Bismol for stomach upset. A country vet told me to do that.

CandF4YHWH said...

I was told my 3 year old dog had hip dysplasia and was given Rimadyl, it didn't seem to help her. After searching on the net I found a study where large doses of vitamin C were used, so I tried it. I don't remember the math but for her it worked out to 2,000 mg and I believe she was about 70#'s. After a couple of weeks she was doing so well it was amazing.

A couple of years later it flared again, and again the Vitamin C worked. As she aged she needed it as winter approached, but each time it seemed to work by stopping the cause of pain not just by covering it.

I highly recommend it to anyone trying to help their pet. It was also recommended to use the coated vitamin C so that it wouldn't upset the dog's tummy which I did.

Karen Workman said...

Thank You so very much for your service... never did trust the billion dollar vet industry

Shelived Bye DeNet said...

I'm impressed with how clear you've made the issue of the ability to have other options than just carprophen. I've been lining the pockets of our vet since the first of this year when our cocker spaniel, "Beau" tore both rear cruciate ligaments within 10 days of each other.
Horribly upset at the time, I went with the meds prescribed we've titrated the 2 meds down to only 12.5mg of tramadol from the 50mg per day over a 6 month period. Also, we're interchanging the A.M. dose of carprophen with about 55mg of ibuprophen for his approximate 35 pound body. His progress was steady by the third month Using an incredible brace by Ortho Dog(tm)for both hind legs and careful monitoring of the meds he's done GREAT. My question is, can I finally take him off of the last of the 12.5mg tramadol? Total cost for the 2 meds has been 130.00/month.
Thanks again, Paul for a WONDERFUL site helping us with our fur families.

Unknown said...

I have a 13-year-old Australian Shepherd mix who weighs 53 lb. She has arthritis in her front shoulder. My vet knows money is tight around here. The vet told me to give my dog two 325mg aspirin twice a day with food. He also said try to trim down her weight but I do not see that happening, she weighed 51 lb at an extremely healthy and active two.

leema said...

Nice post!

How long does it take for ibuprofen to kick in

Unknown said...

Thank you so much for this article. My daughter makes little money and you are a life saver, She was not going to let her dog suffer, so Rimadyl was really putting burden on her