Anti-inflammatories for dogs with arthritis: what to know before starting treatment

Yes, anti-inflammatories for dogs are often the cornerstone of arthritis treatment: veterinary NSAIDs and, more recently, the anti-NGF antibody are the two first-line options for controlling pain. They are prescribed only by your vet, after an examination and often a blood test, and need monitoring. Here is how they work, how to prepare, which side effects to watch for, and how to combine them with the other measures that help your dog day to day.

Why arthritis pain should be treated, not just ‘waited out’

Arthritis in dogs is a chronic, painful joint disease. Pain is not just discomfort: it sets up a vicious circle. The dog hurts, so it moves less; its muscles waste; the joint is less well supported; it wears faster and hurts even more.

Treating the pain breaks this circle. A dog in less pain starts walking again, rebuilds muscle, loses weight if needed and gets more out of physiotherapy. That is why the international COAST guidelines (2023) put pain control at the heart of management as soon as arthritis causes clinical signs, and why the 2022 AAHA (American Animal Hospital Association) pain management guidelines stress a proactive, multimodal approach, rather than waiting until the dog ‘can’t cope any more’.

Many owners are wary of ‘putting their dog on medication’. That is understandable, but untreated chronic pain has a cost too: less activity, muscle loss, poor sleep, irritability, and sometimes aggression when touched.

NSAIDs for dogs with arthritis: how they work

Non-steroidal anti-inflammatory drugs (NSAIDs) inhibit an enzyme called cyclo-oxygenase (COX), which produces prostaglandins. These substances drive inflammation and pain in the joint. By reducing their production, an NSAID reduces pain, stiffness and inflammation.

Several NSAIDs are specifically designed and authorised for dogs, for example carprofen, meloxicam, robenacoxib, firocoxib, cimicoxib and mavacoxib (long-acting). Grapiprant works slightly differently, by blocking just one prostaglandin receptor. They come as palatable tablets, oral suspensions or injections. The choice of drug, formulation and dose is for your vet alone: it depends on your dog’s weight, age, general health and other medicines.

The other side of the coin: why monitoring is needed

Prostaglandins are not only involved in inflammation. As the US Food and Drug Administration (FDA) points out, they also protect the lining of the stomach and intestines, maintain blood flow to the kidneys and play a part in blood clotting. That is why NSAID side effects mainly involve the digestive tract, the kidneys and the liver. They affect a minority of carefully selected and monitored dogs, but they justify a few precautions.

Before starting anti-inflammatories: the checklist

Before the first prescription, and at every repeat prescription, your vet reviews your dog’s situation. You can help by having this information ready:

1. The signs you have noticed: since when, at what time of day, after what kind of exertion. A short video of your dog getting up or on the stairs is very helpful.
2. A complete list of everything your dog receives: medicines, including spot-ons and one-off tablets, supplements, herbal products, food and treats.
3. Medical history: frequent vomiting or diarrhoea, ulcers, kidney, liver or heart disease, past reactions to a medicine.
4. Recent treatments: has your dog had a steroid or another anti-inflammatory in the past few weeks?
5. Your practical constraints: making it easy to give (palatable tablet, liquid, monthly injection) helps you keep the treatment going long term.

Your vet carries out an orthopaedic examination and very often a blood test to check kidney and liver function, sometimes with a urine test. These results provide a baseline: they will be repeated regularly if treatment continues, at intervals set according to your dog’s age and health.

Side effects of anti-inflammatories in dogs: what to watch for

According to the FDA, the side effects most often reported in dogs on NSAIDs are vomiting, reduced or lost appetite, reduced activity and diarrhoea. More rarely, serious effects can occur: a stomach or gut ulcer or perforation, or kidney or liver failure.

Safety rules you need to know

• Never two NSAIDs at the same time, nor an NSAID with a steroid: the risk to the digestive tract rises sharply. When switching from one drug to another, your vet will often plan a break of a few days in between.
• Don’t change the dose yourself, either up when your dog is in more pain or down when your dog is better: call your vet instead.
• Follow the instructions on the prescription label (with or without food).
• Weigh your dog regularly: the dose is calculated on body weight.
• Mention any treatment added by another vet or another practice.

