What is difference between NSAIDs and steroids?

[Christine]

Other than the obvious, does anyone know the other differences i.e. side effects, long term use, etc.?

I suspected Bailey might have a UTI, took her for testing and vet could not get a sample - nor could I. She is doing better now, but vet said that the pred could be delaying clearing of any infection, even the low dose and suggested putting her on a NSAID for a while.

Any thoughts?

[Bobbie]

That's a good question.

Long term use: steroids have serious side effects, increasing the risk of cataracts, glaucoma, and high blood sugar, among others. They may increase the risk of infection. They can't be stopped abruptly unless the dose has been very low. But they help control stress of injury and inflammation. So it is a trade-off.

Your vet is suggesting discontinuing the steroids because it may be decreasing her resistance to infection, hence the UTI.

NSAIDS (non-steroidal anti-inflammatory drugs) may have serious side-effects as well. They can cause GI problems, including ulcers, and can cause liver problems as well. As for benefits, they are obviously anti-inflammatory, but also directly reduce pain.

In spinal cord injuries, the anti-inflammatory effect is very important. Steroids are more effective for that. If pain is present, NSAIDS may not be sufficient to control it, anyway. So steroids are normally used. For arthritic conditions NSAIDS are usually the first thing tried, but steroid injections can also be effective.

Long term use of NSAIDS is preferable to long-term use of steroids in terms of side-effects, but may be less effective as a treatment. But if Bailey has been on a low dose the NSAID may be just as effective.

One thing to do is request a liver panel, if it hasn't already been done, before putting her on an NSAID, and then repeat it regularly while on the drug.

Bobbie (not a vet.)

[Barbara Boehmer]

Steroids can cause loss of bone density, suppress liver function,and suppress the immune system. The negative side-effects are generally shorter-lived than the positive effects. That is why steroids are typically give every other day or every third day when used long-term, in order to minimize side-effects.

[Christine]

Thank you both for your help. During the night, I discovered that one of the NDAIDS is Rimadyl and I definitely would not give that to her. She has had liver issues for the past two years, (levels going from 750 to normal back up to 900, down to 248 and the last blood panel (this week) the vet said that she is doing well in that department so I definitely am not going to put her on one now.

I have decided to go from 10 mg of pred every other day to 5 every other day and give her the muscle and joint support supplement, eventually weaning her off of the pred again in the hopes that this supplement will help her hips.

One other question to those who you who are more knowlegeable than I. Before I took her in for a blood panel and a urinalysis, I gave her 2 weeks dosage of Cephaxon (sp). This vet prescribed another 2 weeks since he could not get a sample just to be on the safe side. I do feel that she is urinating more normally now so hesitate to give her the additional antibiotics (too much of those can also become ineffective, right?)

Thanks again.

[Bobbie]

Have you done something to acidify her urine? (Such as cranberry pills?) It also might help to express her even if she is urinating more normally, as sometimes not all the urine gets out and this causes UTIs. I think you are right to avoid NSAIDS of she has had liver issues already. You might consider SAM-e- it provides liver support and also has anti-inflammatory effects, but check with the vet as to giving it with steroids. (It has essentially no side effects but I don't think I've seen the question of steroids addressed.) I don't know that it has been used in IVDD but it is effective in arthritis.

Bobbie

[Cindidoxiemom]

Christine~
Oscar and Sage are both on preventitive antibiotics for UTI's. I would go ahead and give the full month of treatment. Even in normal dogs, stubborn UTI's can take a month or 6 weeks to fully clear up.
Cindi

[CarolC]

Before I took her in for a blood panel and a urinalysis, I gave her 2 weeks dosage of Cephaxon (sp). This vet prescribed another 2 weeks since he could not get a sample just to be on the safe side. I do feel that she is urinating more normally now so hesitate to give her the additional antibiotics (too much of those can also become ineffective, right?

Bobbie can correct me if I'm wrong. The idea of antibiotics is to kill germs. When you start antibiotics, they start to kill the germs. When you continue antibiotics, they continue to kill more germs. If you stop antibiotics too soon, they didn't get a chance to kill all the germs. The germs that are left tend to be the ones that were most resistant to the antibiotics. That's why they didn't die earlier. Now that you quit the antibiotics, these more resistant germs have a chance to really take over. Now you have a really bad infection, because it is made of germs that are resistant to your antibiotic.

Have you heard of the new strains of antibiotic resistant tuberculosis? Part of the reason it developed is that people have to take antibiotics a long time to kill tuberculosis. It is hard to keep people taking their medicine a long time, so they quit. Then they have a TB infection that was only half killed off, and the half that wasn't killed off is the resistant germs. Yikes! Now they are off the antibiotics and the resistant germs start to grow into a really bad infection. And the antibiotics will have a hard time curing it. That is why in some places (like big cities) they have community health workers go to the homes of people who are supposed to be on antibiotics for TB. They have to be sure the people are still taking the medicine! If they let the people develop antibiotic resistant strains of TB, other people could catch it and it would be a community problem.

