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Think Twice Before Using NSAIDS – A Must Read Article!

As many as 60,000 Dogs have reportedly been killed by taking NSAIDS. Yet many other Dogs have no complications from NSAIDS. We experienced serious complications giving Previcox [an NSAID] to our Golden Pasha 18 months ago. Had we not become aware right away that she had stopped eating and drinking after taking the drug, thus suspending the administration of the drug immediately, Pasha may not still be here today. Our former vet never mentioned the dangers of giving NSAIDS to our Dog, and even argued with us about the risks of Rimadyl, of which we were aware. This vet assured us that Previcox was SAFE (I add: “as long as you don’t take it out of the bottle”). At Posh Dog Knee Brace, we want to presont the risks that exist in Dogs taking NSAIDS.

NSAIDS are commonly prescribed for Dogs suffering from CCL injuries. At Posh Dog Knee Brace, we make high quality Dog knee braces for Dogs with knee injuries, but we also feel compelled to provide information that will protect Dog from other harms.

As a public service, we are re-publishing this excellent and informative article from this site: Dogs Naturally Magazine This is a site and publication we strongly advise Dog parents to read regularly.


You’re almost certainly familiar with the names of Non Steroidal Anti-Inflammatory Drugs (NSAIDs) like Rimadyl, Metacam, Deramaxx and Previcox. These drugs are frequently prescribed by veterinarians to manage inflammation and pain, not only for long term disease like arthritis, but also for injuries and other acute conditions. At some point during your dog’s life, your vet may recommend NSAIDs. But the vet may not tell you about the risks associated with these drugs – information you need to make an educated decision about your dog’s care.

How NSAIDs work NSAIDs work by inhibiting the production of prostaglandins.1

Prostaglandins are made from fatty acids in every cell of the body. There are many different types of prostaglandins in the body and their main job is to mediate inflammation. When tissue damage occurs, an enzyme system converts arachidonic acid to prostaglandins. This conversion is called cyclooxygenase and there are two types: cox 1 and cox 2.2 NSAIDs are designed to inhibit cox 1, cox 2 or both.

Cox 1 functions of prostaglandins are to:

  • promote blood vessel constriction and platelet clotting when needed
  • inhibit stomach acid production and promote gastrointestinal mucus secretion to protect the gut lining
  • increase blood flow to the kidneys

Cox 2 functions include:

  • activating an inflammatory response with pain and fever
  • inhibiting blood vessel constriction and platelet clotting when clotting is not needed

Manufacturers try to produce NSAIDs that inhibit cox 2 more than cox 1. Carprofen (the active ingredient in Rimadyl) has been shown to do this in vitro (i.e., not in a live animal). 1 Aspirin inhibits both. This is why aspirin is said to thin the blood and can cause stomach ulcers.

This might be okay if you’re trying to prevent blood clots and stroke. This isn’t so good if your dog is taking aspirin for arthritis and then goes to the vet for a dental extraction, during which the bleeding can’t be stopped.

What the experts say Dr Colin Burrows, an internal medicine specialist at the University of Florida College of Veterinary Medicine, states: “Aspirin and other NSAIDs frequently cause gastritis or peptic ulcers and should be avoided unless absolutely necessary. NSAIDs designated for human use, such as ibuprofen…, should never be used in dogs or cats. These drugs cause severe, frequently fatal gastric and intestinal ulceration.” 

The manufacturers of Metacam explain, “As a class, cyclooxygenase inhibitory NSAIDs may be associated with gastrointestinal (gut), renal (kidney), hepatic (liver) toxicity…Dogs that have experienced adverse reactions from one NSAID may experience adverse reactions from another NSAID. Serious adverse reactions associated with this drug class can occur without warning and in rare situations result in death.” 

Kidney specialist Dr Gregory F Grauer warns that “dogs of advanced age, those with subclinical kidney disease, or on concurrent medications such as furosemide”(a diuretic) are at an increased risk for kidney damage when an NSAID is added to their treatment protocol.

Idiosyncratic reactions (meaning the cause is unknown) can occur with any NSAID use. Some dogs may be more prone to reaction due to genetic predisposition.

