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Deramax vs. Prednisone

jenncnj
August 11th, 2007, 07:19 PM
Hello there,

I am new to the groups here but hope that someone can offer me some suggestions. My 11 year old Golden Retriever, Avery has been on a regimine of hydroxine and prednisone for the past 4+ years. She was on a minimal does (5-7.5mg) every other day of pred. While on the pred, she was doing better with her arthritis. Now that her vet has suggested taking her off of all and switched her over to Atopica (for her allergies) and Deramax for the arthritis....she is definitely having more problems walking around. How long do i let her go before looking at other options, and are there other options?? She has only been on the Deramax for 2 weeks and i think that should be long enough to see a change, but maybe not. I know there are several issues with long term pred use, but it is worth it if it gives her the relief she needs?? She also takes glucosamine and i have been reading about Adequan and wondering if that too should be considered?? Please....let me know any advice you have.....i am at a loss.

hazelrunpack
August 11th, 2007, 07:28 PM
In our experience, the effects of the Deramaxx are almost immediate, so you may be seeing all the improvement you're going to get with it.

We've had very good luck with glucosamine/chondroitin supplementation, though, and if you've just started that, it might take another few weeks for maximum results. If she's been on it for a while, you might want to up her dose (no higher than the recommended max, though, for her weight)--perhaps without the prednisone she's going to need a higher maintenance dose to get relief.

I have no experience at all with Adequan, so have no advice there.

Was she starting to show side effects from the pred?

glitterless
August 11th, 2007, 08:10 PM
I'm wondering about side effects of prednizone too. I've done some reading up on this because I've had a horse on prednizone for over 2 years. She's only receiving shots every 5 days right now and in the winter she usually only gets a shot every 2 weeks. I believe that I'm already seeing effects of the drug in her. Long term use of prednizone or other corticosteroids can affect the immune system among other things. Maybe your vet is worried that your dog has been on it too long.

Again, no dog experience, but I am somewhat familiar with Adequan in horses. It seems to be effective in treating arthritis in many horses and is usually one of the drugs of choice among vets and horse owners.

I don't know much about treating arthritis with prednizone; my mare is on it for a respiratory condition. However, I would think that Adequan would be totally different as it is not a non-steroidal anti-inflammatory drug meaning that it's not a pain reliever. I don't know much about how it works, but I believe that it somehow lubricates the joints rather than just giving the animal pain relief by decreasing inflammation.

I just found this website: http://www.caberfeidh.com/Adequan.htm and it looks very helpful.

Good luck to you. It does sound like Adequan would be worth a shot.

punkyamberlea
August 11th, 2007, 11:19 PM
you should see the results of deramaxx within a few days. if that isnt working maybe ask about rimadyl, previcox or even j/d (hills) food. Amber

Dr Lee
August 12th, 2007, 02:58 PM
you should see the results of deramaxx within a few days. if that isnt working maybe ask about rimadyl, previcox or even j/d (hills) food. Amber

Great advice Amber!

I am a great advocate of NSAIDs (non steroidal anti inflammatory drugs) such as metacam, previcox, rimadyl or deramaxx over steroids such as prednisone, depo-medrol etc... Steroids can have a lot of negative side effects! They have there place in medicine, but for arthritis they should only be used in some rare instances.

There are many different NSAIDs on the market - one of the reasons is that there is no perfect one for each pet. Some will respond better to one than another. In general a recent study had the following ranked as most safe to least with respect to overdosage: previcox - metacam - rimadyl - derramax. There are many studys though - all are good. My personal favorite is metacam as it is in a convienent honey flavored liquid, also available as an injectable, has a high range of safety and my patients respond well to it. I have also used all of the above and a few others.

Adequan - great supplement. It is basically glucosamine/chondroitin/MSN like compound that is injectable. It has the advantage of testing that the others do not as well as the availability of being injectable (the others are used routinely as injectable in horses, but i have not seen anyone inject glucosamine or chondroitin combo into a dog yet). Wonderful thing about Adequan or glucosamine/chondroitin - you can use it in conjuction with NSAIDS.

