Metacam

August 18, 2008 by Lynette

One of the five million things that drive me batty is some of the dire warnings about using Metacam (meloxicam) in cats. Someone will post on an online forum that their veterinarian prescribed Metacam and get a bunch of responses scaring the bejeezus out of them. Metacam kills! Metacam causes kidney failure!

Does Metacam have risks – SURE! The fact is, cats don’t generally tolerate *any* pain medications well. Metacam is a non-steroidal anti-inflammatory drug (NSAID), like aspirin, ibuprofen, etc, etc. The sad reality is cats don’t very well tolerate aspirin, or ibuprofen, or any of those handy little pain killers that get us humans through our routine headaches and muscle aches. Are there cats that have suffered severe repercussions after the use of Metacam? I’m sure there are.

The question the “Metacam kills” alarmists fail to answer, in my opinion, WHAT IS THE CAREGIVER’S OTHER OPTION? Let their cat suffer in pain?

Are there other pain medications? Yes, but there are really NONE that have a proven great track record for chronic pain. For short-term pain (post-dental, for example), you could give Buprenorphine, or Tramadol, or a larger dose of Metacam, or a Fentanyl patch… but what about chronic pain? Stomatitis? Arthritis?

As far as I know, you’ve got two options, gabapentin (Neurotin) or Metacam (meloxicam). As I noted in my recent post on arthritis, Omaha is on two supplements (Adequan and glucosamine/chondroitin) and two pain medications (gabapentin and Metacam). I will NOT have Omaha suffering in pain. Could he drop dead tomorrow from the drugs he’s on? Sadly, yes. But, what’s the point of avoiding any drugs – and don’t kid yourself, all drugs have side effects – but have him in constant pain with no quality of life? I’d rather push the envelope and give him as pain-free of a life I can give him for whatever time he may have left. I felt the same for Latifah, who was on a larger dose of Metacam for her stomatitis.

Are Adequan and glucosamine/chondroitin (like Cosequin) safer? You bet! But these are SUPPLEMENTS for joint health – they are NOT pain medications. They may help, and they may be enough in milder cases – but they are not enough that Omaha can consistently stand up and walk across a room – and he deserves at LEAST that.

Now, those that feel Metacam is too risky may point me to some of the sites proclaiming it’s risks. Again, I see NO ALTERNATIVES posted on those sites. So, if my cat is in horrible chronic pain, what are my options? I see none listed on these sites that tell me Metacam may kill my cat. Also, of the studies they list, they are giving cats WAY higher doses than what is routinely prescribed. For example, in one study they note some cats died when given Metacam – at doses of 0.3 to 0.6 mg/kg of body weight! Omaha is around 4 kg – so that’s a dose of 1.2 to 2.4 mgs. By contrast, his current dose (the “two pound dose” of the 0.5 mg/mL suspension) is about 0.01 mg’s every other day. That’s less than 1/100th of the dose given to the study referenced by the lovely “MetacamKills.com” site. (Talk about an alarmist name!)

In my very biased opinion, can we focus more energy on exploring options to HELP the cats that experience chronic pain and less energy on scaring their caregivers?

Now, again, I realize some cats have gotten sick and even died from use of Metacam – and my heart breaks for them and their caregivers, and I certainly do not intend to make light of their losses. There are also many cats made sick or died from steroids like prednisolone, and antibiotics like Flagyl (metronidazole), amoxicillan, or clindamycin, or ringworm medications or a myriad of other drugs. DRUGS HAVE SIDE EFFECTS. This is one of the many reasons I’ve expended so much effort in researching proper feline nutrition and alternative/preventative medicine – so we can AVOID drugs. But, when drugs are necessary – we have to note they have side effects and use them judiciously – but please, don’t scare the pants off some poor caregiver, especially if you have no alternatives to offer them or their cat.

More information on arthritis and pain management at Feline Outreach

To read more of my posts on feline nutrition and health, click on the “feline nutrition and health” category on the home page.

