rimadyl and liver problems for dog

cats.and.dogJanuary 7, 2012

Has anyone had an experience like this. I had my German Shepherd spayed on Tuesday. They gave me rimadyl to give for her pain. 2x daily 75 mg. On Friday she started throwing up clear bile and had no appetite. Took her to emergency and they said she was going through possible liver failure probably from the rim. Bloodwork done before her surgery by my vet showed no liver problems.

I would like to hear that somebody else had a positive outcome from this!

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"Took her to emergency and they said she was going through possible liver failure probably from the rim."

What kind of testing did they do to reach this conclusion?

    Bookmark   January 8, 2012 at 7:02AM
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No testing but since the blood work done right before her surgery- on the day of- showed normal levels and good liver function then it stands to reason that this drug is the culprit since it is the only thing she was taking. Since my last post her health has deteriorated. She is bleeding into her lungs.

If she is not improved by tonight I will have to consider putting her down. Also, this drug rimadyl has an alarming reputation for causing just this sort of problem in some dogs. I wish I had been told this when they gave me the pills. There is no warning on the bottle and I was given no literature of any kind. I wish I had googled. Why didn't I google rimadyl?!

This is a nightmare! My daughter and I are always marveling at the turn for the better our lives have taken since Pippa came into it. So much happiness! She is the best dog and we are heartbroken.

    Bookmark   January 8, 2012 at 11:01AM
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Deramax is the best alternative to rimadyl .My english mastiff was on deremax for 2 years no problems. rimadyl has really bad history but it is cheaper .

    Bookmark   January 9, 2012 at 9:52AM
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I am unclear... you said the emergency room did NO blood work or testing (very hard to believe)? Why would they then assume it's liver failure or has anything to do with liver or the Rimadyl? A lot of things can happen to the body post surgically that have nothing to do with a drug given at the time. Vomting bile is a very common symptom of just about any illness a dog can get (It has to be one of the top 5 presentations to any emergency clinic for any dog or cat that comes in). Bleeding into the lungs is much more unusual and certainly not on the top of the list of liver failure symptoms.. in fact it is a pretty bizarre symptom of anything but a coagulation defect, something possibly related to exposure to rat bait, DIC from a surgical complication or severe stress of anesthesia, etc. Anyway, I certainly hope some sort of blood test was done to make the conclusion of acute liver failure before they decide your pet's fate on so little information. Blood testing is vital to help figure out what is going on with her and help the doctors treat her proplely. Has a coagualtion panel been run? What symptoms are there aside from vomiting bile (as I said, a very common symptom with just about any illness from eating something irritating, to post op nausea, to kidney disease etc.) and pulmonary hemmorhage (not an easy thing to even diagnose- how did they do that?)? I hope she does OK. Sounds like a very unusual case.

Either way, the makers of Rimadyl need to know of this case for several reasons- one so they can help you and the veterinarians involved treat your pet, to help you pay for your treatment of your pet (if it seems indeed to be related to the Rimiadyl), and also to help prevent future problems in other pets. I have found manufacturers to be extremely helpful in suspected drug reactions to their products, and in most cases, help the client with payment as well as treatment should any relationship even be likely.

I had a recent negative experience with Metacam a few years ago, a very similar drug which I have had very few problems with and like to use, that caused a problem in one of my patients and the company paid for everything that was done to help that patient (still alive and doing well today).

As for safety of Deramaxx versus Rimadyl, I could not disagree more. I have had three patients now put on Deramaxx by various doctors (one was a surgical specialist) that all bleed out or nearly bled out, from perforating ulcers due to Deramaxx. All died though I managed to keep the last one alive for a month. Admittedly all three dogs were older and several had been on Deramaxx for some time. But one was just put on it 5 days earlier, and had no problems before hand with ulcers. The makers of Deramaxx did help out with that case and did admit Deramaxx was likely to have been involved in the perfortationg uclers. Never seen a dog die of Rimadyl related ulcers.. nor even see a dog get ulcers from taking Rimadyl.

I have only had a dozen or so patients that have been on Deramaxx so three deaths out of that many is a pretty bad percentage. I have not perscribed it nor do I plan to.

