Metacam research needed

jennyr · Jun 6, 2012

Once again I have had a run-in with a vet about Metacam. I have been looking into changing vets since Tasha died, and was very pleased to find a new vet had opened close to me. So I took Dushka to see her on Monday, as she is due for her annual exam and vaccine. The vet confirmed my suspicions that she has some slight athritis (she is 10) and suggested a Cosequin supplement for a month. If that does not help she wants to put her on long-term Metacam, and was very put out when I said no thanks, and explained why. She said Metacam had been proven to be the safest drug longterm in cats with joint problems and gave me a glossy brochure that makes this claim. She asked to see any evidence I had to the contrary.

On reading it at home I found that the brochure cites a study of 76 cats in Melbourne, Australia, in 2011, divided into 4 groups, healthy and in CRF, with and without Metacam, but most importantly, it was underaken and written up by the Director of Research for Boehringer Ingelheim, the manufacturers of Metacam! And she expected me to accept this as a believable scientific study!

So I need to find some evidence. Apart from the FDA notices in 2010 and 2011 I cannot find a credible collection of evidence or a scientifically based independent study. Case studies that simply say 'my cat had Metacam and died' are not enough, distressing though they are. Neither are pure opinion pieces from journalists or even online vets. Can anyone out there point me in the right direction?

simka · Jun 6, 2012

I'll be very interested in such a study or studies also. I've found one short article, but with many references, here:

http://www.sciencedirect.com/science/article/pii/S1098612X10001579

Apart from one cat who developed an upset stomach while on Metacam for joint pain (he has a very fragile gi system), all the cats I've given this drug to have done very well. So, that's one cat who already had issues compared to about 30 who have had anywhere from a few days to more than a year on this medication.

I've met one vet who would use it only once, and four vets at the vet hospital I use and four shelter vets who use it as often as needed. And, quie frankly, the vet who would use it only once was not a good vet. He would not use Baytril at all because it had caused blindness in some cats. All the vets who use it told me the adverse reactions, and publicity, happened years ago when the Metacam given to cats was for larger animals and the dosages were not correct. Now that we are given Metacam for small animals with a special dosage syringe, they consider it as safe as many other drugs.

Draco · Jun 6, 2012

When Cassie first came home from the shelter, something wasn't right. I took her to the vet and she had a virus (forget the name) that attacked her leg joint, causing extreme pain. She couldn't walk on it and she had a high fever.

The vet prescribed metacam. When I voiced my concern, she said previously the vets were instructed to give the wrong dosage. For dogs, its by their weight (1 oz per lb of dog, or something like that).. they were doing the same for cats and it proved to be too much for them. Since then, they adjusted the dosage. My vet also assured me it was safe.

I gave her two dosages, and did not finish the rest as I was apprehensive. but what she said did make some sense, I was still skeptical.

I'd love to see further research on Metacam too.

carolina · Jun 6, 2012

How are all those killed cats and the FDA warnings not evidence?
FYI - the FDA only put warnings like that after many deaths are brought to their attention with proof. Should that not be enough? Those ARE case studies. The same way that glossy brochure is saying cats are safe on it, the FDA is saying they are not, and more than one SINGLE use can cause death by kidney failure.
I would print every single case of Metacamkills, the FDA warnings, and this, from the FDA:

http://www.fda.gov/AnimalVeterinary/NewsEvents/CVMUpdates/ucm231254.htm

FDA Announces Addition of Boxed Warning to METACAM[emoji]174[/emoji] (meloxicam) Labels

October 27, 2010

The Food and Drug Administration (FDA) announced today the addition of a boxed warning to the label of two METACAM[emoji]174[/emoji] (meloxicam) products. The drug’s manufacturer, Boehringer Ingelheim Vetmedica, Inc. (B.I.V.I.), changed the label to include:

WARNING

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.

The label change affects:

METACAM[emoji]174[/emoji] Solution for Injection, under New Animal Drug Application (NADA) 141-219; and
METACAM[emoji]174[/emoji] Oral Suspension, under NADA 141-213.

Boxed warnings on prescription drug labels highlight for prescribers certain contraindications or adverse drug events, especially those that may cause death or serious harm. A contraindication occurs when the risk of using the drug in a patient outweighs any benefit. An adverse drug event, also called an adverse drug experience, occurs when there is an undesired side effect associated with the drug, or when there is a lack of effect (the drug does not do what it is supposed to do).