Edited to add, 6/25/09 – I’ve repeated this in the comments several times below – the rule-of-thumb I was given regarding dose:

Per my veterinarian, 12/10/07

Initial dose 0.2 mg/kg sid
Next 2 days, 0.1 mg/kg sid
Following 0.025 mg/kg 2-3 times per week

*** *** ***

1 kilogram = 2.20462262 pounds

Therefore (using 0.5 mg/mL strength):
Initial dose 0.09 mg/lb sid = 0.18 ml/lb once daily
Next 2 days, 0.045 mg/lb sid = 0.09 ml/lb once daily
Following 0.011 mg/lb 2-3 times per week = 0.023 ml/lb every other day

Therefore (using 1.5 mg/mL strength):
Initial dose 0.09 mg/lb sid = 0.06 ml/lb once daily
Next 2 days, 0.045 mg/lb sid = 0.03 ml/lb once daily
Following 0.011 mg/lb 2-3 times per week = 0.007 ml/lb every other day

Example, cat = 10 lb
Therefore (using 0.5 mg/mL strength):
0.9 mg = 1.8 mL first day (about 20 lb line)
0.45 mg = 0.9 mL once daily, second and third days (about 10 lb line)
0.11 mg = 0.23 mL fourth day and every other day thereafter (about 2 lb line)

Update July 2010:

One rule of thumb equates 20 drops with one milliliter. (Other rules of thumb I found go as high as 25 drops, or as low as 15 drops.)

So, assuming 20 drops per milliliter, two drops would be one-tenth of a milliliter or 0.1 ml.

Update 10/28/10:

Thanks to Jen for providing the link to the FDA black box warning on meloxicam (Metacam).

My thoughts:

1) As always, risks have to be weighed against benefits. There are risks with any drug, especially pain relievers for cats as cats do NOT tolerate NSAIDs well as they metabolize them slowly and rather unpredictably, so they easily build up to toxic levels. However, I personally will NOT tolerate my cats being in pain.

2) It depends a lot on what you’re dealing with. A terminal illness like cancer? A chronic complaint like arthritis? An acute situation like surgery?

3) I think gabapentin is worth consideration. It can be pricey, I had to have it compounded for my Omaha, which adds to the cost. However, while it hasn’t been used much in cats and thus is still rather experimental in my opinion, so far no side effects are known other than possible sedation/sleepiness.

4) Steroids can be an option in some cases (like my cat Rumpelmintz). They have risks as well (diabetes, skin tears, etc) some of which can be mitigated by the proper diet (see 6 reasons not to feed dry food and other posts on nutrition).

Update 9/5/2011: for those that dislike math

Using 0.5 mg/mL strength
Cat’s weight	Initial dose – once daily	Next two days – once daily	Following – every other day
5 lbs	0.9 mL	0.45 mL	0.115 mL
6 lbs	1.08 mL	0.54 mL	0.138 mL
7 lbs	1.26 mL	0.63 mL	0.161 mL
8 lbs	1.44 mL	0.72 mL	0.184 mL
9 lbs	1.62 mL	0.81 mL	0.207 mL
10 lbs	1.8 mL	0.9 mL	0.23 mL
11 lbs	1.98 mL	0.99 mL	0.253 mL
12 lbs	2.16 mL	1.08 mL	0.276 mL
13 lbs	2.34 mL	1.17 mL	0.299 mL
14 lbs	2.52 mL	1.26 mL	0.322 mL
15 lbs	2.7 mL	1.35 mL	0.345 mL
16 lbs	2.88 mL	1.44 mL	0.368 mL
17 lbs	3.06 mL	1.53 mL	0.391 mL
18 lbs	3.24 mL	1.62 mL	0.414 mL
19 lbs	3.42 mL	1.71 mL	0.437 mL
20 lbs	3.6 mL	1.8 mL	0.46 mL