ON the other hand, I have over the years had well over 1000 dogs on Rimadyl (many on it for many years) and seen very few problems with this drug, even with massive overdosing (eating an entire bottle of Rimadyl is not an uncommon occurence with dogs, particularly those able to get onto counters). Not seen any serious problems though sometimes it can make a dog sick to its stomach (as can just about any drug). But I will not deny that serious side effects exist out there somewhere, though there are problems that occur with just about any drug there is if you look hard enough. But you will never convince me Deramaxx is safer than Rimadyl. Even the experts in the field say so- Dr. Dawn Boothe, probably one of the worlds experts in veterinary pharmacology, said in a lecutre at a conference not that long ago, that Rimadyl had easily the best safety track record of all the nonsteroidals and seemed to have the largest safety margin as well (least likely to cause problems if overdosed). Aspirin, which we all take willy nilly, has one of the worst safety records with dogs, yet hardly anyone seems to worry about giving their dog an aspirin now and then.

One of the problems with Rimadyl is it is prescribed 10x more often than all the other nonsteroidals combined, so it is not surprising there are more cases reported of problems with it compared to some of the other drugs (but if you look into Deramaxx problems you might be even more surprised). However, even Deramaxx is relatively safe if you consider how many dogs take it compared to how many have serious problems with it as those I experienced. I think I just happened to come across 3 unusual cases... But that's enough to make me afraid of the drug, especially when I have had very few bad experiences with the others I use (Rimadyl, metacam and Ferocoxib). To me it just doesn't make sense to use it when Rimadyl is obviously safer.

As to which works better for pain or inflammation is much more of a debate and is very subjective as dogs cannot tell you how they feel. We just have to watch and see their responses. Sometimes one nonsteroidal just seems to work better than another for one dog, while another dog will respond differently. Just as some people find Alleve (naprosyn) works better than Advil (Ibuprofen) and other people find the opposite.

Anyway, back to your pet and her illness. I sure hope they can help get her health back. I have been an emergency clinician for years now and it is very scary to have dogs develop severe illnesses after relatively common procedures. It can make you nervous about any procedure- and it should! Any surgery or drug can have serious potential consequences and we need to be a bit afraid all the time or we are going to be making careless mistakes and approach these situations with too little concern.

    Bookmark   January 9, 2012 at 12:14PM
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I won't debate this issue. I am only here to share my experience and what our breeder advised us. When our vet wanted to prescribe Rimadyl, our breeder shared some of her horrific experiences with the drug. She has been breeding Mastiffs for over 25 years now so her experience and knowledge is extensive. Our breeder recommended Deramaxx.

We tried the Deramaxx and it was very effective in treating our 8 year old Mastiff. It made the last few years of his life much more comfortable and he lived to a ripe old age for a Mastiff - 11.3 years.

Obviously the OP's German Shepard may be allergic to the Rimadyl so it might be wise to keep an alternative in mind.

Both drugs are NSAIDS (Non Steroidal Anti Inflammatory Drugs)and both have side effects. However, the reports of adverse side effects are drastically more common with Rimadyl than with Deramaxx.

And while you "couldn't disagree more" there are numerous anecdotal reports of the dangers of Rimadyl. I don't know what world you live in lzrddr maybe an alternate reality.
Vomiting is a BAD SIGN with Rimadyl, take this example:
USA Today story on NSAIDS:
"Rimadyl's fast start had a dark side: Reports of dogs suffering liver damage and other effects began pouring in. One of those dogs was George, a 12-year-old chocolate Labrador retriever owned by Jean Townsend of Johns Island, S.C.

She saw the Rimadyl ads and asked her veterinarian whether Rimadyl could help George, who, while seemingly healthy, was moving slower. Rimadyl seemed to work, but after several weeks, George sometimes couldn't move. He started vomiting and had blood in his stool. Within 30 days of starting Rimadyl, George was put down. An autopsy showed liver damage, ulceration and bleeding.

"I had no earthly idea I was killing my dog," says the 68-year-old retired government worker.

Townsend says she wasn't warned of the risks and didn't ask, trusting her veterinarian. She refused Pfizer's offer of $249 and filed a lawsuit in 1999 that was joined by 300 others.

Pfizer settled in 2003 to avoid costly litigation, it says. Each plaintiff received about $1,000. Pfizer didn't admit wrongdoing and says it informed the FDA of side effects as soon as they were reported.

"We were incapable of informing the world of what we didn't know," spokesman Robert Fauteux says.

Pfizer updated Rimadyl's label twice, the last time in 1999 noting that death occurred in rare instances. That year, it stopped TV ads. Today's print ads include the death warning."

Turns out that many pet owners live in blissful ignorance and just kill their pets with good intentions. Rather than doing the due diligence and getting the info they need to make informed decisions.

