Problems with Rimadyl?

Dr. Marie replied:

Hi Joe. I'm so sorry to hear that Ginger is having these problems.

I want to start first by talking about Rimadyl. Rimadyl does not cause paralysis. Just to be sure I just re-read the label insert of Rimadyl that I have in my office and paralysis or weakness is not a known side effect. I have put many, many animals on Rimadyl and have never seen one have neurological side effects.

I think the confusion may have come from this question about Rimadyl. The person asking this questions states that they have done research and found that wobbliness could be a side effect of Rimadyl. But this is not something that I have seen before.

So, I don't think that Rimadyl was a bad choice for Ginger.

The knuckling that you have described means that there is a problem with the nerve sensation going down to her foot. The radial nerve is often the culprit. When I see a dog with radial nerve paralysis the first thing I think of is inflammation in the neck. If the spinal cord is inflamed in the neck then this can sort of pinch the radial nerve and cause these issues.

If there is inflammation in the neck then usually a non steroidal anti-inflammatory drug such as Rimadyl will help. This is likely why you saw some improvement when you first started Rimadyl. But, it concerns me that the problem came back again.

The next step, as was done with Ginger would be to try a stronger anti-inflammatory drug such as prednisone. If these problems are simply because of inflammation in the neck then a course of prednisone will be really helpful and could even cure the problem.

However,if the problem is coming back or is not getting better then I get concerned about more serious issues. One of these issues could be if there was an intervertebral disc that was bulging. These discs are spongy pads between the bones in the back and neck. If one of them bulges it will push up on the spinal cord and cause neurological problems (i.e. the knuckling). Unfortunately if a bulging disc does not get better with an NSAID (Rimadyl) or a steroid (prednisone) then the only way to fix it is surgery. This surgery is difficult and needs to be done by a specialist and is quite expensive.

The next possibility for a cause of these nerve problems is a tumor either in the neck or somewhere along the leg. While sometimes we can remove these tumors with surgery, the procedure is very costly.

I wish I had better news for you. If you want to go further with figuring out what is going on you can talk to your vet about having an MRI done. This should give us a diagnosis. An MRI usually costs $1000 or more though.

It does sound like your vets are doing all of the same things I would. Again, I wish I had better news for you.

Dr. Marie.


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Dr. Marie replied:

Ah, now we're getting into an area that is indeed complicated. I'll see if I can summarize NSAID issues for you.

First of all, there are many NSAIDs out there for dogs - Rimadyl, Metacam, Deramaxx, Previcox and others. All of them are meant to help decrease inflammation. However, some dogs can have side effects with these drugs. Our goal is to use them when the benefits outweigh the risks.

The most common side effect is mild stomach upset - possibly with vomiting or diarrhea. This is not a big deal and stops once we stop the drugs. A more serious side effect would be stomach ulceration.

NSAIDS can also have some effects on the liver or the kidneys. In a healthy dog this is rare. But if a dog had an underlying condition then an NSAID could make it worse.

And then there are some dogs that can have what is called an idiosyncratic reaction to Rimadyl. It is really rare, but some dogs can suddenly go into liver failure after taking Rimadyl. When it first came out, this reaction was seen in several labs. We don't know if labs are more affected by Rimadyl. But, in my opinion, labs are a breed that commonly have arthritis and so I think more labs were put on rimadyl than other breeds. This side effect is why Rimadyl got a bit of a bad name. It is really rare though. In 12 years I have treated one dog who had serious liver issues because of Rimadyl. It is generally a good drug. Every drug has potential side effects.

Your vet will advise you on how to continue with medications, but it is important to know that you can't use Rimadyl and Prednisone at the same time. This will greatly increase the risk of stomach ulceration, liver issues or kidney problems. If your vet has her on both Rimadyl and Prednisone you may want to call them. Usually, in a situation like this the idea is to totally stop the Rimadyl and just use the prednisone.

Dr. Marie replied:

You're very welcome. Sorry for the delay this time - I was spaying a cat. :)

I personally don't think a splint would be a good idea. My experience with splints is that they can often cause more harm than good. It's really hard to get a splint to stay comfortably on a dog. It might be something I would consider temporarily if a dog had a minor fracture. But, it's not a treatment we usually use for the type of problem Ginger has.

Dr. Marie replied:

Some dogs can have side effects on prednisone. The most common is an increase in thirst and urination. Usually we start off at a high dose and then gradually lower the dose. As we lower the dose the side effects get less.

I'm not a huge fan of acupuncture. I have, however, seen dogs with back and neck problems do well with chiropractic care. If you do this though you need to make sure you see a chiropractor who is a veterinary chiropractor and not a human one as there are differences between the canine and human spine.