Using 1.5 mg/mL strength
Cat’s weight	Initial dose – once daily	Next two days – once daily	Following – every other day
5 lbs	0.3 mL	0.15 mL	0.035 mL
6 lbs	0.36 mL	0.18 mL	0.042 mL
7 lbs	0.42 mL	0.21 mL	0.049 mL
8 lbs	0.48 mL	0.24 mL	0.056 mL
9 lbs	0.54 mL	0.27 mL	0.063 mL
10 lbs	0.6 mL	0.3 mL	0.07 mL
11 lbs	0.66 mL	0.33 mL	0.077 mL
12 lbs	0.72 mL	0.36 mL	0.084 mL
13 lbs	0.78 mL	0.39 mL	0.091 mL
14 lbs	0.84 mL	0.42 mL	0.098 mL
15 lbs	0.9 mL	0.45 mL	0.105 mL
16 lbs	0.96 mL	0.48 mL	0.112 mL
17 lbs	1.02 mL	0.51 mL	0.119 mL
18 lbs	1.08 mL	0.54 mL	0.126 mL
19 lbs	1.14 mL	0.57 mL	0.133 mL
20 lbs	1.2 mL	0.6 mL	0.14 mL

Posted in Feline nutrition and health | Tagged arthritis, metacam, stomatitis | 206 Comments

206 Responses

on August 18, 2008 at 1:47 pm Heather

Rocky cannot use the morphine based drugs because he has asthma. Even for short term pain control (like for a dental) we must use metacam. Buprenorphine depresses the respiratory system and he has asthma. We must weigh the pros and cons of available medication. For us, metacam has the smaller risk.
on August 29, 2008 at 2:06 pm greenbaum

Thank you for the reassurance about using Metacam in cats.
on September 7, 2008 at 9:02 am Sandra

I am one of the unfortunate ones who used Meloxicam (Metacam) for my fifteen year old cat’s arthritis. Despite what you say about pain management, I would rather have my cat have trouble getting around the house than have her in the hospital with IV tubes stuck in her neck battling renal failure like she is today. Yep, prior to taking this drug, she was just fine, except for her arthritis. After taking it for 12 days she started becoming lethargic, having bloody stools, eating less, and having trouble getting around again. I rushed her to the emergency vet as it was a Friday and her vet was closed. The vet there said that her blood levels were through the roof and that it was probably because of the meloxicam. It is not supposed to be given to cats at all and the drug manufacturer even lists it in their literature. If I had known this (I was given an unofficial bottle with no written instructions along with it as to the side effects), you can be sure that I would never have given it to my cat. I read that cats can’t tolerate this drug, that there is no safe dosage, and that even one dose is enough to kill. I would not recommend people to give this drug to their cat after going through what I am right now. I do not know what is even going to happen to my cat and she is a member of my family. For the record, I am glad that I found the site Metacam Kills because without it I would not have the information that I have about what harmed my cat.
on September 7, 2008 at 1:41 pm Lynette

I’m very sorry for your unfortunate experience, Sandra.

The problem is, there are *no* pain medications approved for chronic pain in cats. None.

So, you’re left with Metacam (or Neurontin/Gabapentin which is currently under investigation) or nothing.

For my cat, Omaha, it’s not a matter of “trouble getting around the head”, it’s a matter of being in so much pain he is unable to stand up. I would have to put him down, to relieve his pain. I’d rather give him pain meds with risks to relieve that pain than euthanasia.

You didn’t note the dose you were giving your cat – that would have been helpful.

