Metacam and renal failure

melaniewa

TCS Member
Thread starter
Young Cat
Joined
Oct 6, 2016
Messages
40
Purraise
10
Has anyone had experience of Metacam causing renal failure? My cat started on Metacam just over a week ago for arthiritis and had been doing a little better with her pain. Only reason I considered Metacam was because we were approaching euthanasia.

Today she seems like she just does not feel well. She has not eaten much, and has just laid around and not moved much.  I am wondering what the symptoms of renal failure are? Does anyone have experience of this?

She is due to go for blood work in 2 weeks, but obviously if she carries on like this I'll have to take her sooner.

Thanks in advance for any replies or experiences with this.
 

stephanietx

TCS Member
Veteran
Joined
Dec 1, 2005
Messages
14,761
Purraise
3,484
Location
Texas
I had a kitty who suffered renal failure because of Metacam.  However, we caught it quickly and she was able to live for 5 more years with dietary changes and medication.

Metacam is a pain reliever and it will cause general lethargy and lack of appetite.  I would call the vet and explain what's going on. How severe is her arthritis?  Have you tried a heating pad and Cosequin to see if that helps?
 

white shadow

TCS Member
Top Cat
Joined
Nov 28, 2010
Messages
3,098
Purraise
2,982
Location
CA
 
Metacam is a pain reliever and it will cause general lethargy and lack of appetite......
First off, what I've bolded there simply is not accurate as a general statement about the drug....i.e. these symptoms do not go hand-in-hand with use of Metacam. They have been reported as adverse effects in some cats....but, the vast majority of cats properly dosed show no such effects.

Now, Melaniewa, yesterday you wrote in another thread "I am trying to figure out the best food to feed my kitty with IBD. So far she has been having Fancy Feast (Classic variety) and then pred for a day or 2 when she goes off her food"........the use of steroids is contraindicated with Metacam. It's clearly stated by the UK animal drug agency (no such American reference because it is not approved for cats in the US), but in Plumb's Veterinary Drug Handbook 7th edition (2011), it's stated that these "may increase the risk of gastrointestinal toxicity (e.g., ulceration, bleeding, vomiting, diarrhea)".

So, for starters, this is not a good combination.......whether/not it is responsible for what you're seeing, I have no idea. I wouldn't be giving them to the same cat though.

It would be helpful if you would post
  1. the strength of the Metacam (the mg/ml number)
  2. the amount Metacam in each dose
  3. the weight of the cat
It's a little hard to follow what's going on with her. Two weeks + ago, she was on a multi-modal pain therapy: "She now has a pain patch, also gabapentene 2x per day and a steroid once a day". Laser therapy was also done at that time. There was mention of Veterinary College involvement. Could you put together a quick summary/history?
 
  • Thread Starter Thread Starter
  • #4

melaniewa

TCS Member
Thread starter
Young Cat
Joined
Oct 6, 2016
Messages
40
Purraise
10
Yes, we have 2 cats - one is suffering from arthiritis and the other from IBD.

Muffin, our cat with arthiritis was started on pred. The vet then stopped the pred for 5 days before starting the Metacam. She takes 0.2 ml every other day of Metacam now. I just checked but it does not say the strength on the bottle - she is a little over 13 lbs, She also takes gabapentin 2x per day. We did not take her to the vet school in the end - they said they did not think they could help. Our vet is convinced the issue is arthiritis in her back legs from physical examination and does not think the narrowing between L5 and L6 is the issue. The pain patch was removed about a week ago.

Her sister, Mica has IBD. I give her pred as needed but wondered if I should look into her diet.

Thanks for your replies.
 

white shadow

TCS Member
Top Cat
Joined
Nov 28, 2010
Messages
3,098
Purraise
2,982
Location
CA
Well, two cats explains a lot !

