Luxating patellas - metacam or other medication?

My Surya, who has radial hypoplasia and can use only his hind legs, has developed luxating patellas in those hind legs. He used to jump around like a kangaroo, terrorizing large cats with four usable legs. Now, he can still get up on the sofa sometimes but mostly stays on cat beds on the floor, and he never jumps to move around, simply shuffles. Surya is about 8 years old and has no medical problems. My vet diagnosed him and suggested we use Metacam.

Now, I know that medication is going to ring alarm bells in the minds of some of you, and some vets won't use it except for a single dose, but I'm not opposed to it. I have used it for other cats with excellent effect, and I've used it on one cat (with early onset arthritis) whose stomach couldn't tolerate it. Of course we've used Cosequin on Surya but that didn't help at all.

Does anyone have other drug suggestions, or any other suggestions on how to help? I should add that my background is in traditional medicine and in general I will not use herbal remedies (except those that have become drugs.)  

Thank you.

A lot of cats get a shot called Adequan which is for severe arthritis. Also, I'd use Buprenex for pain meds instead of Metacam. It's a prefilled syringe with a gel you put on their gums. Works well.

That's interesting. The shelter vet mentioned this drug when I was talking to her about the foster with early onset (he's only 3) arthritis and said she would look up whether it could be used on cats. She got back in touch and said it couldn't. I didn't think to question what she told me since I've worked with her for years and respect her abilities. I did a little googling after your response and find it has been used on cats. Now I'll be getting back in touch with my own vet and the shelter vet about Adequan.

I'm a bit surprised you suggested Buprenorphine (which I've used lots of times on cats who have gone through surgery) instead of using Metacam since it's a narcotic and I think of it as a heavy-duty drug. Does Metacam really worry people that much?

Yes, metacam worries me that much! My oldest girl, now 16, was given metacam in 2006 after eating toxic pet food (didn't know at the time) and it put her into acute kidney failure. I will never allow any of my cats to have Metacam ever again. Google it and you'll see that there have been many cases of it hurting cats. Better safe than sorry.

CJ also has severe arthritis and takes gabapentin for pain and gets adequan shots every 4 weeks. She is slow moving, but comfortable and happy. We have also used buprenorphine for pain management for some of my other cats with no problems at all.

My vets are on staff at a university teaching veterinary hospital and I trust them completely (they are not the ones who prescribed the metacam - that was a private vet).

Just my 2 cents worth.

Agreed, I'd pick Buprenex ANYDAY over Metacam. It's safer and it's not that strong. They give you a prefilled syringe so you don't give too much.

This might be a little more detailed than what you want, but I'm just a crazy woman who is passionate about kitties and their care. Just so you know, I am not a proponent of using drugs for kitties except as a last resort if alternative methods don't seem to help, or in conjunction with alternative methods. That being said , here's my 2-cents:

I would never use Metacam. Metacam is only approved for one-time use for kitties, and even that one time can be deadly. Repeated doses are extremely detrimental for kitties. The FDA does not give its approval and has required (since 2010) new labeling on boxes: http://www.fda.gov/AnimalVeterinary/NewsEvents/CVMUpdates/ucm231254.htm

"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. See Contraindications, Warnings, and Precautions for detailed information."

This document does a nice job explaining what types of pain kitties can experience and which class of drugs are most appropriate: http://www.catvets.com/uploads/PDF/Pain Management Guidelines_FINAL.pdf

All pain medications have risks, but these come with the fewest, so would be “safer” choices for pain medications for kitties [one must do their own due diligence]. I've also attached a pdf at the bottom of this post that gives more information on each of these in a table format to help in making a decision.

• Buprenorphine (Buprenex)
• Butorphanol (Torbutrol, Torbugesic)
• Tramadol (Ultram)
• Fentanyl (Duragesic)

Common pain medications not routinely recommended due to higher risks for kitties:

• Codeine
• Dormitor
• Gabapentin
• Morphine
• Medetomidine
• NSAIDs: Metacam
• Steroids: Prednisone, Prednisolone, Dexamethasone, Depo Medrol

I am sending your sweet Surya many feel better soon thoughts and gentle headbutts from my bubbies.
https://statich.thecatsite.com/b/ba/baab8ac0_Kitty_Pain_Meds.pdf

I don't agree with the some of that stuff from this vet though, gabapentin is proving to be very useful for pain and seizures in cats and not as risky as this vet makes it sound. I know pred has it's risks but there are thousands of cats on it for years for IBD (NOT that I am recommending it's completely safe, NOTHING IS), with no problems at all. I have actually seen more issues with Fentanyl and it should never be used with any kitty with liver disease (not this kitty in particular, just mentioning it), as it can and has caused liver failure. I've had a friend online that happened to a few years ago. JMO though.

My cat became very ill from metacam after surgery for a luxating patella. She stopped eating and drinking and it was really scary for a while. She'll never have that drug again.