I’d also note that ALL drugs have side effects. For example, about one in one hundreds cats taking Tapazole (methimazole) for hyperthryoidsim will develop a life-threatening bone marrow problem. (One of my friend’s cats died from this.) Yet, we use the drug routinely in cats – because there are no other drug options – only surgery, which doesn’t always work well – or radioactive iodine treatment.
on September 13, 2008 at 10:12 am Nina Taylor

I have been giving ‘metacam for cats’ to my lovely lil cat Missy for a few months now and it has worked wonders. The improvement right away was amazing. She is 12 years old but still runs around like a crazy kitten. However, last year she suddenly had all sorts of problems and was noticeably in pain and the life just sucked out of her… you could see the sadness in her eyes. We soon discovered it was her hips and most likely arthritis, which cause cystitis because of the pain and stress 😦 I was also told that dry biscuits cause cystitis in cats… I had just started giving her Iams senior biscuits as a treat! I was told to give her a daily dose of 0.1mg? (I do find the doseages confusing! There isn’t even a number 1 on the syringe… it starts at 2, so I fill it half way between 0 and 2) which we did for the first week. She improved so much we cut down to every other day, keeping a close eye on her, as we simply couldn’t afford to give it her daily. I now give it her once or twice a week when we notice she is a little stiff, especially on cold rainy days. I am now researching it online and trying to find a cheaper alternative. I was VERY scared by the metacamkills website and others. I totally sympathise with these animals and owners… I don’t know if I could ever forgive myself if that had happened to Missy! I didn’t hesitate to give it her and the vet didn’t seem concerned at all. It’s such a dilemma, as there are no alternatives. I would have agreed to anything as she was in such pain… you feel like a helpless mother and just want to make it better! I am so, so grateful it has worked for her. I can’t find another alternative, and it eases her pain, so I will keep giving it to her. The only thing that still concerns me is I have read it is much better to treat your animal before the symptoms start, so I don’t want her to be in pain or her condition to worsen because I am not treating her daily, so I will speak with my vet again soon. Thank you for this website and all your information, you have eased my worries and given me all the information I needed. Many thanks, Nina and Missy 🙂
on September 13, 2008 at 10:53 am Lynette

Hi Nina!

I believe the “1 pound line” on the Metacam syringe is less than 0.01 (1/100) mg.

I’d also consider giving Missy glucosamine/chondroitin (the Cosequin brand is most often used by vets, but I use a cheap human version – it’s over-the-counter) and maybe talk to your vet about Adequan.

More about arthritis in a prior blog post or here:
http://www.felineoutreach.org/EducationDetail.asp?cat=Arthritis

Lynette
on October 1, 2008 at 9:20 am Liz

My 8 year old cat Gizmo has just been prescibed Metacam. On researching the drug on the internet I was alarmed by various warnings that Metacam is dangerous for cats.

My cat is 6Kg and also now on a wieght loss plan. Her dosage is 18 drops once a day. She only has stiffness in one of her front legs, and was previously able to get around fairly well albeit she did sleep a lot. The vet suggested her lack of exercise was due to arthritic pain.

In your opinion should I stop the Metacam and give the diet a chance to work in the hope that she will be more comfortable with a some weight off, or should I only give her Metacam on bad days or should I stop giving it to her altogether.

Many thanks
on October 1, 2008 at 4:42 pm Lynette

Hi Liz,

1) I would stop feeding ANY dry food and get Gizmo on an all-wet diet. This will help her lose weight safely and effectively, as well as helping her joints.
http://www.felineoutreach.org/EducationDetail.asp?cat=Obesity

2) If not already giving glucosamine/chondroitin – I prefer to start there for minor arthritis pain. It’s a supplement with no known side effects. I do NOT believe in letting any animal suffer in chronic pain, so I DO believe in using Metacam where it is needed to keep a cat comfortable. Unfortunately, it’s difficult to know when a cat is in pain as they are so good at hiding it – does she seem better on the Metacam? Often, improvement after getting meds is our only way to know if they were experiencing pain before.

PLEASE NOTE: There are two strengths of Metacam! 0.5 mg/mL or 1.5 mg/mL – so 18 drops doesn’t tell me what dose your cat is getting, as it depends on which strength you are using.

I’m not a vet, nor a licensed vet tech – I’m merely sharing what I’ve learned through my own research and with my own cats. Best of luck!
on October 6, 2008 at 8:05 pm Albert M Stern

,

BACKGROUND

Patches is a 14 year old male feline with a healthy history. In mid-February, 2008 he is showing some difficulty in his movements.

