painkillers are so important but are they safe more specifically is metacam
safe for cats we used to think that cats weren't too affected by pain well of
course they are and now our cats are living longer many
are suffering from the effects of chronic pain due to arthritis as well as
following surgery or suffering injuries
hi I'm dr. Alex Avery from ourpetshealth.com helping you and your cat to
live healthier happier lives now this drug is one of the most
commonly used medications in cats meloxicam is the active ingredient with
metacam being the most common trade name products used it is a member of the
non-steroidal anti-inflammatory drug group which has been discussed
separately in a video all you ever wanted to know about non-steroidals today
though I want to talk about safety in cats specifically so metacams use
cats it's highly controversial in some parts of the world notably the u.s.
despite this it is completely accepted by the majority of vets in other parts
notably Europe and Australasia this has led to different licensing of the
product in other words the same drug has different dosing regimes depending on
where it is being used in Europe and Australasia meloxicam can be used as a
one-off injection it can be given orally for several days after a lower
dose injection or it can be used for the long term management of pain such as
that caused by arthritis in the US however it can only be used as a single
injection to comply with its licensing there is also a so-called black box
warning from the FDA which states that repeated use of meloxicam in cats has
been associated with acute renal failure and death do not administer additional
injectable or oral meloxicam to cats now that's pretty scary stuff but surely
both approaches and the both opinions can't be right
well in a way they can but that doesn't mean that both are in the cat's best
interest no one will deny that there are risks with giving any non-steroidal and
cats do appear to be more sensitive to these drugs it's been shown clearly that
giving the highest licensed dose for just three days can cause mild changes
in the intestines and kidney with nine days of this treatment dose causing
intestinal ulceration and peritonitis in very rare instance
a single dose may cause acute kidney failure but again this really is very
very rare the fact of the matter is though that for long term treatment the
licensed dose is six times less than this single treatment dose the
additional benefit of meloxicam being available as a liquid is that it gives
us the ability to gradually reduce the dose given to the lowest effective dose
but how do we know that this is safe well there have been several studies
looking at this with a couple of studies in Australia that looked at safety in
these patient histories of cats over 7 years of age were collected and those
cats taking metacam for arthritis were compared with those not taking metacam
when cats were free of renal disease before starting treatment there
was no difference in kidney function as they aged regardless of whether they
were receiving metacam or not when the cats already had kidney damage before
starting metacam now there was actually less deterioration in kidney function in
those cats taking metacam compared to similar cats not taking the drug
this means that rather than be dangerous long-term meloxicam may actually help to
delay the worsening of disease in cats with otherwise stable chronic kidney
failure now as with most studies there are some points worth noting this study
was funded by the manufacturers of metacam so there may very well be some
bias here also the dose of metacam given was very low less than half the
licensed dose for long-term use or twelve times less than the licensed
single use dose now this doesn't mean that it wasn't working just that the
dose may well be much lower than that given to cats who have experienced side
effects finally a study looking back at records
like this is less valuable and less powerful than ones where animals are
looked at and followed during treatment now despite all these facts the study
clearly shows that the Australasian and the European approach is likely to be
perfectly sensible and unlikely to be as reckless as suggested by the US black
box warning I really hope that there will soon be more studies that look into
this to either back up or to refute these findings now the flip side is that
nonsteroidals offer our cats one of the best chances of a pain-free life be that
during the recovery from surgery getting over a ligament or muscular injury or
living with arthritis long term yes there are alternative pain killers
but none of them are proven to work as well in cats especially long-term and in
most instances they themselves are actually not licensed for this use
either pain has many detrimental effects has a massive impact on the cats quality
of life and it should not be ignored now of course we don't want to use any drugs
irresponsibly and there are a number of actions we can take to reduce the risk
of any side-effects the first of these is to run some blood tests in older
patients or any patient that is is likely to be taking the drug on a
long-term basis a pretreatment blood sample should be taken with following up
monitoring bloods run as advised by your vet this will help pick up those
individuals when there are concerns regarding liver or kidney function if
this is the case then it may be that an alternative treatment plan is made or
that your cat is monitored more closely to be sure they don't deteriorate now
number two is to stop if vomiting or diarrhea develops any cat that
experiences vomiting or diarrhea should not continue to take the drug or risk
the development of stomach ulcers a few days off treatment will most likely
result in recovery although your vet may want to give them some treatment to aid
in this recovery it may be that your cat will be fine if they start the drug
again after all vomiting and diarrhea is a fairly common problem in otherwise
healthy cats who are not on any treatment for those seriously affected
though or known to have very sensitive stomachs or in other concerns it may be
that alternative treatments are then explored so next up is to stop if your
pet appears depressed they become unwell they stop eating or drinking if your cat
is unwell for any other reason they stop eating or drinking then do not continue
to give a non-steroidal the reason for this is that if a cat becomes dehydrated
then their organs may be under strain and anti-inflammatories they're more
likely to cause damage especially to their kidneys now running quickly
through the rest of our actions is to not give a higher dose than your vet is
prescribed number five do not give any nonsteroidals at the same time as
steroids or any other non-steroidal next we have the fact that you should not use
human painkillers unless specifically advised to by your vet and never ever
give your cat paracetamol and then at seven you should always contact your vet
promptly if you have any concerns number eight is to use other management and
treatment strategies for arthritis and other chronic pain conditions
to reduce the dose of nonsteroidals needed to help keep your pet pain-free
at number nine is that any pet who is on painkillers following surgery or injury
really make sure that you follow your vet's instructions fully to minimize
pain and inflammation and allow a shorter course or lower dose of
medication to be used finally number ten is that if your cat is fat we should
give them a dose appropriate to their ideal weight not their actual weight if
we follow these recommendations we can make sure our cats are really unlikely
to experience any significant side-effects while at the same time
they'll be as pain-free as possible don't be the owner who condemns their
pet to suffer in silence when there is another way be sensible yes don't use
any drugs inappropriately of course but don't ignore pain you owe that to your
cat now I expect anyone whose cats may have had side effects to comment and
know this video is not being sponsored by anyone
please though let me know how painkillers have helped your cat to live
a healthier happier life what have you noticed them doing how have you noticed
that their quality of life has improved I would really love to hear from you
also if it's your first time here consider subscribing to make sure that
you don't miss out on future content and allow me to continue to help you and
your cat so until next time i'm dr. alex from our pets health com because they're
family