Liquid Piroxicam for squamous cell cancer of the skin

My FIV+ cat Ghost, 11 years old, just had two large growths removed from her neck area and they biopsied as squamous cell cancer.  The vet says we can give her chemo, but that involves giving steroids as well to keep up her appetite and that would probably cause the FIV to go into overdrive.

As an alternative they suggested the liquid form of Piroxicam.  1/2 cc two times a week for two weeks.  If she tolerates that, then the dosage would be 1/2 cc every other day.  The medicine won't treat the cancer, just slow down it's progression.

I've read up on this drug and I'm concerned about the potential side effects (kidney damage, ulcers).  We just picked up the medicine today and I'm going to hold off on starting it until I talk with the vet again when she gets her stitches out next week.  In the meantime, just wondering if anyone has any experience with this drug, good or bad.

Thanks for any advice you can offer.

Maureen

I have not used it and would hesitate to use ANY form of NSAIDs in cats, but it looks like this particular drug is frequently used in feline bladder cancer.  I will see if I can get someone with more knowledge to answer your question.

Sorry to hear about your kitty, Ghost, Maureen. I don't have an answer for you either. Hoping someone else will come along with some knowledge on Piroxicam. IF it is related to Metacam (and check with your vet) then I personally would not want to use it. BUT - if it will give your cat some quality of life, a better quality of life even short term, then I would possibly do it if it were the only option. Metacam, though, is very damaging to cat's kidney's from what I have heard and would not want to use it. I assume Piroxicam is in the same family. for Ghost.

My experience with Piroxicam correlates with what you read as possible side effects.  My 17 year old cat has bladder cancer, which actually is relatively rare in cats.  Most of the literature results found on use of this medicine relates to dogs, who tolerate NSAIDs much better than cats. As stated, the goal is to control/reduce the inflammation that goes hand-in-hand with the cancer.  Controlling inflammation helps to slow the cancer's growth. 

My cat took Piroxicam for about 3 months, dose was every three days.  He became quite lethargic and had an upset stomach.  They gave him an additional medication to settle the stomach (I believe it started with an M).  We were questioning whether to continue the medicine since it was affecting his quality of life and we didn't know if it was actually helping his bladder, when his kidney values started to go up.  We stopped the medication immediately and the kidney values fell back down to his normal. 

The masses in the bladder grew quite a bit, and a year and a half later we tried again with a different NSAID, Onsior, taken daily.  He also had surgery to extend the urethra opening further into the bladder, beyond the tumor mass.  This time there were no evident side effects, in fact he behaved like a brand new cat, very active, eating, and he peed great.  After about 9 months of that medication, the kidney values again spiked.  We stopped the medicine, started sub-q fluids, and his health has significantly declined. 

I had a "look back" conversation with my vet awhile ago, and we agree that giving him the last NSAID was the correct course of treatment at the time.  When dealing with a terminal health situation, such as inoperable cancer, the treatment goal is to provide the best quality of life for as long as possible.  In this instance, we chose a treatment that could have a negative impact on the kidneys, and it apparently did.  BUT, my cat's brother is in mid-CRF, so was it really a matter of time anyway?  The one thing I would have done differently is introduce sub-q fluids along with taking the NSAID.  Dr. Kris, recently in a kidney forum, offered that as a suggested course of treatment with taking NSAIDs, as a means to help protect the kidney.  I did some further reading, which supports that thought.  So, if you are going to give a NSAID to your cat, that would be my suggestion. 

We are very grateful that our cat is still with us.  Average life with this cancer is about a year.  He was diagnosed three years ago, and has been doing relatively well for two and a half years.  These last few months has seen a decline in health, mostly for lack of eating, and he's lost significant muscle mass.  Is it the kidneys?  Is it the cancer? 

I wish you the best in your decision making.  It is never easy.  Please enjoy your time with your cat and may she live long and well!

I wanted to make sure it is clear (not to you OP, but to general readers) that use of a NSAID is not to be taken lightly.  In general, NSAIDs are not approved for cat use because of potential long-term health dangers.  They are administered by vets, legally, but outside the approval of the FDA.  Certain NSAIDs are specifically black labeled against use in cats.  Onsior is approved for use in cats, but only if taken for three days, and only in certain surgical situations.  Again, a NSAID should only be given with careful consideration and conversation with your vet. 