On February 29, 2008, he is diagnosed by a vet clinic HVAH with a chronic arthritic condition. Blood tests reveal borderline healthy kidney function. Otherwise he is in good condition.

He is given Metacam injection 0.3 mg/kg by Dr. P. Then oral Metacam 0.8 ml is given once daily for two days followed by 0.2 ml once daily every other day for two weeks. Never mentioned to the client at any time is the possible adverse reactions from the Metacam injection nor the FDA non-approval of oral usage in felines(see below for label warning).

Patches returns to the vet clinic HVAHon July 25 after some of the arthritis symptoms returned. The other veterinarian, Dr. G, gives Patches a second injection of Metacam. Owner is not told of the possible adverse effects of the injection, nor told that a second injection is contraindicated on the Metacan label. In addition no blood testing is done to properly evaluate Patches’ current condition. Owner is not told of the reason or need for a physical exam or blood test; owner is not told the name of the drug injected in either visit; and the owner is never advised of the high risks of a follow-on Metacam injection.

Patches begins losing weight in mid-August with unusual sluggishness and increased vomiting, two weeks after the second injection.. He is barely eating, and on September 4 is brought to another vet clinic VBand seen by Dr. B. She exams him , gives a blood test and reports that he has serious liver and kidney deterioration. After giving antibiotics and supplements to get Patches to eat, Dr. B reports no improvement. Dr. B recommends Patches be given an ultrasound scan for a more specific diagnosis.
The scan done on September 10 shows major failure in liver, gall bladder, kidney, stomach, pancreas, peritoneum and lymph nodes. His ultrasound is done by Dr. A. at another vet clinic VCAHand she states that he has chronic renal disease, pancreatitis, and cholangiohepatitis with dehydration and jaundice.. It is recommended that aggressive medical management be instituted with IV fluids, liver aspirate and e-tube.

On September 12, Patches is admitted to this vet clinic VCAH. After two days of hospitalization, he is in organ failure, and is euthanized on September 15.

FROM THE METACAM LABELS AND INSERTS
“Additional doses of meloxicam in cats are contraindicated, as no safe dosage for repeated NSAID administration has been established. “. In black label, the insert states, ” Do not administer a second dose of meloxicam. Do not follow meloxicam with any other NSAID.” But, a second dose was administered, despite the warning. Also, in the Metacam Oral Suspension label, which is used exclusively for canines, there is an additional bold letter warning for felines, ” Do not use in cats.” However, the oral suspension was used and no warning given by Dr. P for the off-label use.

” When administering any NSAID, appropriate laboratory testing to establish hematological and serum biochemical baseline data is recommended prior to use in dogs and cats. All cats should undergo a thorough history and physical examination before administering meloxicam. Do not repeat dose in cats.” No blood test nor exam was administered before his second Metacam injection.

“Foreign Experience: Repeated use in cats has been associated with acute renal failure and death. ” This severe warning, stated in black label, was ignored with the second injection.

“Information for cat owners. Meloxicam, like other NSAIDs, is not free from adverse reactions. Owners should be advised of the potential for adverse reactions and be informed of the clinical signs associated with NSAID intolerance…Cat owners should be advised when their pet has received a meloxicam injection.” In fact this narrow margin of safety with oral Metacam is reflected in the FDA’s Adverse Drug Experience for June 9, 2006 where the agency reported that in 320 felines, 105 suffered kidney failure, 48 died and 35 cats had to euthanized.. Despite these statistics and warnings, neither Dr.P or Dr. G ever mentioned that Metacam was used on Patches nor the significant health risk to him.

I am outraged by the the loss of my pet! I cannot believe I lost my cat because of this incompetence. I want to save other animals from this fate.