The reported incidence of liver disease from carprofen use is only 0.05 percent of dogs treated. Interestingly, carprofen is primarily metabolized in the liver. But not all reactions are reported, so that number might be understated.

Regardless of the percentages, a reaction doesn’t feel so rare when it affects your pet! I’ve seen a distraught pet owner who learns her dog has irreversible dry eye due to a course of the NSAID etodolac (Etogesic) and the anger of another whose pet suffers from kidney disease caused by deracoxib (Deramaxx).

And even worse, in most cases, dog owners are not forewarned of these dire side effects.

What to watch for If your dog is taking NSAIDs, you should monitor your dog for vomiting, blood in the vomit, black stool, blood in the stool, loss of appetite, grinding of the teeth, lethargy and, if blood work is performed, anemia or low protein in the blood due to blood loss through the gastrointestinal tract.

Benefits versus risks Dr Wesley Roach and Dr Spencer Johnson from the College of Veterinary Medicine at the University of Georgia concur that NSAIDs should be used for the management of osteoarthritis. In addition they recommend chondroprotective agents such as injectable polysulfated glycosaminoglycans, oral glucosamine, chondroitin sulphate, hyaluron, opioids-such as butorphanol or Tramadol, and even acupuncture. They emphasize nutrition and low impact exercise (such as swimming) for weight control. Disease will progress despite these therapies, they say.

The reason all these therapies are still recommended for maintenance, even with NSAID use, is because NSAIDs are not effective in improving joint health and, not surprisingly, they even damage joint health.

Two placebo-controlled masked studies on Metacam using 277 dogs demonstrated statistically significant improvement in all measured parameters in the first study and only in two parameters in the second study. All parameters were based on subjective evaluation of improvement only.

Making arthritis worse? According to Dr Ross Hauser, “one of the most serious adverse reactions to NSAIDs, that is little appreciated, is that as a class of compounds they cause the breakdown of articular cartilage, thereby accelerating osteoarthritis, the very disease for which they are most commonly prescribed! The pathogenesis of osteoarthritis is accelerated by NSAIDs.” 

Even the authors of the esteemed Small Animal Surgery textbook assert, “Most NSAIDs interfere with chondrocyte (cartilage cells) glycosaminoglycan synthesis and therefore should be used continuously only for a short time.” They suggest chondroprotective food additives, which may decrease joint inflammation. The same authors suggest gastroprotective medications alongside NSAIDs.

It’s hard not to conclude that the risks outweigh the benefits of NSAIDs, especially when there are natural options that can be just as effective.

The body’s ability to heal Sometimes we forget how good the body is at doing what it’s meant to do. The best approach to medicine is often not to interfere with the body’s natural processes. The concept of hormesis embraces this fact and teaches us that a little stress is something that helps the body to repair and strengthen. Dog licking paws and lick granuloma solutions at http://www.doglickingpaws.com.

Inflammation is a natural, protective, physiologic mechanism that’s necessary to stimulate the body’s healing processes. Inflammation is aptly derived from the Latin word meaning fire. Anyone who has experienced significant inflammation understands how the redness, swelling and pain of the inflammatory process feels like the burn of a flame on the skin.

It’s the acute (short lived) pain of inflammation that forces us to stop the insult to the tissue, which then allows the healing process to begin. If you touch a hot stove, the burn will only begin to heal once you remove your hand from the stove. If you touched the stove and didn’t feel any pain, your hand would suffer considerable burning and damage. But the sensation of pain is a deeply ingrained trigger within the body to quickly protect it from harm.

The longer term pain of chronic inflammation is more difficult to manage than just removing your hand from the hot stove. Inflammation becomes chronic because the cause of the body’s inflammatory response is persistently present. For example, a sliver or an intestinal foreign body will stimulate inflammatory cells to attempt to expel the invader until it’s removed.

So pain and inflammation would seem like a good thing for the body. Yet conventional medicine says we should suppress inflammation – I guess, because it hurts. Fortunately, there are other options.

Alternatives to NSAIDs

There are several natural treatment alternatives that have been shown to relieve discomfort in dogs without the deleterious side effects of NSAIDs.