All NSAIDS have risks but it turns out the Rimadyl is one of the more lethal drugs on the market.

Here is a link that might be useful: USA Today report

    Bookmark   January 9, 2012 at 9:03PM
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The OPs dog didn't vomit - it was bile. Hence the question on other symptoms and what testing was done. Sounded like a bit of leap to conclude liver failure based on bile and inappetance.

"reports of adverse side effects are drastically more common with Rimadyl than with Deramaxx."

Could that be because Rimadyl was the first NSAID for dogs and has been out longer and therefore more adverse reaction reports due to time on market? All drugs need to be assessed risk:benefit. Your dog might have done just as well on the Rimadyl as on the Deramaxx. OPs dog may have had same result on Deramaxx or on no drugs at all, since still not clear on the cause or tests done or dx. Correlation does not imply causation.

    Bookmark   January 9, 2012 at 10:15PM
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Hi All-

I think I misunderstood what Cynthia was asking. There was blood work done when I took Pippa on Friday that determined that there were serious goings on with her liver. Her ALKP went from 28 U/L before surgery to 2973 U/L four days after surgery and six rimadyl tablets. Her ALT went from About bleeding into the lungs. The doctor who saw her on Saturday I believe said that her labored breathing was due to fluid in the lungs and that this was probably blood. How she determined that I do not know. In all of her gagging Pippa never coughed up any blood that I saw.

This is what was determined through testing and observation:

-X rays showed no GI obstruction
-Ultrasound showed coarse liver- no other abnormalities
-Diagnosis: acute liver failure, coagulopathy. Pippa was given a transfusion. Given poor prognosis.

Pippa was given a lot of treatment in the form of IV fluid, Vitamin K, antibiotics, pain meds that would not affect her liver.

She was able to stay home with me last night. She took a small amount of food through a syringe. She still had episodes of labored breathing but then there were also long stretches of relatively peaceful breathing while asleep. She even showed a little of her old personality when I put on her leash to take her out to pee.

I took her back to the vet this morning where she will stay till 11:30 tonight. The vet called about an hour ago to let me know some good results. Her clotting times have returned to normal. Other levels are returning to normal. ALT now at 682 and ALKP now at 1400. Hopefully these will continue to go down. Also she has no fever today. She mentioned some other things but I don't have time to list all of it right now and some of it is a bit confusing for me honestly. She said she thinks Pippa suffered severe hepatotomy rather than acute liver failure.

I hope I am relaying all of this correctly. I am so happy at the good news although the vet also did mention the possibility of chirossis developing further down the road. She kept mentioning Sega Palm poisoning over and over again. I don't know if that's what she thinks happened and when I told her I don't have any of the stuff in or around my house she said it was just an example. Then she just kept mentioning it some more. I'm thinking that they want to blame this on Sega Palm.

I appreciate all the replies.

    Bookmark   January 10, 2012 at 2:20PM
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I'm sorry your dog is sick but glad that she's recovering.

I have 3 of my own dogs and so many patients I can't count on Rimadyl every single day.

Some dogs do have horrible reactions to it, but that is more common in Labs than in other breeds.

Deramaxx is the NSAID most likely to cause GI ulcers with long-term use. I usually switch those dogs to rimadyl or meloxicam and they are fine. I like deramaxx for short-term pain relief though.

That said, every individual is different. Just like in people, one drug may work better than another, and one drug may cause problems for one person or animal and another animal or person can be 100% fine.

One of my patients when into acute liver failure for no reason whatsoever. At least none that anyone could find. $35,000 later all I know is the immune functioning part of her liver isn't 100% recovered- the dog gets really bizarre infections (one time cultured horse strangles) for no good reason. But we never did determine a cause.

I think the timing of the sudden illness with rimadyl is extremely suspect at least. I would certainly suspect the rimadyl. I'd also report the problem to the manufacturer so there is a record of it although we know this is possible.

Sabal Palm is a highly liver toxic plant that could also explain what Pippa is going through. A dog doesn't have to eat much of this plant to die from liver failure. We don't see too much of that here because it is not a very hardy plant but further south it definitely happens a lot. Mushroom toxicity is another possibility.

The only way to have known for sure what caused the problem is to have had her stomach contents analyzed. That's kind of a useless expenditure though- I'm sure this treatment isn't cheap and it's better to treat than to find the cause in this case.

In any case of liver failure, there is possibility of permanent damage. The good thing is that the liver is a very regenerative organ, so there is good chance there won't be problems. Also dogs don't need a lot of working liver to survive. I would just be VERY careful of avoiding anything that can affect the liver in the future. I'd not give her NSAIDs of ANY type ever again.

