NSAIDs or steroids for IVDD? How the two types of anti-inflammatory compare

NSAIDs or steroids for IVDD?

Your dog has IVDD, or a slipped disc, and the vet has sent you home with an anti-inflammatory medicine. It might be an NSAID (a nonsteroidal anti-inflammatory drug). It might be a steroid (a corticosteroid). Maybe a friend's dog got the other kind, or you read online that one is "better," and now you are wondering why your vet chose the one they did.

The short answer is that both types reduce inflammation, they work in different ways, and they come with different side effects. Veterinarians, including specialists, do not all choose the same way. The choice depends on your dog's exam, how long the signs have been going on, other health problems, other medicines, and how your dog has responded before. Neither type replaces strict rest.

This guide puts the two side by side so you can ask better questions. It does not tell you which one your dog should have.

If your dog is suddenly weaker, cannot walk, is in severe pain despite medicine, or cannot pee, do not wait. See IVDD emergency signs and call your vet or an emergency hospital now.

What each type does

NSAIDs block some of the chemical signals the body uses to create inflammation and pain. Vets prescribe dog-specific NSAIDs for many painful conditions, from arthritis to recovery after surgery.

Steroids (corticosteroids) are copies of hormones the body makes on its own. They calm inflammation broadly, across many parts of the immune response. At different strengths they are used for allergies, immune diseases, and inflammation, including some cases of spinal pain.

Both are anti-inflammatories, so a vet will almost always choose one or the other, not both. Either one is usually just one piece of a plan that also includes strict rest and, often, other pain-relief medicines. Our IVDD medications guide explains how those pieces fit together.

Side by side

How to read this table:

• It is a general comparison of two drug types, not a guide to any specific medicine. Individual drugs within each type differ.
• Your vet may have reasons that aren't on this list, such as your dog's bloodwork, other conditions, other medicines, or past reactions.
• The side effects listed are common ones, not every possible one. Your vet or pharmacist can tell you what to expect from your dog's medicine.

What the research says

Here is something that may surprise you: there is real disagreement among specialists about which type to use for IVDD, and the research is limited.

• The question is still open. A 2020 review of IVDD treatment described the NSAID-versus-steroid question as "somewhat polarizing" in veterinary medicine and said genuine uncertainty remains. There are no large, high-quality trials comparing the two head to head for dogs managed without surgery.
• The consensus statement leans one way, with caveats. The ACVIM consensus statement, a review by veterinary specialists, recommends NSAIDs for dogs managed without surgery when there is no reason to avoid them, and says steroids are not recommended for routine use in the early, acute phase. It also says a short course of a steroid at anti-inflammatory strength may help some dogs later on, particularly those with ongoing spinal pain.
• Some of the evidence behind that is old and indirect. One frequently cited study from 2007 looked back at 223 dogs managed without surgery and found that dogs given steroids were less likely to have a successful outcome, based on owner questionnaires. The authors themselves said the results should be read cautiously.
• Some specialists make the case for steroids. In a 2019 conference talk reported by dvm360, a veterinary neurologist argued that short, low-strength steroid courses have a real place in managing IVDD pain when used carefully.
• Side effects are a big part of the trade-off. The ACVIM statement reports that stomach and gut side effects happen at similar rates with either type alone, and at higher rates when the two are combined. A small 2023 study of dogs having spinal surgery found similar recovery of walking in both groups, but more vomiting and poor appetite in the dogs given a high-strength steroid.
• High-strength steroids given to "protect" the spinal cord are no longer recommended. That use was common years ago. Current evidence doesn't support it, and it is different from the lower-strength anti-inflammatory use discussed above.

What this means for you: if your vet chose a steroid, that is a recognized option, not necessarily a mistake. In either case, it is fair to ask your vet why they chose that type for your dog.

Why vets avoid giving both at once

Vets generally avoid giving an NSAID and a steroid together, or giving one right after the other, because combining them raises the risk of stomach and gut problems, including serious ulcers. That is a decision for your vet, who may sometimes direct and monitor a carefully planned change.

What this means at home:

• Never combine the two on your own, even if you have leftover medicine from another time or another pet.
• Don't add over-the-counter or human pain relievers. Some are dangerous for dogs. Our IVDD medications guide covers which products to keep away from your dog.
• If you see a second vet, such as an emergency hospital or a specialist, tell them exactly what your dog has had and when the last dose was. When a vet switches from one type to the other, they often plan a gap between them. Your vet sets that gap.

Side effects: when to call

Call your vet promptly if you notice:

• Vomiting, diarrhea, or refusing food.
• Black, tarry, or bloody stool.
• Much more thirst or peeing than your vet said to expect, or accidents in the crate.
• Unusual tiredness, restlessness, or panting at rest.
• Yellow gums or eyes.

Some of these can also be signs of pain or of the IVDD getting worse, which is another reason to call rather than guess. Our guide to recognizing and tracking pain can help you describe what you see. Do not stop, skip, or change a medicine on your own because of a side effect. Call, and ask what to do.

Other pain-relief medicines vets may add

An anti-inflammatory is often only one part of the plan. Depending on your dog, a vet may also add:

• Nerve-pain medicines, for the sharp, nerve-type pain a disc can cause.
• Muscle relaxants, for painful muscle spasm around the spine.
• Stronger short-term pain relief, often in the hospital or for a few days after surgery.

These are prescribed and adjusted by your vet. Some can cause sleepiness or wobbliness, which can look like the IVDD getting worse, so ask what to expect. The medications guide has a simple system for keeping track.

Feeling better isn't the same as healing

This is the most important part of this page. Both types of anti-inflammatory can make your dog feel much better within days. That comfort is welcome, but it does not mean the disc has healed.

A dog who feels better on medicine is more likely to jump, spin, pull toward the door, or fight the crate. That is exactly the movement strict rest is meant to prevent. Medicine and rest work together. Medicine does not replace rest.

• Keep to the rest plan your vet set, even when your dog seems back to normal. See crate rest that is safe and workable.
• If your dog is getting restless, see which toys are safe during crate rest and leaving your dog alone during crate rest.
• When the medicine course ends, pain can come back if the dog has been doing too much. Ask your vet what to watch for. See IVDD recovery setbacks.
• Wondering when rest can end? See is 4 weeks of crate rest enough. Your vet decides.

The ACVIM statement also notes that if a dog still needs pain relief beyond the first stretch of treatment despite proper rest, that is a reason for the vet to look further, which may include imaging or a talk about surgery. See IVDD surgery or strict crate rest and medical management for IVDD.

Questions to ask your vet

• Why did you choose this type of anti-inflammatory for my dog?
• What side effects should I watch for, and which ones mean call today?
• Does my dog need bloodwork before or during this medicine?
• How should this medicine be stopped when the course ends? Does it need to be reduced gradually?
• If we ever need to switch types, how would that work?
• Which other medicines, supplements, or products should my dog not have while taking this?
• If my dog feels better, does anything about the rest plan change? (Usually, no.)
• What would make you want to re-examine my dog sooner?

Before you change anything

This page is purely informational and is not perfect advice. Your vet knows your dog, has examined them, and can see things a web page can't. Follow your vet's plan, and always check with your vet before changing, altering, or supplementing anything, including medicines, supplements, and over-the-counter products. If something seems wrong, call your vet. If your dog is suddenly weaker or cannot walk, treat it as an emergency.