It is better to do what the doctor says and be sure you get all the germs right now, so you don't end up with a resistant strain of germs in her bladder. Then you're searching high and low for something that will work, because then the antibiotic is ineffective. Hope this makes sense.

But why can't your vet get a sample??? Maybe he should try again?

[critters]

Bobbie can correct me if I'm wrong. The idea of antibiotics is to kill germs. When you start antibiotics, they start to kill the germs. When you continue antibiotics, they continue to kill more germs. If you stop antibiotics too soon, they didn't get a chance to kill all the germs. The germs that are left tend to be the ones that were most resistant to the antibiotics.

You're right.

[Bobbie]

Right. The danger with antibiotics is taking them when they are not necessary, or stopping them too soon. When my Lab Abbie had a UTI the vet was able to check her urine sample after two weeks and say she was clean, and we stopped them- otherwise she would have had two more weeks of antibiotics. (She was on Clavimox.)

Bobbie

[Wise Owl]

Christine, This is just a thought but is there anyway you can take a clean glass jar or plastic one with a lid and catch some morning urine tomorrow and run it over to the vet for them to do a test on it? I think that would clear up whether or not she still has an infection and still let you know whether to continue the antibiotics.
The overuse of antibiotics can make anything in the future harder to treat if it is continued when not indicated. The urine test is the way to check. Take her to her favorite pee spot and when she starts to go, catch it in the bottle...sometimes you have to be sneaky......heh. We have done that with Luka but we did it outside on the dog walk at the vets. There were lots of smells to encourage her to go. It's a little trick we use....

One more thing, is she getting any probiotics for her stomach like acidopholus? If she has been on anti's for any length of time they will also kill off the good bacteria in her stomach and intestines. She needs that bacteria to digest her food properly. You can give her the pills or some yogurt that is high in acidopholus. Check the container to make sure the numbers of lacotbacillus are high.
Luka gets one pill twice a week to make sure her gut stays active. I use one that is really high in lacto....

[Christine]

Loads of good information here..l.thanks again. I have been giving her cranberry drops twice a day for about three weeks and made sure that they would not conflict with the antibiotic.
I got some UTI Free granules from PetAlive.com which are supposed to be very good, but I need to check mixing them with the antibiotic as well.

I thought the vet would express her to get a sample, but he only sent her out with his techs 3 or 4 times and she never urinated the whole time she was there. (I wanted them to teach me how to express her, but he said that I only needed to concern myself with that if she were paralyzed...(I honestly believe no one in the office knows how )- my other local vet, who I love admitted that she never had any luck with it.

Unfortunately, Bailey does not like any kind of interruption when she is urinating (whether she starts to lose her squat), or God forbid, I should try to catch some of it...she just stops until the next time, which, if she had a UTI, is the reason. If we can eliminate this problem and I can finally find something that strengthens her hips, she will be fine.

Her hip weakness has always been so very curious as she is fine walking and trotting outside, only has some difficulty lowering herself to lie down. She never sits up any more, she either stands or lays down with her front legs outstretched. She rarely ever lies on her side anymore either, so I make sure to give her good tummy rubs while she is standing.

I will continue to teach myself with what I have learned here and pray that I will finally get it. (Julie was kind enough to give me a step by step as Luka and Bailey are both girls and the same size.)

Keeping all things in mind, I will start her back on that second round of antibiotics including acidopholus. I will be making another viist to my health food store to check interactions with any of the supplements I am giving her.

I will be printing out all of your comments to really read and absorb. Thanks again.

[CarolC]

Christine, how's your wrist doing? I'm thinking of the expressing.

[Christine]

Hi Carol,

I am doing much better. Don't even have to wear the brace unless I am feeling uncomfortable or needing to do something strenuous. I have been going to physical therapy and slowly regain ROOM. Am wearing a scar sheet and arm band to help flatten out the scar.

Also, I wrote to the Property Manager of the mall where I fell and just heard back yesterday. They have turned it over to their insurance company and have been very nice about everything. I decided to give them the opportunity to just pay my deductible and co-pays instead of having an attorney get involved - hopefully, I will be able to work it out without litigation.

Thanks for asking.

[Wise Owl]

Christine, are you still doing the massage? Ice? Moist heat to limber up the joints?

Glad to hear your arm is getting better! That is a tough one to deal with and also have a big dog to help. I have the bad back problem.....but then I bend over a lot, lol....

There must be a way to catch her urine without disturbing her. Anyway to position her over a pan of some sort? A clean pan obviously...Or have hubby catch it for you? While you distract her? that's how we did it. Hubby was doubtful but he got the job done...heh...I think he got sprayed a little as he was muttering about needing to find a sink and soap/water, ect ect.... heh. He survived tho.....hah.

Where there's a will theres a way. Might take two people to get it done.

[Christine]

I got a urine sample!!!! I will be waiting at the vet's door this morning at 8:30.