Author Topic: This is where I'm going to need some major help. . .  (Read 1270 times)

Offline DeeDee

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This is where I'm going to need some major help. . .
« on: September 13, 2015, 09:52:17 PM »
Vlad has been on golden paste for a while. Once he got Addison's, a lot of people said he can't have it because turmeric acts like an NSAID--specifically a selective COX-2 inhibitive NSAID. (I've quoted the whole article that they keep on pointing to in the bottom of this post.)

Now everyone in several groups keeps on equating turmeric with COX-2 inhibiting NSAIDS and saying it's bad. HOWEVER, they promote using Omega-3s and other things like Bosweilla Extract WHICH ARE ALSO COX-2 INHIBITORS!

Several COX-2 inhibitors are regularly used in joint compounds that they promote. Expecially the Omega-3's "because they don't inhibit COX-1." Well goshdarnit, NEITHER DOES TURMERIC! http://www.ncbi.nlm.nih.gov/pubmed/11566484

My question that NO ONE will answer is:

If one COX-2 inhibitor is bad, then would it not ALSO rule out using any other COX-2 inhibitors such as Omega 3's, Thunder God Vine, Resveratrol, Flavonoids and Bosweilla Extract?????   bangshead bangshead bangshead bangshead bangshead

Quote
NSAIDs and Pred in Addison’s Disease:
The other day, I gave Aidan, my healthy athletic whippet a Previcox tablet.  He is a performance dog; he’s been to the AKC National Agility Championship and competed against some top names in agility.  This spring, he sprained his shoulder, and I was working with a rehabilitation regimen to get him back in shape and back to competing again. I was frustrated that things weren’t going as planned; his shoulder was mending, but now his knee was hurt.  I had some pain meds on hand, and after watching him limp one night, I handed him a non-steroidal anti-inflammatory. 

Yum!  The next day he was feeling awesome.  The limpwas gone, and he was obviously feeling better.  So I repeated it.  Why not?  I’m a vet, I knew the risks, and could watch him carefully for any fall-out or problems.  I’d been
treating him for Addison’s for over a year, and he’d been perfectly controlled on his percorten and Pred since day 1.
Later that week, I noticed his water intake and urination increase dramatically.  After checking a urine sample, panic set in.  Low urine specific gravity, and casts in the urine.  Even though he acted fine and ate well, even though his blood tests were normal, still the evidence was there: kidney disease!  I’d made a huge mistake, thinking that his Addison’s dose of pred was so low, that he would be able to handle the other drug as well.  The combination of prednisone and an NSAID was killing his kidneys. 

NSAIDs control pain and inflammation by inhibiting the enzymes cyclo-oxygenase (COX).  These enzymes are in charge of making prostaglandins, which are the messenger molecules that contribute inflammation.  By stopping the COX enzymes, less prostaglandins (PGs) are made, and inflammation, pain and even fever can be reduced oreliminated.  But prostaglandins aren’t always bad guys. 

Although PGs cause trouble when they are at higher than normal levels in the body during inflammation, at normal levels, they help with other body functions.  PGs help to keep the stomach lining safe and protected from the normal acid secretion needed to break down food.  Without the right level of PGs, the mucous lining of the stomach breaks down, and ulcers develop.  Ulcers, if large enough, can cause bleeding and even rupture of the stomach.  1

PGs also help regulate blood flow to the kidneys.  PGs help open up the arteries to the kidneys, which keeps blood flowing, and keeps the kidneys healthy.  Without PGs, the blood flow to the kidneys slows, and parts of the kidney are damaged, sometimes irreversibly.  This leads to kidney failure.

So, we can control pain with NSAIDs, but there is risk to other body systems when we use them.  It would be nice to have just enough PGs to do their job, but not so much that we feel pain and inflammation.  Researchers thought they had an answer when they discovered there were 2 different COX enzymes:  COX-1 and COX-2.  In the lab, COX-1  enzymes were thought to be in charge of regulating the “good” PGs that helped with stomach and kidney health, and COX-2 enzymes were supposed to be involved in pain and inflammation. 

NSAIDs were created that only blocked the COX-2 enzymes, and these drugs were thought of as safer or more effective. 
Sadly, what happens in the lab doesn’t always hold true for our bodies.  When used in people, and pets, side effects still do occur, even with the new class of NSAIDs.

Aidan received a COX-2 selective NSAID, and still developed signs of renal disease.Prednisone, the life-giving drug we give our Addisonian dogs, also causes changes to the prostaglandin pathway.  Even though we are giving tiny amounts, enough to just barely replace the hormone they would normally be making, it is still enough to inhibit prostaglandins.  Any time we add any other drug that affects this pathway, like NSAIDs, or other drugs that affect blood flow to the kidneys, we run the risk of causing terrible damage these and other organs.There are other choices for pain control for our Addisonain dogs: other medications that use other pathways, nutritionalsupplements, rehabilitative exercises, massage, PROM, cryotherapy, heat therapy, acupuncture, TENS, laser, extracorporeal shock-wave, just to name a few.  Be sure your veterinarian is familiar with these options if you need to treat your Addisonian for pain, and be aware of the risks and signs to watch for if you choose to use an NSAID.    2

Aidan eventually recovered most of his kidney function, but I’m sure there will be some permanent scarring.  But the risks were much higher than even I had anticipated.     
"In order to really enjoy a dog, one doesn't merely try to train him to be semihuman. The point of it is to open oneself to the possibility of becoming partly a dog." Edward Hoagland
"Thorns may hurt you, men desert you, sunlight turn to fog; but you're never friendless ever, if you have a dog."

