Piroxicam for Dogs: Benefits, Risks, and What Pet Owners Must Know

Piroxicam is a nonsteroidal anti-inflammatory drug (NSAID) sometimes prescribed by veterinarians for dogs suffering from chronic pain, especially from arthritis or certain types of cancer. It’s not a drug you can buy over the counter, and it’s not safe for every dog. Used correctly, it can improve mobility and comfort. Used wrong, it can cause serious harm-or even be fatal.

How Piroxicam Works in Dogs

Piroxicam reduces inflammation and pain by blocking enzymes called COX-1 and COX-2. These enzymes produce prostaglandins, chemicals that trigger swelling, fever, and pain. Unlike some newer NSAIDs made just for dogs, piroxicam isn’t selective-it hits both enzymes. That means it’s effective, but also more likely to cause side effects.

It’s commonly used for osteoarthritis in older dogs. One study from the Journal of Veterinary Internal Medicine showed that 68% of dogs with arthritis showed improved mobility after two weeks of piroxicam treatment. It’s also used off-label for transitional cell carcinoma (a type of bladder cancer) because it may slow tumor growth by reducing inflammation around the tumor.

When Vets Prescribe Piroxicam

Most vets won’t start with piroxicam. They usually try safer NSAIDs first-like carprofen, meloxicam, or deracoxib. These are designed specifically for dogs and have a better safety profile. Piroxicam comes into play when:

• Other NSAIDs don’t control pain well enough
• The dog has cancer, especially bladder or nasal tumors
• The dog can’t tolerate other medications due to liver or kidney issues

It’s not a first-line treatment. It’s a backup. And even then, it’s only used if the dog’s bloodwork is normal and the vet believes the benefits outweigh the risks.

Common Side Effects and Warning Signs

Piroxicam is tough on the digestive system. About 1 in 5 dogs will have some kind of reaction. Most are mild, but some are dangerous.

Watch for these signs:

• Vomiting (especially if it’s bloody or looks like coffee grounds)
• Dark, tarry stools (a sign of internal bleeding)
• Loss of appetite lasting more than 24 hours
• Lethargy or weakness
• Yellowing of the gums or eyes (jaundice-sign of liver damage)
• Increased thirst or urination (possible kidney trouble)

If your dog shows any of these, stop the medication immediately and call your vet. Don’t wait. Piroxicam can cause stomach ulcers or kidney failure in as little as 48 hours if the dog is dehydrated or has an undiagnosed condition.

Who Should Never Take Piroxicam

Some dogs should never get piroxicam. These include:

• Dogs under 6 months old
• Dogs with a history of stomach ulcers or gastrointestinal bleeding
• Dogs with kidney or liver disease
• Dogs on other NSAIDs or steroids (like prednisone)
• Dogs with bleeding disorders
• Pregnant or nursing dogs

Even healthy-looking dogs can have hidden problems. That’s why vets always run blood tests before starting piroxicam-and again after a few weeks. A dog might seem fine, but its kidneys could already be under stress.

Dosage and How to Give It Safely

Piroxicam is given once a day, usually with food to reduce stomach upset. The typical dose is 0.3 mg per kilogram of body weight. For a 25kg (55lb) dog, that’s about 7.5 mg daily.

Never guess the dose. Piroxicam comes in 10mg tablets, and splitting them accurately is hard without a pill cutter. Many vets prescribe the 10mg tablet and tell owners to give half for a medium-sized dog. But if you’re not sure, ask for a compounded liquid version-some pharmacies can make it easier to dose small dogs.

Always give it at the same time each day. Missing a dose? Don’t double up. Skip it and go back to the regular schedule. Overdosing increases the risk of serious side effects.

Drug Interactions to Avoid

Piroxicam doesn’t play well with other drugs. Mixing it with these can be dangerous:

• Other NSAIDs (ibuprofen, aspirin, naproxen)
• Corticosteroids (prednisone, dexamethasone)
• Anticoagulants (like warfarin)
• ACE inhibitors (used for heart or kidney disease)
• Diuretics (like furosemide)

Even over-the-counter supplements can interfere. Fish oil, turmeric, and ginger have natural anti-inflammatory effects. Combined with piroxicam, they can increase bleeding risk. Tell your vet about every supplement your dog takes.

Monitoring and Follow-Up

There’s no such thing as a “set it and forget it” prescription with piroxicam. You need regular check-ins.

Most vets require:

1. Blood work before starting (to check kidney and liver function)
2. Repeat blood work after 7-14 days
3. Every 4-8 weeks while on the drug

They’re checking for rising creatinine (kidney stress), elevated liver enzymes, and low red blood cell count (anemia from internal bleeding). If numbers shift, the dose may be lowered-or the drug stopped entirely.

Keep a journal. Note your dog’s appetite, energy, bathroom habits, and any vomiting or diarrhea. Bring it to every vet visit. Small changes matter.

Alternatives to Piroxicam

If piroxicam isn’t right for your dog, there are other options:

• Carprofen or Meloxicam: Safer NSAIDs for long-term arthritis pain
• Gabapentin: Helps with nerve pain and can be used alongside NSAIDs
• Tramadol: A mild opioid for moderate to severe pain
• Physical therapy: Hydrotherapy, laser therapy, and massage improve mobility without drugs
• Weight management: Losing even 10% of body weight reduces joint stress significantly
• Joint supplements: Glucosamine, chondroitin, and MSM can slow cartilage breakdown

For cancer-related pain, some vets combine piroxicam with chemotherapy or radiation. But again, that’s only done under strict supervision.

Real-Life Example: Max, the 11-Year-Old Labrador

Max had severe arthritis. He couldn’t jump onto the couch, and his walks were short and slow. His vet tried meloxicam first. After three weeks, Max was still limping. The vet switched him to piroxicam.

Within five days, Max was walking longer distances and even wagged his tail again. But on day 12, he started vomiting. His owner didn’t think much of it-until the stools turned black. They rushed him in. Blood tests showed internal bleeding and early kidney damage. The vet stopped piroxicam right away. Max recovered after a week of IV fluids and stomach protectants. He’s now on a safer NSAID with regular monitoring.

Max’s story isn’t rare. It’s a reminder that even when a drug works, safety comes first.

What Pet Owners Often Get Wrong

Many owners think:

• “If it helps, I can give more.” → Never. More isn’t better. It’s riskier.
• “My dog seems fine, so I’ll skip the blood test.” → Problems build silently. Bloodwork catches them early.
• “I gave my dog aspirin last year-it helped.” → Aspirin is not safe for long-term use in dogs. It’s not a substitute.
• “I’ll just stop it if he gets sick.” → Stopping suddenly isn’t the issue. The damage is already done.

Piroxicam isn’t a quick fix. It’s a tool. And like any tool, it needs respect.

Final Thoughts: Is Piroxicam Worth the Risk?

For some dogs-with the right diagnosis, careful dosing, and strict monitoring-piroxicam can mean the difference between a painful old age and a good quality of life. For others, the risks are too high.

It’s not about whether the drug works. It’s about whether it’s the right drug for your dog, right now. Talk to your vet about alternatives. Ask for bloodwork. Ask what signs to watch for. Ask what happens if things go wrong.

Your dog’s comfort matters. So does their safety. Don’t choose one over the other. Demand both.