Zeel* A small double blinded study of dogs with moderate to severe osteoarthritis showed that dogs receiving the homeopathic blend Zeel® (made by Heel) for eight weeks had significantly less pain than their placebo peers, although carprofen was more effective. Homeopathy as a treatment is often seen as elusive and controversial, but considerably safer than an NSAID. This study warrants respect and further investigation.

In addition, two homeopathic remedies were found to inhibit leucocyte elastase activity in an in vitro study. Leucocyte elastase is an enzyme that’s released during an inflammatory response and damages articular cartilage. Arnica montana inhibited this enzyme activity by up to 70 percent. Similarly, Rhus toxicodendron inhibited the leucocyte elastase up to 77 percent. Less cartilage damage means less pain for your dog. Both of these remedies are contained in the Zeel complex.

These findings help scientists understand and accept the validity of homeopathic medicines. The more mainstream our natural treatments become, the more our animals will benefit.

Traumeel* From the same parent company Heel, comes Traumeel®. Made popular among humans who find it to be effective, many holistic veterinary practitioners and rehab specialists use this blend for dogs and cats. Zeel is most often recommended for osteoarthritic conditions while Traumeel is for soft tissue injuries. Each comes in tablet or injectable form.

*Note: Heel has exited the US and Canadian markets and Heel Inc. has been sold to MediNatura Inc. Effective January 1st, 2015, Zeel and Traumeel will be replaced by MediNatura products T-Relief Arthritis and T-Relief, respectively. These products will be available in the same dosage forms and sizes as Traumeel and Zeel.

Corydalis This Chinese herb is a natural anti-inflammatory can replace or avoid many NSAID prescriptions. It’s especially interesting to note that corydalis is an analgesic that actually protects the GI tract. In a large sample of patients with stomach and intestinal ulcers or chronic inflammation of the stomach lining, corydalis improved healing and symptoms in 76percent of the patients. A constituent of the herb called THP (tetrahydropalmatine) reduced nerve pain in 78percent of human patients tested in a 1990 study. Sedation and anticonvulsant effects are other indications for this herb. The species used is Corydalis yanhusuo, a native to the northern Chinese province of Zhejiang.

California Poppy When mild sedation is desirable in addition to pain management, California poppy comes to the rescue! Clients who prefer to avoid NSAIDs for post-operative pain have been happy with their pet’s pain management when California poppy is prescribed. It contains small amounts of morphine and has analgesic effects that have been demonstrated in studies.

Boswellia is also an effective anti-inflammatory and is often used by migraine sufferers to manage their pain. Pet owners report their animals need less or no NSAIDs when they use Standard Process Boswellia Complex twice daily for their large breed dogs with osteoarthritis.

In a clinical trial with Boswellia serrata (BSB108, product of Bogar AG) 71percent of dogs with degenerative conditions showed improvement. A potential mechanism for this efficacy is due to the presence of boswellic acids in the herb, which have been shown to reduce inflammatory cell infiltrates.

Quality and therefore efficacy can vary substantially among herbs and other natural supplements. This is why I recommend Standard Process Boswellia.

Arnica My experience with Arnica is with the herbal liniment from Buck Mountain Botanicals. This provided amazing relief for a Labrador Retriever with severe neurologic pain. When NSAIDs, Tramadol, and gabapentin did nothing, this old fashioned topical massaged on to the affected area brought immediate and long lasting relief. While homeopathic preparations of Arnica are extremely safe, Arnica the herb when taken orally is extremely toxic, so licking must be prevented! Some active constituents in Arnica are the sesquiterpene lactones. Sesquiterpenes are a chemical class of constituents present in many herbals and essential oils.

Copaiba/Wintergreen/Peppermint Don’t underestimate the hot/cold relief you can give your dog with the essential oils, copaiba, wintergreen and peppermint. Massage these oils onto the affected area but save one drop of peppermint for last; peppermint is a potent oil that drives the others in deeper.

Copaiba is extremely high in beta-caryophyllene, a potent anti-inflammatory. Copaiba is a resin tapped directly from a Brazilian tree and not distilled. It is generally regarded as safe and may be taken orally or topically for arthritis. Wintergreen contains methyl salicylate, which is anti-inflammatory and analgesic when used for conditions such as arthritis, muscle and nerve pain.10

I use all three of these oils topically for almost all of my canine patients who have spondylosis, disc disease or osteoarthritis.

