Meloxicam Use in Cats

Meloxicam is an NSAID (nonsteroidal anti-inflammatory drug) used for pain. Like any NSAID, meloxicam can cause serious side effects, especially in cats.

The following is from Plumb, a veterinary drug handbook:

Meloxicam is contraindicated in cats with known hypersensitivity to meloxicam or other NSAIDs. The manufacturer warns that additional doses of meloxicam or other NSAIDs are contraindicated as no safe dosage for repeated NSAID administration has been established. Use in cats less than 4 months of age has not been established. Use preoperatively for cats undergoing major surgery where hypotensive episodes are possible; may be at higher risk for renal damage.

The human label states that no dosage adjustment is necessary in patients with mild to moderate hepatic or renal impairment. Use extreme caution in dehydrated, hypovolemic, or hypotensive animals as there is a potential increased risk of renal toxicity developing.

Adverse Effects
Experience in Europe and Canada has demonstrated a relatively safe adverse effect profile for meloxicam in dogs. GI distress is the most commonly reported adverse effect, and in US field trials vomiting, soft stools, diarrhea, and inappetence were the most common adverse effects reported. Renal toxicity appears to be quite low. Post-approval adverse effects reported have included GI effects (vomiting, anorexia, diarrhea, melena, ulceration), elevated liver enzymes, pruritus, azotemia, elevated creatinine, and renal failure.

In cats, single doses of meloxicam appear relatively safe. In field trials some cats developed elevated BUN, post-treatment anemia and, rarely, residual pain at the injection site. In other studies, meloxicam has caused GI effects (vomiting, diarrhea, inappetence), behavior changes, and lethargy. Repeated use of meloxicam in cats is controversial, as repeated doses have been associated with renal failure and death. Recently, the FDA has changed the label in the USA to warn against repeated doses in cats. However, low dose chronic use is licensed in some countries and the ISFM & AAFP guidelines for long-term NSAID use in cats suggests that benefits of treatment often outweigh the risks (Sparkes et al. 2010).

When discussing the dose of meloxicam, Plumb says the following:

Cats:
For pain:

1.  For labeled indications: 0.3 mg/kg as a single one-time administration subcutaneous dose that should not be followed by additional doses of meloxicam or other NSAIDs. (Label information; Metacam® Injection for Cats - BI)
Note: The following dosages are extra-label in the USA and in 2010 the drug sponsor (BIVI-USA) and the FDA issued the following: Warning: Repeated use of meloxicam in cats has been associated with acute renal failure and death. Do not administer additional doses of injectable or oral meloxicam to cats. See Contraindications, Warnings and Precautions for detailed information.
However, in another document published in 2010, the ISFM and AAFP Consensus Guidelines: Long-Term Use of NSAIDs in Cats, in their summary points they state: "It is only recently that NSAIDs have become licensed for long-term use in cats in some countries. The panel believe that these drugs have a major role to play in the management of chronic pain in cats, but at present only limited feline-specific data are available. To date, published studies of the medium- to long-term use of the COX-1 sparing drug meloxicam in older cats and cats with chronic kidney disease provide encouraging data that these drugs can be used safely and should be used to relieve pain when needed. While further data are needed, and would undoubtedly lead to refinement of the guidelines presented here, the panel hope that these recommendations will encourage rational and safe long-term use of NSAIDs in cats, thereby improving patients' quality of life in the face of painful disease conditions." (Sparkes et al. 2010)

 

Client Information

• Shake oral liquid well before using
• Carefully measure dose (oral liquid); do not confuse the markings on the syringe (provided by the manufacturer) with mL or kgs. If using drops to measure dose in small dogs, do not place drops directly into dog's mouth; mix with food. Otherwise, may place oral syringe into dog's mouth or mix with food.
• If animal develops adverse effects, contact the veterinarian
• If dispensed for outpatient use, obtain client information sheet for this medication

 

As we treat an increasing number of cats, we may find Meloxicam cannot be used more than once, or we may find it can be used safely if given infrequently. For now, caution is advised.

Share this post