Most common side effects of NSAIDS are mild and patients may not experience any side effects at all, particularly if only taking for a sort time (less than 3 days). However some side effects, though rare, are potentially life threatening (ulceration of gastric tract, renal failure) and so patients should always be monitored closely whilst taking NSAIDS. The risk of side effects associated with NSAID usage increases with age and therefore caution is advised in the elderly with an in-depth risk benefit analysis undertaken before commencing.
The pre-emptive use of NSAIAs is controversial due to their potential for harm. Various studies using pre- operative administration of NSAIAs in veterinary patients did not specifically screen for adverse reactions. 14, 15 Studies specifically assessing efficacy and safety of NSAIAs given pre-operatively, in a variety of surgical procedures where intra-operative fluid therapy was administered and patient monitoring conducted, noted adverse reactions with some of the NSAIAs. 16–19 Adverse effects noted included acute renal failure with the combination of methoxyflurane and flunixin meglumine, g and incisional oozing in some dogs receiving ketoprofen. However, a recent study conducted at the Ontario Veterinary College demonstrated no ill effects with the administration of meloxicam or carprofen prior to orthopedic or soft tissue surgery in both cats (meloxicam) and dogs (meloxicam and carprofen) ( unpublished data ). In these studies, the pre-operative administration of an NSAIA provided very good to excellent analgesia. The possible benefit for pre-operative use of NSAIAs is the potential for a pre-emptive effect and the presence of analgesia upon recovery. When NSAIAs are administered upon recovery, opioids should be administered concurrently as 45 minutes are required for therapeutic effect of the NSAIA. Another potential approach in the prolonged surgical procedures could be to administer the NSAIA 45 minutes prior to extubation, where possible. The NSAIA can be given orally, once the patient can swallow, although administration of the NSAIA on an empty stomach may predispose to local gastric irritation.