Addendum

By Wendy C. Brooks, DVM, DipABVP
Educational Director, VeterinaryPartner.com Date Published: 11/1/2004 10:46:00 AM
Date Reviewed/Revised: 11/12/2007

Side Effects
The side effects of concern are the same with all NSAIDs: stomach ulceration, loss of kidney function, and inappropriate bleeding. These are dependent on the dose of medication used and on risk factors of the host (for example: an aged pet may not efficiently clear a dose of medication from its body leading to stronger and longer activity of the drug). There is also a particular idiosyncratic reaction for NSAIDs that has received a great deal of press. An idiosyncratic reaction is one that is neither dose-dependent nor predictable by any apparent host factor; it simply happens out of the blue. This particular idiosyncratic reaction is a liver toxicity that is rare enough that it did not show up in any of the initial 400 carprofen test subjects, nor in the U.K., and was not recognized until carprofen was used in over a million dogs in the U.S. after its release as the first NSAID. This reaction is reviewed below. While originally it was carprofen use that led to the recognition of this reaction, it is now felt that all veterinary NSAIDs have potential to cause this reaction.
The most common side effects of meloxicam are nausea, appetite loss, vomiting or diarrhea. If any of the above are noted, meloxicam should be discontinued and the pet brought in for a liver enzyme and renal parameter blood test. In most cases, the reaction is minor and resolves with symptomatic relief, but it is important to rule out whether or not the patient has more than just a routine upset stomach.
If a patient has borderline kidney function, NSAIDs should not be used as they reduce blood flow through the kidneys(my underline). It is also important that NSAIDS not be given to dehydrated patients because of this potential side effect. This is particularly true in cats.
The hepatopathy side effect (usually occurs within the first 3 weeks of use).

** Names removed by blog owner **
on October 6, 2008 at 9:02 pm Lynette

Mr. Stern,

I’m very sorry for your loss. Unfortunately, Metacam (just like every other drug) is not without its side effects.

I’ve personally only used the oral version of Metacam, and at a lower dose than used for your cat. I am aware of the risks, but in my cases the only other option was euthanasia, so I had/have nothing to lose.

If you’ve looked at my post on arthritis, I do recommend other options that can be explored other than Metacam – acupuncture, glucosamine/chondroitin, Adequan, Gabapentin… in two cases I’ve worked with, these weren’t sufficient… one for arthritis, and one for stomatitis/triaditis… and using Metacam has bought me some precious time with my beloved friends.

I won’t argue that Metacam doesn’t have risks – it certainly does. However, I’ve seen cases where the cat is in so much pain it can’t eat… can’t walk… and personally, I’d take the risk of a *low oral* dose of Metacam to save that cat’s life.

Lynette
on October 6, 2008 at 11:59 pm Albert M Stern

Thanks, Lynette. I appreciate your comments. If the vets had told me the risks, I never would have approved. That is the big problem along with giving Metacam w/o a blood test the second time. Bert
on October 7, 2008 at 2:49 pm Lynette

Thank YOU Bert!

My heart really does ache for you and your loss. I can sympathize to some extent – one of my cats was put on a low dose of oral prednisolone (a steroid) for diarrhea in 2004. I was not informed of the potential side effects, including diabetes. She was at high risk for diabetes as her (former) diet included dry food. Even after I called the vet, concerned with her excessive drinking and urination, my concerns were dismissed. I insisted on additional bloodwork a couple months later and I nearly lost my cat to diabetic ketoacidosis. Fortunately, her story had a happier ending than your precious cat’s.

In my opinion, ANY drug should be used judiciously, with caution. Caregivers should be informed of the potential risks – and the potential benefits. I changed vets twice in 2004, and I’m very pleased with the clinic I landed up with and am still with – as we discuss options and make decisions for my cats TOGETHER.

Lynette
on October 30, 2008 at 8:31 am Jessicaelise

I have a 4 year old, 9 pound Persian who has been fighting chronic urinary tract problems. About four times a year she starts spending all her time in the litter box. with our old vet we had been giving her medicine (sorry, don’t remember the name but started with a c I believe) to treat the infection. It would go away and then a couple months later come back. About a year ago we started using a new vet. He wanted to take some samples on Biscuit (my cat) so that he could send it off to a lab to have the bacteria grown. This way we would know what the infection was from and if we needed to treat it a different way.

