NPAIDs, once largely relegated to the rehab setting, have gained a foothold in daily practice as veterinarians report how these nonpharmaceutical anti-inflammatory devices successfully treat an array of conditions in pets.
The benefits can be financial as well when practitioners prescribe pulsed electromagnetic field (PEMF) products like the Assisi Loop and the Ivivi Roma for either in-clinic or at-home administration.
A feline-friendly veterinary hospital, for example, can develop an NPAID protocol for treating chronic osteoarthritis in senior cats that score sufficiently high on the Feline Musculoskeletal Pain Index. While in-office laser therapy remains an option, some clients may prefer to take home a PEMF device rather than subject their pet to stressful, frequent trips to the clinic.
These clients often receive a take-home Assisi Loop good for three months’ use before it needs to be replaced. Assuming the veterinary team uses the NPAID protocol in 153 cases a year that are identified as appropriate for treatment, added income of $60,000 may be generated.
Thumbs-Up From FDA
NPAIDs are increasingly being used to control inflammation and pain in animals without side effects. The most rigorously tested NPAIDs marketed for veterinary use are a group of 510(k) devices cleared by the U.S. Food and Drug Administration to target pain and inflammation in people. 510(k) devices differ from unregulated therapeutic tools in that the FDA reviews the devices’ performance and concurs that they meet required safety and efficacy standards.
The 510(k) class includes certain PEMF devices like the Assisi Loop and some Class IIIb and Class IV lasers, such as select offerings from Companion Therapy Laser and Cutting Edge.
In their traditional role, NPAIDs are used alone or in conjunction with other modalities, such as NSAID medications, acupuncture, cryotherapy and heat therapy, to treat a chronic condition.
Put Into Practice
Erin Troy, DVM, CCRP, CVPP, the medical director at Muller Veterinary Hospital in Walnut Creek, California, prescribes NPAIDs more often these days.
“We started out using them on maybe 4 or 5 percent of patients and now about 15 percent, Dr. Troy said. “Initially, we were using NPAIDs on our rehab patients to treat muscle pain, for example. Now, the scope of patients we use NPAIDs on is much broader and includes those with ear infections, gingivitis, post-op pain and wound healing.”
How to Integrate
The hardest part of instituting any change in a veterinary practice is often knowing how to get started. Veterinarians who wish to effectively incorporate NPAIDs into their hospitals may want to do this:
- Step 1: Become comfortable with NPAIDs. Veterinary rehabilitation specialist Laurie McCauley, DVM, DACVSMR, CCRT, CVA, CVC, advises practitioners to “try it on your own pets and those of the staff to become familiar with its efficacy in different disease processes.”
“Once the veterinarian is comfortable with a device’s uses and effects, it can be incorporated into practice protocols and used on clients’ pets,” Dr. McCauley said.
- Step 2: Develop practicewide treatment protocols that include NPAIDs for use with common conditions where anti-inflammatory and analgesia effects are required for optimal care.
- Step 3: Identify patients that might benefit from the new protocols. This can be done by screening patients using assessment tools such as the Feline Musculoskeletal Pain Index.
- Step 4: Calculate the economic impact that adopting NPAIDs is likely to have on the practice.
- Step 5: Offer NPAID therapy as part of the treatment protocol and as an option to owners, emphasizing the benefits to the patient.
For Elizabeth Colleran, DVM, MS, DABVP (feline), the starting point can be the Feline Musculoskeletal Pain Index to identify good patients.
Many times, NPAIDS are what the doctor then orders.
“It is a win all around for the vet, patient and owner,” Dr. Colleran said.