j/d - I know this forum hates Science Diet but i will talk about this diet anyways (please forgive me). It has high levels of EPA eicosapentanoic acid which is a fish oil. At high enough levels and given for a period of over two weeks it will lead to the cessation of inflammatory mediator release by the joints. this will cause great pain relief. Hills took this diet to the FDA and tested it according to the criteria as if it were a new NSAID drug - it passed with flying colors! So according to FDA study it works well enough to be a new pain relief drug. Many of my patients on j/d have been able to come off of the NSAIDs! I would rather relieve pain with natural methods than with drug if I can. One note - many people will hear this and start reaching for the fish oils instead - an average lab would need 33 capsules of your fish oil capsule to obtain the level of EPA needed. So far I have not found a sole EPA source that works as well other than j/d.

glitterless
August 12th, 2007, 03:04 PM
Dr. Lee, I know that in horses we try to avoid prolonged use of NSAIDs as they can cause stomach ulcers. Is this an issue in dogs?

Dr Lee
August 12th, 2007, 03:10 PM
For my arthritis and osteoarthitis patients I will offer the following options which can be added in this order and all used together.

1) glucosamine, chondroitin supplementation. Adequan could also be used in this category.
2) J/D food. if clients do not like using a science diet product then I will add in fish oils however until a pure EPA source is available it will not be adequate to provide the pain relief needed. If anyone on this forum knows a quality producer of pure high concentration EPA please let me know!!!! I would love to offer this!
3) NSAIDs (metacam, previcox, rimadyl, deramaxx, etogesic). Please do NOT use aspirin, even buffered - all have been shown to cause some gastrointestinal bleeding of some degree, all will cause platelet dysfunction and reduce kidney blood flow. Also I recommend against ketoprofen due to similar reasons. NOTE: can NOT use more than one of these at a time and there should be a two week 'dry out' period of time between switching any NSAIDs.
4) tramadol. a great pain reliever - an opioid. This medication is safe, and effective. It's disadvantage is that is does not reduce inflammation like the above medications or supplements. For this reason I add it on last. In people it can be addictive but still considered very safe.
5) If all of these are not causing relief - then the pet really needs to see an orthopedic surgeon to evaluate for a surgical option!


Additional thoughts on arthritis - the following are additional non-medication or supplement options that can greatly help improve the lives of arthritic pets: massage/physical therapy, chiropractic therapy, magnet therapy, acupressure/acupunture, and non-invasive K laser therapy.

By using a multi-modal approach we can greatly improve the quality (which I think also by defacto, quantity) of life for our arthritic pets.

I hope this helps!:pawprint:

Dr Lee
August 12th, 2007, 03:18 PM
Dr. Lee, I know that in horses we try to avoid prolonged use of NSAIDs as they can cause stomach ulcers. Is this an issue in dogs?

Great question. Not if you use the right medication and do not mix NSAIDs. If you use OTC aspirin, ketoprofen, ibuprofen, etc... yes, you are at high risk of stomach ulcers! The studies for prescription NSAIDs (previcox, metacam, etc...) show remarkable cox-1 sparing behavior thus minimizing this risk. For any patient that may be predisposed to ulcers etc... I recommend using famotidine (pepcid).

In horses there is finally a new NSAID on the market called equicox. It is very exciting. It IS previcox. This should revolutionize NSAID therapy in horses. I do not know much more than this as I do not work on horses. For more info I would go to www.merial.com

Hope that answers your question.

glitterless
August 12th, 2007, 06:58 PM
Thank you for the explanation, Dr. Lee :) The info on Equicox is definitely very exciting; I'm going to share it with some horsey friends. So many horse owners use bute to keep their horses comfortable, but have to deal with stomach ulcers...so Equicox will be a great alternative.

Jenn, sorry if I'm getting too off topic here. I hope that you can find a way to keep your dog comfortable.

jenncnj
August 14th, 2007, 10:09 PM
A great big thanks to everyone who responded...I am going to call my vet tomorrow and ask about the Metcam that many of you mentioned. I am not seeing remarkable improvements with the Deramaxx.

Some of you asked about the pred.......yes, i was begining to see the side effects as was the vet, excessive panting and some weight gain which she contributed to the long time on pred. She has also been getting just plain ole people (1/2 dose) glucosamine chond.....which my previous vet said to use, but perhaps there is something better out there more suited to dogs/animals than people glucosamine, or maybe i should give her the full adult dose according to the bottle?

I am not against the dog food switch, BUT....I have to be careful because she has allergies which are partly attributed to molds and so she is on a mix of 1/2 can and 1/2 dry food to keep her exposure to dry foods to a minimum.

Thanks again....and I will keep you posted!

Jenn