Rimadyl: Relief From a Swollen Wallet

A reader of this blog has a dog with limber tail, a rare problem in some hard-working field dogs (mostly bird dogs such as labs and pointers).

Basically, the muscle at the base of the tail seems to inflame, and the tail is pulled down and held close to the body, rather than standing proud and held high, as is normal. It's unclear why this condition occurs.

Apparently this condition has happened to this dog before, and the owner has been advised to keep Rimadyl on hand and dose the dog for a day or two to ease the inflammation. Normally, the problem is self-correcting in a few days.

The question: Did I know a cheaper source of Rimadyl other than going to a vet? Rimadyl is pretty expensive, and a vet visit is an additional charge as well.

First of all, what is Rimadyl? Rimadyl is a non steroidal anti inflammatory drug (NSAID) called Carprophen.

Car-prophen. Look at that name closely. It it reminds you of the name of another drug -- Ibu-profen -- that is not an accident.

In fact, Ibuprofen (aka Motrin, Advil, Nuprin) is also a non steroidal anti inflammatory (NSAID), and Ibuprofen and Carprophen are chemically very similar. One is is Cox-1 drug (Ibuprofen), and the other is a Cox-2 drug (Rimadyl).

What's the difference between a Cox-1 and a Cox-2 drug? In the real world, not a damn thing unless you are taking the drug daily and for a very long period of time (i.e., more than 3 weeks of daily dosing).

Cox-2 drugs, such as Rimadyl, have NOT been shown to be more effective at alleviating pain than Cox-1 drugs such as Aspirin and Ibuprofen.

So, to put a point on it, almost all Rimadyl sales by veterinarians for short-term use are a rip-off; you could be using buffered children's Apirin or a low-dosage of Ibuprofen for a lot less money.

At the core of the scam you have drug company that has created a "me too" version of Ibuprofen that they sell through veterinarians. Veterinarians sell the drug at a big profit (more than 100 percent markup) and also create client dependency as folks have to come back in those cases where a recurring condition (like limber tail) might arise. The drug company makes a lot money, the veterinarian makes a lot of money, and you, the customer, are out of money.

Some veterinarians trying to protect the profit-and-dependency business model will protest that dogs "do not process Ibuprofen as well as Rimadyl."

Which is barely true. All NSAIDs are a little bit hard on the stomach (including Rimadyl), and while Cox-2 drugs are a little bit easier on the stomach than Cox-1 drugs (like Ibuprofen or Aspirin) the differences are minimal, and are essentially zero for short-term use (i.e. anything less than three weeks).

Nor are Cox-2 drugs completely safe. Cox-2 drugs like Vioxx, Celebrex and Bextra have all been implicated in heart attacks and strokes in humans, and Vioxx was pulled after it was implicated in killing perhaps as many as 20,000 people. Bextra too has been pulled from the market, and Rimadyl, once sold to humans, is now only sold for veterinary use, under the theory that dogs do not typically suffer from hypertension.

Will your veterinarian tell you all this? Not likely! You see, there is too much money to be made selling Rimadyl.

There is, of course, another factor at work. I call this the "Witch Doctor's burden."

If you've taken a dog to the vet, no matter what the reason, you are going to billed for an office visit, which is only fair: time is time. Around here, that office visit alone is going to cost you about $80.

Now, if the vet glances at your dog's ass, shrugs her shoulders, and says "Ibuprofen might help," you are really going to wonder what you have paid your money for.

Yet, if this same vet looks carefully at the tail, scrunches up her face, and says "What we seem to have here is a rare condition, found only in certain working dog breeds, and only in very active dogs. This is a temporal, breed-specific, idiopathic, neuro-muscular condition, and not the kind most vets see every day. But I have good news: I know what it is, and I have a prescription for a medicine. The medicine is not cheap, but I am pretty sure it will work."

Well! After that kind of stem-winding (what's it all mean?) , most patients are eager to write a check for another $50.00 ("is that all?"), and the vet is only too happy to oblige knowing that a dog with limber tail is likely to be in again for a prescription refill -- at which time perhaps a round of unnecessary vaccines, unnecessary blood work, and unnecessary teeth cleaning can be sold.

Now, if you simply "google" (this is now a verb) Ibuprofen and dogs, you will not find out what I have told you here unless you do a lot of reading and read very carefully. Instead, what you will find are a bunch of ninnies (some of who are vets trying to protect their price-gouging-and-dependency business plan), who say that short-term Ibuprofen use will rip up a dog's stomach and is even poisonous to dogs because it is so easy to overdose a dog.

Which is, of course, complete nonsense. Here are the facts:

1. Ibuprofen will NOT damage your dog's stomach if given daily for any period under three weeks duration. In addition, Rimadyl may damage your dog's stomach if given for over three weeks duration. For long-term daily use (such as arthritis in an aged dog), Rimadyl may be better than Ibuprofen, but if money is a big issue, buffered children's aspirin is the way to go.
   


2. ANY medicine is a poison if it is not given in the proper dosage. This is as true for Rimadyl and any Cox-2 drug as it is for Ibuprofen and any Cox-1 drug (such as Aspirin). In fact, the proper per-pound of dog dosage for Rimadyl is one-fourth to one-half that of Ibuprofen. Yes, yes, you have to give a smaller dose of Ibuprofen to a 20-pound dog than you do to 200-pound human, but that is true for ALL drugs!
   

To repeat: proper dosage is important for ALL medicines, and Ibuprofen is the same, in this regard, as everything else.

The proper dosage for Ibuprofen in a dog is 2 to 4 mg per pound of dog, every 12 hours.

For a 10-pound dog, that means 20 to 40 mg every 12 hours. For a 20-pound dog, that means 40 to 80 mg every 12 hours.

Do the math for your dog, based on weight, and buy chewable 50 mg Ibuprofen to make it simple. Split a tablet for a 10-pound dog, and give him the whole tablet if you have a 20-pound dog. Scale up the dosage, by weight, if your dog is larger. Start with lower-dosage; it will probably be enough.

If you prefer, you can go to your neighborhood pharmacy's children's health section, and get Ibuprofen for infants (it comes in a liquid with a syringe. A 50 mg dose is typically 1.25 ml (1 cc is the same as 1 ml, and there are 5 ml or 5 cc to a teaspoon), but read the packaging. The pharmacy will also have 100 mg tablets of Ibuprofen for young children, which can be split in half for a 20-pound dog (use a pill cutter).

You do not have to go with Ibuprofen. Another fine Cox-I drug is called Aspirin, and you can either buy buffered children's Aspirin at the local pharmacy, or you can pay a little more money and order "veterinary Aspirin" (Vetrin) , which is dosed at the rate of 8-12 mg per 1 lb. of dog body weight. Dose every 12 hours, as per Ibuprofen.

Finally, an end note: Never give any NSAID (not Rimadyl, not Ibuprofen, and not even Aspirin) to a cat. Cats and NSAIDs generally do not mix, even at low doses.