Steroids vs. NSAIDs for joint pain in dogs: Pros and cons

When a dog begins to show signs of joint pain—whether from arthritis, injury, or an orthopedic condition—one of the first questions that arises is how to manage their discomfort effectively and safely.

Two of the most common pharmacological approaches are the use of non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. While both are capable of reducing inflammation and providing relief, they differ significantly in their mechanisms, applications, and risk profiles.

NSAIDs are typically the first-line treatment for managing chronic joint pain in dogs. These drugs work by inhibiting enzymes involved in the inflammatory cascade, specifically cyclooxygenase (COX), which helps reduce pain and swelling at the site of injury or degeneration. NSAIDs like carprofen, meloxicam, and deracoxib are widely used in veterinary medicine and are often considered relatively safe when administered under veterinary guidance.

Because they act locally at the site of inflammation, they tend to have a more targeted effect. However, NSAIDs are not without risk. Long-term use, especially in older dogs or those with pre-existing liver or kidney conditions, can lead to gastrointestinal ulcers, renal impairment, or hepatic enzyme elevation. Routine bloodwork is often recommended for dogs on prolonged NSAID therapy to monitor for adverse effects.

Corticosteroids, on the other hand, are far more potent anti-inflammatory agents. Drugs like prednisone, dexamethasone, or triamcinolone can be incredibly effective in rapidly reducing inflammation and suppressing immune-mediated responses that may be contributing to joint degeneration. They are sometimes used when NSAIDs fail to provide sufficient relief or when inflammation is particularly severe. However, steroids come with a different and often more significant set of side effects. Prolonged use of corticosteroids can lead to increased thirst and urination, weight gain, muscle atrophy, suppression of the immune system, and a higher risk of infections. In some cases, long-term steroid use can also contribute to the development of conditions such as iatrogenic Cushing’s disease.

Choosing between steroids and NSAIDs often depends on the underlying cause of the joint pain, the dog’s overall health status, and how the animal responds to initial treatment. For many cases of osteoarthritis, NSAIDs offer a safer long-term option, especially when combined with supportive therapies like joint supplements, weight management, or physical rehabilitation.

Steroids may be reserved for more acute or refractory cases where inflammation needs to be aggressively controlled, or when the joint pain is associated with an immune-mediated disease rather than wear-and-tear.

Ultimately, the decision should always be guided by a veterinarian who can weigh the benefits and risks in each individual case. In some situations, a short course of steroids followed by a transition to NSAIDs or alternative therapies may provide both immediate and sustainable relief.

Ongoing communication between the pet owner and veterinary team is essential to adjust treatments, monitor for side effects, and ensure the best quality of life for the dog.

References:

1. Lascelles BDX, et al. "Nonsteroidal anti-inflammatory drugs in the dog and cat: beyond COX inhibition." Veterinary Clinics of North America: Small Animal Practice, 2010.
   

2. Plumb DC. Plumb’s Veterinary Drug Handbook. 9th edition. Wiley-Blackwell, 2018.

About the autor

Felipe Garofallo is a veterinarian in Brazil, specialized in orthopedic and neurosurgical care for dogs and cats.

He is also the founder of Ortho for Pets – Veterinary Orthopedics and Specialties.