Metacam

I took Zoey to the vet today, mainly because her tail is really sensitive. Really, she tried to bite of the vet's hand when he tried to examine it. Good thing though, because he examined her x-rays from last week again, and it looks like she has an injury in her lower back/tail that he missed the first time around. They originally assumed her tail limpness and limping was a neurological symptom of FIP.

He gave her an injection of Metacam (around 3pm-ish), but we can't start the oral medication until Saturday, because she has been on prednisone.

How long does it take for metacam to kick in? Her tail still seems really sensitive - it's now about 8:30pm - so 5 1/2 hours or so). Should she have improved already? She does seem to be a little more courageous than she has been (put her legs up on the couch trying to jump up, climbed onto me when I was laying on the floor), but she has been improving gradually for the last couple days. But, the tail pain doesn't seem to have improved (of course, she's probably sick of people touching it). Do I just need to give it more time?

Thanks....so far the advice I've received from the forum has been excellent!

Coco had the Metacam Shot last Nov for her Arthitis in her Spine. The Shot helped her alot the next day. Give it time to work. I do not like Metacam Oral because I have heard alot of bad things about it. The Vet gave Coco buprenex oral for her pain. What oral med did you get?

Thanks...exactly what I was looking for. I wasn't sure if, being an injection, it should work immediately.

He gave her oral metacam. She's a teeny cat, so she's just going to get one drop a day. She's not starting until Saturday, and we have an appointment with the vet on Monday. I have read some stuff about oral metacam (both bad and good) as well, and am slightly concerned. I will keep a close eye on her once she starts on Saturday.

Edited to add: The vet said to stop the metacam immediately if there was any vomiting, blood in stool, etc. She had a complete blood workup last week.

I have heard good and bad things too. I am glad your Vet told you what to watch for and took tests. The Shot did help her alot once it worked. She had Hissed at me from pain and had never hissed at me before. She screamed too. I hope it works wekk for your Cat too.

The injectable should work much faster than the oral. Metacam should be used only on a short-term basis. I hope your cat's tail is feeling much better soon.

Originally Posted by zoeysmom

...I have read some stuff about oral metacam (both bad and good) as well, and am slightly concerned. I will keep a close eye on her once she starts on Saturday...

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I'm afraid that keeping an eye on her won't reveal what may be happening...

"Unfortunately meloxicam (metacam) is nephrotoxic, i.e. toxic to the kidneys. In fact, it can cause permanent damage to the kidneys (papillary necrosis), with the result that a number of cats seem to have developed acute or chronic renal failure after taking meloxicam." http://www.felinecrf.org/causes_of_crf.htm#metacam


http://www.metacamkills.com/

http://www.persiancats.org/medicalalerts/
http://www.persiancats.org/nss-folde...isksInCats.pdf


I will NEVER allow my cats to receive this drug orally.

Originally Posted by BLAISE

I'm afraid that keeping an eye on her won't reveal what may be happening...

"Unfortunately meloxicam (metacam) is nephrotoxic, i.e. toxic to the kidneys. In fact, it can cause permanent damage to the kidneys (papillary necrosis), with the result that a number of cats seem to have developed acute or chronic renal failure after taking meloxicam." http://www.felinecrf.org/causes_of_crf.htm#metacam


http://www.metacamkills.com/

http://www.persiancats.org/medicalalerts/
http://www.persiancats.org/nss-folde...isksInCats.pdf


I will NEVER allow my cats to receive this drug orally.

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This is the scary side of the story. Not that I disagree (I won't give it to my cats either), but to temper it just a bit: this appears to happen to cats that are pre-disposed to kidney (renal) problems. The problem is that you have no idea if your cat is pre-disposed. You are taking a risk with this drug.

I'm going to call the vet tomorrow morning to talk about my concerns about metacam. I noticed someone higher on the thread mentioning the use of oral buprenex as a pain killer instead. Does anyone else have any other suggestions for alternatives?

I'm assuming that the injectable is OK?

What I've read about the injectable's is that you shouldn't give them more than a single dose and that is usually used post-op.

I've used Torbutrol on 2 of my cats. It made one of them very loopy and the other took it fine.

Besides the buprenex, some people have used Tramadol with success. For inflammation, my vet just gave me Duralactin--while not a pain reliever, it is apparently a good anti-inflammatory.

Zoe has already had an injection of metacam on Thursday afternoon. Does that mean that other NSAIDs in oral form will be dangerous? She has not yet taken any oral metacam.

I know she's in pain, so I really want to get her on something, but metacam is scary...

The Buprenex did help Coco but I got scared and didnt give it to her until a week later. The Matacam really scared me. I am glad it was only a Shot and not the Oral dose of Metacam. My Sisters Cat was given Metacam in Jan and she took it back to the Vet and got something else.

I would be very hesitant to give a cat any NSAID, because they do not have the proper liver enzymes (most notibly, glucuronyl transferase) to metabolize non-steroidal anti-inflammatory drugs. Here is a link from the MERCK VETERINARY MANUAL, which explains NSAID toxicity in cats.