Anti-NGF antibody therapy for dogs: another first-line option

NGF (nerve growth factor) is a protein present in excess in arthritic joints, where it amplifies pain signals. Bedinvetmab is a ‘caninised’ monoclonal antibody that neutralises NGF. It is not an anti-inflammatory in the strict sense: it acts directly on the transmission of pain. It is given as a monthly injection at the vet practice and has been authorised in the European Union since late 2020.

In the key placebo-controlled study of 287 dogs with osteoarthritis, 43.5% of treated dogs met the owner-assessed success criterion at 28 days, compared with 16.9% on placebo; the difference was measurable from day 7 and was maintained at later check-ups (Corral et al., 2021). In this trial, side effects were seen at a similar rate in both groups. Like any medicine, it has contraindications and possible side effects, listed in its package leaflet, which your vet will go through with you.

NSAID or anti-NGF: how your vet chooses

The COAST group unanimously recommends one or other of these drug classes for dogs with signs of arthritis. The choice depends on the dog.

The two options can also be combined in some cases, on your vet’s advice.

Other treatments for arthritis pain

When pain is still not well enough controlled, your vet may add another painkiller rather than replace the baseline treatment. In the COAST guidelines, most experts mention amantadine and gabapentin in particular, especially for long-standing pain. Tramadol is less recommended.

• Corticosteroids (steroids) are not used routinely by mouth or injection for arthritis in dogs. Injections into the joint may be discussed in severe cases affecting one or two joints, never at the same time as an NSAID.
• Joint injections (platelet-rich plasma, hyaluronic acid, among others) or certain intramuscular injections are sometimes offered depending on the stage of the disease.
• Physiotherapy and hydrotherapy rebuild muscle without overloading the joint. Our guide to dog physiotherapy and hydrotherapy explains what the sessions involve.
• Surgery remains an option for some badly affected joints.

‘Natural anti-inflammatories’ for dogs: different, complementary roles

This is a very common search, and a fair question. The answer comes down to one idea: medicines and supplements don’t play the same role; it isn’t a contest between the two. The prescribed medicine treats pain. A joint supplement contributes to supporting joint function, alongside a healthy weight, suitable exercise and veterinary follow-up. Both have their place in a multimodal approach.

What the studies say

Marine omega-3 fatty acids (EPA and DHA, from fish oil or green-lipped mussel) are the most studied ingredients in dogs with arthritis, in enriched diets or in supplements. In the meta-analysis by Barbeau-Grégoire et al. (2022), which pooled 72 trials, omega-3 products showed the clearest effect on arthritis pain; collagen and multi-ingredient formulas were judged promising, with more studies needed; and the glucosamine-chondroitin combination did not show a clear effect on pain. Our article on omega-3 for dogs covers the sources and how to choose one.

To get the most from a supplement: choose a formula with declared ingredient levels and quality-controlled manufacturing, give it regularly for at least 6 to 8 weeks before judging, and always tell your vet about it, especially if your dog is already on medication. Our guide to joint supplements for dogs helps you read the labels.

What you can do alongside treatment

Medicines work best when they are backed up by simple daily measures:

1. A healthy weight: every extra kilo loads the joints. Our guide to overweight dogs and joint health gives a step-by-step method.
2. Short, regular walks, rather than one long outing at the weekend.
3. Gentle strengthening exercises: see our exercises for dogs with arthritis, all of which can be done at home.
4. Non-slip floors and a thick, warm bed.
5. A diary: note each week how easily your dog gets up, how long the walks last and how keen your dog is to play. It is the most valuable tool for adjusting the treatment with your vet.

Key points before your dog starts anti-inflammatories

A well-chosen, well-monitored veterinary anti-inflammatory can transform daily life for a dog with arthritis. Have a check-up before starting, stick to the dose, watch for digestive problems, never mix it with a human medicine and see your vet regularly. Combine the treatment with a healthy weight, suitable exercise and, if you wish, a joint supplement: each has its role. Find all our guides on dog joint health.