You may recognize salicylate or salicylic acid as the chemical constituent in aspirin. The chemical balance present in herbs and most essential oils is what helps prevent the side effects that commonly occur in the drug counterpart.

Natural products in the form that nature intended are usually the safest and most effective approach to controlling chronic inflammatory disorders, just as they have been historically. In fact, most medical discoveries began with a study of historical uses of plants as traditional remedies.

The plants begin to get more dangerous when their chemicals are isolated. Noted herbalist Greg Tilford once told me, “Don’t ever forget, the whole herb is always greater than the sum of its parts.” Surely this is especially true when we’re discussing safety. Natural remedies tend to facilitate the body’s innate ability to change or balance itself, while drugs tend to force the body into change.

Many natural approaches can be used simultaneously. They can also be used in conjunction with laser therapy, massage or acupuncture. Most work synergistically while some would be best alternated, especially the energy medicines.

All these natural options to pain and inflammation merit further investigation. Both double blind studies and massive amounts of anecdotal evidence are making a case for natural solutions. Pet owners have the right to be informed and to make educated decisions regarding how to best manage their best friend’s care.


  1. Plumb’s Veterinary Drug Handbook Plumb 2008
  2. Virtual Chembook Elmhurst College Ophardt 2003
  3. Clinical Medicine of the Dog and Cat Iowa State Press Schaer 2003
  4. Metacam insert, Boehringer Ingelheim Vetmedica, Inc.7/2010
  5. Clinical Veterinary Advisor Second Edition Cote 2011
  6. Journal of Prolotherapy Volume 2 Issue 1 February 2010
  7. Small Animal Surgery Mosby Fossum 1997 p.945
  8. Evidence-based Complementary and Alternative Medicine 2009 December (6) 4, 465-471
  9. Veterinary Herbal Medicine Wynn and Fougere 2007
  10. Essential Oils Desk Reference Fourth Edition 2009

Posted for anyone who is investigating using a dog knee brace, or dog stifle brace, as an alternative to TPLO, TTA or other CCL knee surgeries for Dogs.

SUPPLEMENTS: Pashas Daily Dog CCL Injury Supplements

We are the only Dog knee brace site who offers advice and tips on holistic and homeopathic supplements. We believe in natural healing. We use and  recommend the following products. We do not get paid from any of these companies, who do not even know we recommend their products. We are not part of any affiliate program. We have included links for your convenience, but feel free to look into other companies who sell the same products. As with all the content of this website, it is not to be construed as medical advice in any form. If you seek medical advice, consult with a veterinarian.

In addition to wearing a Dog Knee Brace for a K9 torn knee ligament, Pasha is given a daily “cocktail” of high quality supplements which support healing, accelerate tissue repair, and help alleviate pain and inflammation in her injured knee. We use a mix of supplements, including Nupro Silver for Dogs with CCL or ACL Injuries. Nupro Silver is a fabulous, high quality nutritional complex supplement which contains glucosamine, kelp, shark cartilage, MSM and other ingredients which can help your Dog recover from a ligament injury along with a Dog stifle brace, exercise, and conservative management.

You can get Nupro Silver online.

Ever since Pasha suffered a complete rupture of the Cranial Cruciate Ligament (CCL) in her left hind leg in 2013, part of her recovery has included a special, yet simple, daily “bone juice” which we give our 72 lb. Golden. She gets this once every AM and then the rest of her food throughout the day. (She fully recovered from her complete rupture over 14 months ago and no longer wears her Posh Dog Knee Brace).