In our case, giving our cat a NSAID long-term was our best option in a terminal situation.  And this was decided after consulting with our vet, the oncologist and internist. 

LCat4 said:

 
I wanted to make sure it is clear (not to you OP, but to general readers) that use of a NSAID is not to be taken lightly.  In general, NSAIDs are not approved for cat use because of potential long-term health dangers.  They are administered by vets, legally, but outside the approval of the FDA.  Certain NSAIDs are specifically black labeled against use in cats.  Onsior is approved for use in cats, but only if taken for three days, and only in certain surgical situations.  Again, a NSAID should only be given with careful consideration and conversation with your vet. 

In our case, giving our cat a NSAID long-term was our best option in a terminal situation.  And this was decided after consulting with our vet, the oncologist and internist. 

Click to expand...

I agree about using NSAIDS.  I used to think in very black and white terms about NSAIDS, that they should never be used for cats.  I now believe there is a time and place for them but they have to be used with caution.  I would want to completely trust my vet before using them.  I have seen some threads here where I believe NSAIDS were being given to all kitties as a general pain reliever.  I still don't believe that they should be used in that way, the pain relievers like Buprenex should be used as the automatic go to pain reliever.

Thanks to everyone for their replies.  While I still haven’t made a final decision until talking to the vet again, I'm leaning toward NOT using the Proxicam.

My precious Ghostie already has 3 strikes against her (FIV+, age, cancer) but right now she is acting like her usual self with a normal appetite.

I forgot to mention that she's also part feral.  I had a small TNR colony in my backyard (her, her brother and her mother) and I live trapped her at 1 ½ when her mother got very sick and had to be put to sleep and her brother disappeared.  She has never fully lost her mistrust of humans, although she does allow me to brush her every morning while she flip-flops around on the floor :-).

She keeps to herself most of the time and the only time we can pick her up is when we’ve scared her out from under the bed with the vacuum and she corners herself behind a chair.  My thought when I brought her inside was never to make her a lap-type cat, just to keep her safe, fed and sheltered.  Obviously this complicates the situation if we have to add additional meds to counteract the probable nausea/side effects Proxicam will cause because her distrust will probably grow if we have to use the vacuum regularly.  We have 5 other rescue cats in the house too, so we would probably have to keep her in one room by herself so we can monitor appetite, water intake, vomiting, etc. She loves to roam the house at night, sit by the windows, etc. so she wouldn’t understand why she’s being locked out from all of that.

My husband is taking the “if it’s her time” approach, wanting to make whatever time she has left with us the most comfortable and happy we can. 

I’ve only lost one cat before this so I’m strugging with what I want vs. what is best for her.  Thank you for the well wishes.

Denice said:

LCat4 said:

 
I wanted to make sure it is clear (not to you OP, but to general readers) that use of a NSAID is not to be taken lightly.  In general, NSAIDs are not approved for cat use because of potential long-term health dangers.  They are administered by vets, legally, but outside the approval of the FDA.  Certain NSAIDs are specifically black labeled against use in cats.  Onsior is approved for use in cats, but only if taken for three days, and only in certain surgical situations.  Again, a NSAID should only be given with careful consideration and conversation with your vet. 

In our case, giving our cat a NSAID long-term was our best option in a terminal situation.  And this was decided after consulting with our vet, the oncologist and internist. 

Click to expand...

I agree about using NSAIDS.  I used to think in very black and white terms about NSAIDS, that they should never be used for cats.  I now believe there is a time and place for them but they have to be used with caution.  I would want to completely trust my vet before using them.  I have seen some threads here where I believe NSAIDS were being given to all kitties as a general pain reliever.  I still don't believe that they should be used in that way, the pain relievers like Buprenex should be used as the automatic go to pain reliever.

Click to expand...

