Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) – These medications block inflammation. They are highly effective, but pets are more sensitive to these medications than people which is why you won’t find them available over counter (at least not safe/effective ones). They must be monitored by a veterinarian and used with caution because there is the potential for liver, kidney, stomach, and/or intestinal problems. We monitor for anemia and liver and kidney changes frequently. Despite these side effects, they are typically the most effective at allowing your pet to feel ready for that walk again.
Neuromodulators – This includes our most recent favorite medication gabapentin. Gabapentin works on blockage of the pain pathway. It is most effective when given long term, but I will use it occasionally “as needed” for patients. It has other effects that are nice, sometimes sedation, anti-anxiety, and it is a mild anti-seizure medication.
Opioids – This category is mostly used for acute pain post-op in the hospital but occasionally we will use hydrocodone or tramadol which is opioid-like for additional pain control. Unfortunately, tramadol has very wide responses in pets so we use it sparingly at this point.
Corticosteroids – Cortisone and synthetic cortisone-like drugs (prednisone, prednisolone, methylprednisolone, budesonide and dexamethasone) are strong anti-inflammatory medications. They are often used to reduce arthritic, allergic, or dermatologic discomfort. We also use them for neck pain when NSAIDs are less likely to be helpful. They are most commonly used for immunosuppression instead of pain, but do have pain relief as a side effect (along with a lot of other long term side effects, this medication is monitored closely).