Wearing a Dog knee brace for a canine CCL injury is just one part of the holistic approach and solution for a Dog ACL knee injury. Here is our recipe which we feed our 62 lb. girl daily:

  • 1 1/2  scoops of Nupro Silver powder
  • 1 chewable wafer containing MSM / marine derived glucosamine / 600 mg Green Lipped Sea Mussel – We used to list the company, but they refused to reciprocate with us, so we no longer promote them. 
  • 3 Squirts of Wild Alaskan Salmon oil
  • 4 oz DECAF green tea
  • 750 mg Olive Leaf Extract for arthritis, inflammation & MANY other health benefits.
  • 1 crushed tumeric pill (450 mg – 95% curcuminoids + black pepper for increased bioavailibility) . Get a formula with both pepper  & 95% curcuminoids.
  • 1 Green lipped mussel capsule by www.FoodScienceOfVermont.com  (Not needed if you do not buy the Glyco Flex, which has 600 mg of green lipped sea mussel)
  • 1 tsp of Spirulina powder from www.NowFoods.com Read these great two articles about Spirulina for Dogs: http://www.dogsnaturallymagazine.com/benefits-of-spirulina/ AND this one: http://www.dogsnaturallymagazine.com/is-it-safe-to-give-dogs-spirulina/
  • Boswellia Extract – We buy from NowFoods.com
  • (For pain) White Willow Bark (natural aspirin) with pineapple bromelaine.

We buy the Nupro Silver from www.USBones.com. It comes in various sizes. This outstanding nutritional supplement for joint and connective tissue health contains glucosamine, sea kelp, shark cartilage and other beneficial ingredients!

When combining Nupro Silver with Glyco-Flex 3, be sure not to exceed the ingredients, as there is ingredient redundancy in these products.

The Alaskan wild salmon oil offers a high concentration of Omega-3 essential fatty acids and in more effective concentrations and higher quality than traditional fish oil.

Shop around for the spirulina, green lipped mussel, and tumeric to get the best pricing.

Some credible websites recommend UP TO 500 MG of glucosamine per 25 pounds of body weight. It may be a good idea to gradually build up to the appropriate dosage over a few weeks. Please read the entire article, particularly the section about contraindications. BTW this site has lots of truthful and outstanding articles about Dog Health – a must read!

We give our Golden baby 4 oz of DECAF green tea in her bone juice, since it is so beneficial for preventing cancer and overall health, BUT it MUST be decaf – caffeine can be very dangerous for Dogs! BTW check back soon for tips on avoiding and treating cancer in Dogs.

Remember that helping a Dog recover from a partial or complete rupture of the ACL involves more than just a well-built custom Dog knee brace or Dog stifle brace for a canine knee injury from Posh Dog Knee Brace, it also involves nutritional supplements and conservative management! Look for our upcoming blog about this.

Wishing your Dog a long, healthy and fulfilled life! Give your beautiful Dog a BIG hug from all of us at PoshDogKneeBrace.com!

Update # 1: In addition to giving Pasha DECAF [caffeine will harm Dogs!] green tea each day as an anti-cancer measure, we’ve also added a daily capsule of medicinal mushrooms: Reishe, Maitake and Shiitake mushrooms. Even though Pasha does not have cancer, given her age, we are introducing herbs and other confirmed, safe, anti-cancer agents to her daily routine. 

We learned about this amazing mushroom mixture, used by Eastern (real) doctors for many centuries, at AnimalWellnessMagazine.com, a fabulous magazine that promotes REAL heath, and NOT big-pharma, 100% profit-based “health” in Dogs! 

Update # 2: Although she presents with no symptoms of cancer or malignancies, and as apreventative measure, and after spending >> hundreds << of hours researching confirmed alternative and authentic treatments for cancer (many say cures), each day we give Pasha 6 crushed, raw, unpasteurized apricot kernels which we buy from ApricotPower.com These MUST be unpasteurized seeds, since pasteurization removes most nutrients from any food. Just search LongLivingPets.com to learn more, or search “laetrile cures cancer”. Apricot seeds have a very high density of naturally occurring laetrile.

Update #3:  Now That Pasha is 13, she is no longer fond of mixing a lot of the foregoing supplements in decaf green tea. We now give her supplements wrapped (hidden) in fresh ground turkey “eggs,” i.e. Packed into about 2 tsp. of ground turkey. For the supplements in powder form, like the ground apricot seeds and Nupro Silver, we fill large gelatin capsules and wrap those with ground turkey. You can buy 500 large gelcaps on amazon for almost nothing.

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