Test results came back yesterday and actually came back sterile….no signs of any infection. Vet feels that she probably has a stone in her bladder. He wants me to put her on food for urinary tract health and to give her Metacam to help with the pain.

I have read so much information online about how Metacam has not been approved as an oral drug in cats (only dogs) plus it is supposedly a higher risk for Persians (because of their delicate system already) and cats under 10 lbs (mine is 9).

Is there anything I can give my cat to help her with this issue?
on October 30, 2008 at 1:24 pm Lynette

Jessicaelise,

It is most likely that your cat, Biscuit, has idiopathic cystitis – that is, urinary tract inflammation. (By the way, urinary tract bacterial infections, treated with antibiotics, are EXTREMELY rare in cats unless the cat has kidney disease, unregulated diabetes, or another issue that results in a urine more dilute than normal).

The single best thing you can do for Biscuit is to feed WET food ONLY. Cats evolved from a desert species, they were designed to get the majority of their moisture intake with their food – they do not have strong thirst drives.

Studies have shown the ONLY proven treatment effective for urinary tract disorders is to ELIMINATE ALL DRY FOOD!

For more information, see my FLUTD post:
https://meowmeowmom.wordpress.com/2008/08/02/feline-lower-urinary-tract-disease/

and visit:
http://www.felineoutreach.org/EducationDetail.asp?cat=Cystitis

Best of luck to you and Biscuit,
Lynette
on November 2, 2008 at 3:18 pm hornblower

Thank you for this informative post & for advocating for pain control in our pets. I do agree that pet owners should make informed decisions but I also believe that it is cruel to leave an animal in pain. I would rather a cat lived for 3 mos of pain-free joyous life, than 1 year of hobbling along with agony from inflamed joints.

Colorado State University has an International Veterinary Academy of Pain Management which has excellent resources for professionals. http://www.ivapm.org/

I have read of some other options that have been used with success: transdermal tramadol (applied to alternating ears) & gabapentin. A woman who runs a senior animal rescue, has had success with prednisolone. Of course there are risks & side effects. But to stand by & do nothing is unacceptable.

I’ve just started my cat on metacam for OA pain. She’s been getting Cosequin & DogGone Pain (1/2 tab/day) but now needs more.

She’s early CRF and I had to advocate strongly to get something for her as my current vet is of the opinion ‘better in pain than dead’. I just disagree so strongly with this (I’m looking for a new vet btw). When quality of life is affected, when there is no joy, life is at an end anyway & I’ll take the risks to her kidneys.
on November 5, 2008 at 4:31 am supermoose37

I know this was about cats, but my Dog was given metacam last week. It gave her a stomach ulcer, which led to internal bleeding. She died last night. Please come look at her pictures http://supermoose37.wordpress.com/2008/11/05/rip-daisy-aka-vet-killed-my-dog/
on November 8, 2008 at 8:16 pm Stefani

A lawsuit has been WON by an owner against a vet because of the use of Metacam – as follows, quoted from http://www.dolittler.com, a veterinary blog:

“Vet D’s client sued after the geriatric cat he was treating for severe arthritic pain went into renal failure, potentially because he received a three-dose regimen of Metacam . . . The vet lost because he hadn’t explained that the Metacam, given orally, was not approved for use in cats”

See
http://www.dolittler.com/index.cfm/2007/4/1/pet.vet.dog.cat.law.malpractice.4.1.07

There ARE other options that should be tried first, IMHO, AND if the vet decides to recommend metacam, s/he should NEVER prescribe it without thoroughly reviewing the adverse side effect information and telling the owners what to look for and what the dangers are so that the decision, if it is made, is a fully informed one.

If I were this poster I would certainly report this incident to the State Board of Veterinary Medical Examiners, and also, if I had the resources, I would consider a lawsuit.