On board with you both too. I know of many cat friend's who have vet's that readily use Metacam and the like for pain in cats and comment that if you get the dosage correct, then all will be well. NOT SO, IMO. Both of these friend's cats went in to CRF from using Metacam - one seriously so that there was no hope in saving the cat and the other is still needing fluids all the time now. I also use Buprenex for any pain related needs for cats.

mcchesney said:

My husband is taking the “if it’s her time” approach, wanting to make whatever time she has left with us the most comfortable and happy we can

.I’ve only lost one cat before this so I’m strugging with what I want vs. what is best for her.  Thank you for the well wishes

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Bless you for helping feral cats and you are absolutely right in that you need to made the decision based on her personality/temperament and whether you can even medicate such a cat on a daily basis. I believe that what you have done thus far for Ghost far reaches any life she would have had otherwise outdoors fending for herself. A much better life - and love :heart3: - that is what you have given her. I have been where you are now and have had to let some go when their time came rather than trying to catch them for medications and vet visits. I see it as if we are their angels on this earth and our duty may not be to prolong life by stressing them to no end with medical treatments but to love them, care for them, given them a home and then, if need be, help them to the bridge peacefully. In the end, I always felt better with THAT decision rather then causing the cat major stress, causing them to live in fear of you coming after them for meds, destroying any trust they had in you by trying to force medication. Also, having to confine them away from the other cats in the house, thus taking away their safety, their normal routine, there territory was never an option for me either. It was and will always be the right thing in my mind for these feral or semi-feral cats. Not easy but a better life than what they would have had if not for us. Just my thoughts. You will know what is best for Ghost. :nod:

Feralvr said:

 I have been where you are now and have had to let some go when their time came rather than trying to catch them for medications and vet visits. I see it as if we are their angels on this earth and our duty may not be to prolong life by stressing them to no end with medical treatments but to love them, care for them, given them a home and then, if need be, help them to the bridge peacefully. In the end, I always felt better with THAT decision rather then causing the cat major stress, causing them to live in fear of you coming after them for meds, destroying any trust they had in you by trying to force medication. Also, having to confine them away from the other cats in the house, thus taking away their safety, their normal routine, there territory was never an option for me either. It was and will always be the right thing in my mind for these feral or semi-feral cats. Not easy but a better life than what they would have had if not for us.

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Thank you for the wonderful words.  That is what I feel in my heart as well.  I've done all I can for her on this earth and if my final act of love is to make her transition as comfortable as possible, so be it.  I take comfort from the words of a poem my father gave me many years ago.  It's called "A Cat's Life" and the part that I have read over and over again these past 2 weeks is this (read as if the cat is talking)....

I hope you knew how much I cared

For you and the life we daily shared

No more of you could I expect or ask

But sadly for you there’s one more task

Because the day will come when we must part

A time I know will break your heart

If I could I’d help you decide

But your love for me will be your guide

Please don’t let me linger when my time has come

And there’s nothing more that can be done

Let me go to my final rest

Knowing as always you’ve done your best

Go with fond memories from when I first heard you say

“Little Kitty, have you lost your way?”

mcchesney said:

I hope you knew how much I cared



For you and the life we daily shared



No more of you could I expect or ask



But sadly for you there’s one more task



Because the day will come when we must part



A time I know will break your heart



If I could I’d help you decide



But your love for me will be your guide



Please don’t let me linger when my time has come



And there’s nothing more that can be done



Let me go to my final rest



Knowing as always you’ve done your best



Go with fond memories from when I first heard you say



“Little Kitty, have you lost your way?”

Click to expand...

Beautiful. :touch: :heart3: Gave me the chills. :heart2: Sometimes when they have come to me, lost their way....., they are so utterly sick and ill and I know what must be done. It is almost as if they know that one lives in that house that can save them from anymore suffering and help them to their final destination. :shame: Reminds me of a dear red tabby tom I had never seen before who was at my front door one morning on the rug deathly ill with eyes glued shut and ears frozen shut and black. How he made it to my house, I have no idea. But, obviously knew I was caring for other feral cats out back. He was very, very, very emaciated and appeared to be extremely old and obviously had a life of an outdoor feral tom cat. There was no, absolutely no hope other than to end his torture. He peacefully allowed me to get him into a crate and to the vet who confirmed what I had already known on the way I still think of him today.

Here's a link to the entire poem FYI....http://www.serendipityrancher.com/catslife.htm

My dad did the puzzle for me as gift and had it framed and mounted as well.