Here's a good link that explains feline pain management: http://www.vin.com/proceedings/Proce...6621&O=Generic

I would be very hesitant to use the oral Metacam on cats, just because of the possibility of renal damage. (Of course, having two renal failure cats, causes me to be extremely cautious about any thing that's potentially nephrotoxic. Neither of my cats have had Metacam...their renal failure is totally unrelated to medication.) If I needed to consider pain management in any of my cats, I would probably look into Butorphanol, Tramadol, or even Fentanyl.

So, should I specifically be asking for a non-NSAID (ie. an opioid) medication for pain releif? Are there NSAIDs that are safer to use with cats (judging from the above article - no?)?

My concern is that I'll call the vet and he won't have anything else to offer. I've been to the other vets in town, and did not have good experiences. This vet has been very good to me and to Zoey, and I really respect the decisions he has made for her treatment so far.

I know Zoey is in pain...she meows everytime her tail is grazed or moves...and looks terrified when the pain persists. I need something to help her.

I'm really reluctant to give her metacam at this point. She's just getting over a health crisis, is tiny (~3lbs), and is not drinking (has had sub-q fluids and can go in tomorrow to get more). She had a complete bood workup last week and her kidneys were fine, but a whole whack of stuff has happened since, and who knows what has changed. It seems really risky - especially on a weekend when getting her into a vet if something happens will not be easy.

Thank you to everyone for their input so far.

Originally Posted by zoeysmom

Does that mean that other NSAIDs in oral form will be dangerous?

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"Metacam (meloxicam) is a non-steroidal anti-inflammatory drug (NSAID) available in both injectible and liquid (oral) form. It is approved for use in dogs in both forms, but since cats tend to metabolise NSAIDs very poorly, in the USA meloxicam is only approved for use in cats in its injectible form. This is because it is intended to be a one-off treatment as a painkilling injection following surgery." http://www.felinecrf.org/causes_of_crf.htm#metacam

Originally Posted by zoeysmom

So, should I specifically be asking for a non-NSAID (ie. an opioid) medication for pain releif?

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YES

Originally Posted by zoeysmom

Are there NSAIDs that are safer to use with cats (judging from the above article - no?)?

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NO.

Originally Posted by zoeysmom

My concern is that I'll call the vet and he won't have anything else to offer.

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There are a number of alternate analgesics - pain relievers - available to be prescribed. Go to the link which Pookie=Poo provided (World Small Animal Veterinary Association) http://www.vin.com/proceedings/Proce...6621&O=Generic and scroll down...

Originally Posted by zoeysmom

I know Zoey is in pain....I need something to help her...I'm really reluctant to give her metacam at this point...

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I would encourage your reluctance to use the Metacam. If it were me, I would call the Vet tomorrow - Saturday - and explain that I really do not want to use the Metacam and need him to prescribe something else for the 2+ days until he sees her Monday. Be prepared to describe how she is showing the pain and to express your concern about Metacam and that you are not prepared to use it. I suspect that, considering how you express yourself here, you will be equally able to convey your carefully considered decision to the Vet - and that he will respect your opinion and recommend an alternate medication.

We have Beauty on metacam. Our vet basically told us that the studies on the effects of metacam in cats are not final, so they are still in the experimental stages.

They are monitoring her heavily (chemical testing once a month) to make sure that nothing bad happens to her. Basically without she's barely able to move her hind legs...with it shes a ton better.

Originally Posted by lunasmom

...Our vet basically told us that the studies on the effects of metacam in cats are not final, so they are still in the experimental stages....

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http://www.drugs.com/vet/metacam-oral-suspension.html :
"Contraindications
Dogs with known hypersensitivity to meloxicam should not receive MetacamÂ[emoji]174[/emoji] Oral Suspension. Do not use in cats."

"Warnings
Not for use in humans. Keep this and all medications out of reach of children. Consult a physician in case of accidental ingestion by humans. For oral use in dogs only."

Post-approval Experience
The following adverse reactions are based on voluntary post-approval reporting. The categories are listed in decreasing order of frequency by body system.
Gastrointestinal: vomiting, anorexia, diarrhea, melena, gastrointestinal ulceration
Urinary: azotemia, elevated creatinine, renal failure
Neurological/Behavioral/Special Sense: lethargy, depression
Hepatic: elevated liver enzymes
Dermatological/Immunological: pruritus
In rare situations, death has been reported as an outcome of the adverse events listed above. Renal failure has been reported as an outcome of repeated oral dosing of cats.

...doesn't sound like "experimental stages" to me.

When Coco got the Metacam Shot I was told never to get the Oral form of Metacam. That is why Coco was given the Buprenex. My Vet was in the top 16% of his Class when he went to Uc Davis. I forgot to add that I loss a few Cats to Kidney Failure but the did not have the Med.

One further reference point....this time from the FDA:

http://www.fda.gov/cvm/Documents/N141219pi.pdf

Originally Posted by BLAISE

One further reference point....this time from the FDA:

http://www.fda.gov/cvm/Documents/N141219pi.pdf

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Okay, this article has me convinced that I will never allow Metacam to be used on my cats (and I was extremely hesitant to begin with!) I don't think the benefit could ever outweigh the risk.