It's important to know the strength of the solution you've been given. Oral Metacam is only available in the US in 1.5mg/ml concentration and is only licensed/approved for dogs. In the EU, Canada, Australia and some others it is approved for cats at a strength of .5mg/ml......one-third the American product's strength. When American vets began using it "off-label" for cats, hundreds (if not thousands) of cats were overdosed with kidney failure (destruction, really) and death resulting. The website  metacamkills.com tells some of those stories. The non-relenting outcry from outraged 'owners' finally resulted in the FDA issuing both a warning letter to all American Veterinarians and a "black box" warning on the drug itself a few years ago.

If the drug strength isn't indicated on the bottle (which I believe is mandatory in most/all jurisdictions) I would call the Vet clinic and insist that the question be put to the Vet. That will both ensure that the issue comes to the Vet's attention (in case there might be an error) and ensure you get an accurate answer.

I mentioned 'multi-modal' pain relief earlier....it's modern pain relief which targets pain from different 'angles' using a combination of drugs, often three. You can read about it here: http://todaysveterinarypractice.navc.com/focus-on-pharmacology-management-of-chronic-pain-in-cats/   where you'll find this chart:


You're using a drug from the NSAID class and one adjunct med......but, the opiod (the pain patch) has been discontinued......

If it were me, I'd be asking for a replacement opiod drug.....and, for me, that would be Buprenorphine. It's very effective and very easy to dose, being simply dropped into the side of the mouth.
 
  • Thread Starter Thread Starter
  • #6

melaniewa

TCS Member
Thread starter
Young Cat
Joined
Oct 6, 2016
Messages
40
Purraise
10
Thank you for the information - that is very helpful.
 

Geoffrey

TCS Member
Alpha Cat
Joined
Apr 17, 2016
Messages
521
Purraise
387
Location
Sydney Australia
Hello Melaniewa,

Meloxicam is a NSAID.  I am a human doctor, not a vet, and I rarely use NSAIDs (except aspirin in low doses,) in humans because of the side effects and interaction with other drugs. However there is adequate information to conclude that NSAIDs are contraindicated in human renal impairment and that NSAIDs, given long term, can cause human interstitial nephritis.  

It is always dangerous to extrapolate from humans to animals (and vice versa) but there is a useful study in the Journal of Feline Medicine and Surgery  by Anna Charlton et alii in the August 2013 vol. 15 no. 8 678-690 , in cats, that shows that short or medium term use of NSAIDs are safe, but long term use can cause renal disease.  In view of this, widely quoted, article I conclude, subject to veterinary opinion, that your cat can use Meloxicam orally, but I would have kidney function tests taken before using it for your cat and would suggest that you ask your veterinarian if there is an alternative, non-NSAID  analgesic for your cat for the long term. 

Incidentally the symptoms of early kidney disease are vague and nonspecific.  They may well be missed, but loss of appetite can be indicative of early kidney disease (or many other diseases) and increased drinking and urinating frequently with loss of weight are later symptoms.  Our 14 year old Siamese, Rupert, started drinking freely from my night glass of water so we gave him his own glass to use !  We didn't realise that this was a symptom of the kidney disease that killed him a year later.

I hope that this helps,

Geoffrey
 
Last edited:
  • Thread Starter Thread Starter
  • #8

melaniewa

TCS Member
Thread starter
Young Cat
Joined
Oct 6, 2016
Messages
40
Purraise
10
Thank you for the information, that is helpful. I am sorry you lost your kitty. 
 
  • Thread Starter Thread Starter
  • #9

melaniewa

TCS Member
Thread starter
Young Cat
Joined
Oct 6, 2016
Messages
40
Purraise
10
Hi Stephanietx, how long after you started Metacam did your kitty suffer renal failure?

Muffin has been on it for 2 weeks now, and her labs are due again in just over a week.

Her kidney function was good before we started, but this drug makes me nervous especially when she has a day when her appetite is not so good (like today).

Thanks in advance.
 

stephanietx

TCS Member
Veteran
Joined
Dec 1, 2005
Messages
14,761
Purraise
3,484
Location
Texas
She only had one injection (for arthritis), but she wasn't diagnosed with CRF or CKD until about 6 months later when we had her blood work done.  I don't know if metacam was THE cause of her CKD, but it was definitely a contributing factor.  After the shot, we started her on Cosequin and that helped her.
 
Top