Offline Pookie

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Re: This is where I'm going to need some major help. . .
« Reply #1 on: September 13, 2015, 10:15:52 PM »
My question that NO ONE will answer is:

If one COX-2 inhibitor is bad, then would it not ALSO rule out using any other COX-2 inhibitors such as Omega 3's, Thunder God Vine, Resveratrol, Flavonoids and Bosweilla Extract?????   bangshead bangshead bangshead bangshead bangshead

Wow, I've never heard of some of these, not that I'm an expert.  I understand what you're saying.  In looking at what you quoted, this is the only thing that makes me think that some COX-2 inhibitors are better choices than others:

Quote
  There are other choices for pain control for our Addisonain dogs: other medications that use other pathways,

Is it possible that Omega 3's, for example, use different pathways that don't affect kidney function and the stomach like the NSAID did, and therefore would be a better choice?  I don't know, I'm just thinking out loud here.  We don't know what pathways they or the other things you listed use, so we don't know if they'd be better choices.  That would probably take some digging to find out.

In the course I took last year, the instructor mentioned that digestive enzymes, when taken separate from food, reduce inflammation.  While it was a course for human healing, I wonder if the same is true for dogs and cats.  It might be something to consider, if you want to look into it.

I don't know if this helped you at all, but I hope it did.   :-*
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Offline DeeDee

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Re: This is where I'm going to need some major help. . .
« Reply #2 on: September 13, 2015, 10:41:33 PM »
The only thing I've been able to link in them all is that they're COX-2 inhibitors that don't inhibit COX-1. They're all used for inflammation/arthritis/pain.

I just can't help but think if one is bad for that reason alone, then they all are. Especially when no one can give me specific information on WHY one would be okay when any of the others wouldn't be. I'm always pointed back to that article on the prednisone and NSAID being used concurrently in the dog with Addison's. I know that omegas and Bosweilla are pretty popular for joint supplements though.

And he's on digestive enzymes, and those aren't going to be removed. I just really hate being told, "This is okay but this isn't, but I can't tell you why." That makes no sense to me.

Then it's not okay for me to quote a study done on rats because they're nothing like dogs. Another study done on humans isn't okay because humans aren't like dogs, BUT we're going to quote this human information when we're talking about Omega-3s not inhibiting COX-1's, and that's okay that it's a human study when we're quoting it--though humans aren't like dogs. (Really it's hard to quote specific studies done on dogs when concerning a lot of food supplements that aren't going to make some big pharma a lot of money because they're just that, food supplements; so big pharma isn't going to pay to have studies done at all.)

All the while, we'll all just ignore the fact that all of the supplements I listed don't inhibit COX-1s either.
"In order to really enjoy a dog, one doesn't merely try to train him to be semihuman. The point of it is to open oneself to the possibility of becoming partly a dog." Edward Hoagland
"Thorns may hurt you, men desert you, sunlight turn to fog; but you're never friendless ever, if you have a dog."

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Re: This is where I'm going to need some major help. . .
« Reply #3 on: September 14, 2015, 12:58:24 PM »
My guess is that perhaps not all COX-2 inhibitors work the same way.  They may have the same end result, but work in a different way to achieve that result, which may make some safer than others.  I don't know this for sure, but just putting it out there as a theory.

Assuming that Vlad gets digestive enzymes with his food, I was suggesting that he also get them without food (between meals) so they can reduce the inflammation.  If they don't have food to digest, they will then "digest" the inflammation.  At least, that's what my instructor told us.

I'm sorry the folks on the Addison's forum aren't being helpful about this.  I can only imagine your frustration.

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Offline DeeDee

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Re: This is where I'm going to need some major help. . .
« Reply #4 on: September 14, 2015, 06:05:38 PM »
It's okay. I've figured out that the answer is that no one knows what really occurs with any of them. They keep on pointing out that Omega-3s work differently b/c they don't inhibit COX-1--over and over. I quit talking at all b/c they won't pay attention when I tell them that those other COX-2 inhibitors don't inhibit COX-1 either. I really think that a lot of people didn't realize that they're all COX-2 inhibitors which is why they preach against turmeric--but not the others.

Until he gets on a lower pred dose, I'll just make sure he doesn't get any of it.

Just MEH.
"In order to really enjoy a dog, one doesn't merely try to train him to be semihuman. The point of it is to open oneself to the possibility of becoming partly a dog." Edward Hoagland
"Thorns may hurt you, men desert you, sunlight turn to fog; but you're never friendless ever, if you have a dog."

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