FDA asked B.I.V.I. to add the boxed warning based on FDA’s review of reported adverse drug events for METACAM[emoji]174[/emoji]. FDA identified many cases of kidney failure and death in cats associated with repeated use of METACAM[emoji]174[/emoji].

METACAM[emoji]174[/emoji] Solution for Injection is approved for one-time use in cats before surgery to control postoperative pain and inflammation associated with orthopedic surgeries, spays, and neuters. In the United States, the safety and effectiveness of more than one dose of METACAM[emoji]174[/emoji] Solution for Injection has not been shown in cats for any condition.

METACAM[emoji]174[/emoji] Solution for Injection and METACAM[emoji]174[/emoji] Oral Suspension are approved in dogs to control pain and inflammation associated with osteoarthritis. METACAM[emoji]174[/emoji] Oral Suspension is approved for dogs only. No safe and effective dose of the oral suspension is approved for cats.

FDA is aware that some veterinarians prescribe or use METACAM[emoji]174[/emoji] in an extra-label manner. When an approved drug is used in a manner other than what is stated on the label, it is an extra-label (or “off-label”) use. Under certain circumstances, veterinarians are allowed to use a drug in an extra-label manner. The new boxed warning on the METACAM[emoji]174[/emoji] labels helps inform veterinarians of the serious risks associated with extra-label use of meloxicam in cats.

If this is not enough, I am sorry.....
BTW..... The manufacturer has been through several wrist slapping by the FDA for that brochure.
http://www.fda.gov/downloads/Animal...e&utm_term=metacam safety study&utm_content=4
http://www.fda.gov/downloads/Animal...e&utm_term=metacam safety study&utm_content=3

It is YOUR choice in the end. Not your vet's choice. She can say whatever she wants, and you don't need to say a word back.
The only thing you need to say is a NO.

carolina · Jun 6, 2012

P.S. - I have worked with the FDA - in labeling drugs, I mean.... they have very firm and clear guidelines on labeling, and nothing goes on without clinical trials - studies are necessary. So, there is data behind this warning, you can be sure of that.
The FDA customer service is also very helpful.... While information can be hard to find on their site, you can call them on the phone, and they can guide you on finding information, or email it to you. If you leave a message, they will call you back.

simka · Jun 6, 2012

I am more inclined to base which way I would move forward on this topic by reading thoroughly scientific clinical trials where all conditions are carefully controlled and monitored. Also, I am not willing to believe that the 8 vets I've worked with who have prescribed Metacam are not keeping up with their professional literature or are dispensing drugs in a careless manner. I trust them to a great degree, although I always do my own research and ask plenty of questions.

When I clicked on the links you provided I saw letters that were stamped 2004 and 2005. At that time, Metacam was being prescribed incorrectly.

carolina · Jun 6, 2012

Simka said:
When I clicked on the links you provided I saw letters that were stamped 2004 and 2005. At that time, Metacam was being prescribed incorrectly.

Depends what you call correctly - according to the FDA, there is no correct manner to prescribe Metacam oral to a cat EVER, and injections should be prescribed only once, during spay, or osteo-surgery. So, what do you suggest "the correct way" to prescribe Metacam to be? :dk:

From the FDA - prettymuch the first thing you will read on the METACAM label, is actually to not give to cats, or to give it one time only:

METACAM[emoji]174[/emoji] Solution for Injection is approved for one-time use in cats before surgery to control postoperative pain and inflammation associated with orthopedic surgeries, spays, and neuters. In the United States, the safety and effectiveness of more than one dose of METACAM[emoji]174[/emoji] Solution for Injection has not been shown in cats for any condition.

METACAM[emoji]174[/emoji] Solution for Injection and METACAM[emoji]174[/emoji] Oral Suspension are approved in dogs to control pain and inflammation associated with osteoarthritis. METACAM[emoji]174[/emoji] Oral Suspension is approved for dogs only. No safe and effective dose of the oral suspension is approved for cats.

Metacam research needed

jennyr

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Thread starter

simka

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Draco

NOT Malfoy!

carolina

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carolina

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simka

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carolina

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