Hope she continues to do well.

    Bookmark   January 10, 2012 at 9:49PM
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Rimadyl killed people - which is why it is no longer on the market for people. I hate Rimadyl and will ask my vet to substitite any other pain killer. Ask your vet for Medcam, vicodin or something else. Most vets dont like prescribing vicodin but I gave my dog half a dose on and off for 13 years due to a botched surgery on his leg and he did great on it. His orthopedic surgeon even stated it was safe. Good luck

    Bookmark   January 12, 2012 at 3:49PM
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Does sound like acute hepatic disease, and an NSAID would be certainly suspect as well. Hope Pfizer was contacted. Never said that this could NOT be related to the Rimadyl, but saying it IS for sure does not make it so, either. Sago Palms (not palms, but cycads actually.. and NOT Sabal Palms, which are completely non-toxic and are true palms) are extremely hepatotoxic, but if you don't have one, then that certainly rules that out as a possibility. Glad your pet is recovering- thankfully liver is one of the few organs that can regenerate so your pet may make 100% recovery. Let's hope so. I would, just in case, avoid all NSAIDS in the future (including Rimadyl, Deramaxx, Metacam, aspirin etc.). Your pet may have an acute sensitivity to that form of medication.

Vicodin has acetominophen in it, a risky drug (basically tylenol) to be giving a dog for any length of time, though single doses are probably OK now and then. That one has been shown to cause liver failure in dogs with any prolonged use (far more dangerous than most NSAIDS). So careful with that one.

The reason there are so many more anecdotal stories of Rimadyl toxicity is it is used, as suggested above, well over 100x more often than all the other NSAIDS combined. So more use, more stories. Had Deramaxx gotten onto the market first, then I'm certain it would be the other way around. Metacam has a longer history of use than both, but unfortunately did not get its OK for use in the US until more recently. I have taken the human form of that myself, though I find Advil works better for pain for me.

Many veterinary drugs have idiosyncratic effects in people and that is why they are not used in people- does not correlate in any way, necessarily to safety problems in pets.. one of the best, safest and most used (probably overused) antibiotics in pets, Baytril, causes people to seizure and can't be used in humans. But that does not mean it is unsafe for pets. Just as Acetominophen is pretty safe in people but one dose will kill a cat. Animals and people are not the same things.

    Bookmark   January 13, 2012 at 2:34PM
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Somtimes it seems you have to choose the lesser of two evils.

    Bookmark   January 13, 2012 at 8:40PM
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My dog was on Ramadyl for a leg injury.. He has never been sick and was always healthy..He started to vomit and stopped eating 4 day's after taking it.. Took him to the vet yesterday.. The vet called today and said my dog was in liver failure.. I'm so angry.. I didn't know this could happen.. When i called the manufacture all they can do is take a report.. Really... My dog is more then likely going to die and u can take a report... My dog is only 4 years old.. Heart broken after reading all these story's.

    Bookmark   October 22, 2013 at 4:15PM
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The information, as well as the misinformation is out there. You can always ask your veterinarian, but you should be aware there are very few drugs in either veterinary medicine or human medicine that are 100% safe. There will always be some one or some pet that reacts differently to most of the others- that is true with antibiotics, antihistamines, cortisones, heart and stomach medications etc. as well as with non-steroidal anti-inflammatory meds.

You see the ads all the time on TV for this new drug and that one, though now the TV ads all list all the possibly side effects (including death)... but does that keep them from being used? Not in most cases, because the alternative is a poor quality of life, either due to pain or some other unpleasant situation (infection, inflammation, cancer etc). I have seen several cases of fatal or nearly fatal results from using common antibiotics, flea prevention products, sedatives etc... all ones that are given out like 'water' by many physicians and veterinarians. Be we keep on using them since in MOST cases they work well and help the problem.

Rimadyl comes with a handout by Pfizer made specifically for the client that ideally should be sent home with each client so they can read about the possible side effects and what to look for. Some of the other super commonly used drugs have these, too.

Practicing medicine is always fraught with unexpected results and as safe a drug as something like Carprofen is, there are always going to be patients that cannot tolerate it... as there are with every other non-steroidal drug on the market (including Aspirin). We always are looking and hoping for 'perfect' drugs but so far I know of none that have come along. If one does, I will be using that one myself, I am sure.

    Bookmark   November 4, 2013 at 3:00PM
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