It is one thing to make an informed decision that you are willing to risk your pets life to relieve its pain. It is entirely another for your vet to make that decision FOR YOU and your pet WITHOUT notifying you.
on November 27, 2008 at 9:18 am Joe G

I had reservations at first when my vet prescribed Metacam, since I read all these horror stories. But after speaking with her, a lot of misconception was cleared up.

We are fortunate to be able to have a vet that specializes only in cats, and has done so for years. So I feel she has a different perception and is in the best hands possible. She indicated that the dosage she was prescribing for our cat was a much lower dose than that for a dog of the same weight. The reason being that cats have different tolerance levels. It was noted above that the cats might be prescribed a dose of .3 -.8 ml dose. According to my vet, thats really way to high. Our cat is 13 pounds and is getting a dose of .009 ml, every 2 days. After talking to her, its become apparent to me that cats should receive a different dose. AND, if your vet decides to give your cat the same amount as recommended for a dog, I would seriously get a 2nd opinion, with a vet that understands cats and how they react to Metacam. You also should ask the vet how much experience they have had in treating a cat with Metacam.

The bottom line is, vets, just like doctors need to understand the medicine they are prescribing for each patient. And their failure to do so, is putting your cat at risk. Its sad to read all these stories about cats getting sick, but also sad if the vet isn’t being diligent.

I don’t deny their are risks with Metacam. My vet first checked our cat’s liver and kidney function BEFORE suggesting this as a treatment. AND, she will be checking these levels every 2 weeks.

It makes me just as upset that a vet would not do more research before they prescribe the medicine. Lets face it, vets are able to talk to other vets, and learn about their experiences, as well as medical research studies. This is not to say that all vets arent doing it.

Also, it makes me wonder why my vet has never had a death in her practice in using Metacam, and has had many successful treatments. Maybe because she is learning all she can about the product, and the best way to make it work for cats.

One more thing. I am not a vet, employee of the drug manufacturer, nor an employee of any vet clinic.
on November 27, 2008 at 10:15 am Lynette

Thanks for the comment, Joe – very good point about the dose.

Also, I think one of the important things to note is you are dosing every OTHER day. Cats clear NSAIDs like Metacam (meloxicam) and aspirin from their system much slower than humans or dogs. For that reason, it’s important that drugs like Metacam and aspirin are generally dosed no more frequently than every OTHER day so they have a much lower chance at building up to toxic doses in their little systems.

… and I am also not a vet, employee of a drug manufacturer, or employee of a vet clinic. 🙂

I also agree with you – I wish every vet was a member of VIN and utilized all the resources available to them. Obviously, their time is limited and most likely many are like me in my job – and don’t really want to work all day then read about work in the evening – but fortunately, many do. I’m fortunate, if I bring an idea to my vet, he’s willing to research it on VIN and even print out information for me so we can review it TOGETHER. He’s a gem.

Lynette
on December 14, 2008 at 12:50 am Jan Kolbohm

Thank you for your article on Metacam. The horror stories are frightening. Although my cat has urinary/bladder problems, Metacam has been prescribed for her along with antibiotics. The results are remarkable. She is more lively than ever and started using her litter box again —- soo happy about that! The Vet told me to reduce Metacam dosage until a minimum was found. I’m confused about the measurements. I have the 1.5 mg/mL Oral Suspension and the intial dose is 0.4 mL daily. Please tell me how that equates with the dosage you are giving your cat. A lot? A little? I do realize each situation is different, but would like to know what has worked for others.
- on December 14, 2008 at 11:12 am Lynette
  
  Hi Jan,
  
  You are giving 0.4 mL of the 1.5 mg/mL solution, that equates to 0.6 mg.
  
  For comparison, the cats in the study (that proved fatal for many) were getting doses of 0.3 to 0.6 mg per kg of body weight. Assuming the cats weighed around 3 to 4 kgs, that’s a dose of 0.9 to 2.4 mg.
  
  Omaha’s dose was 0.01 mg every other day.
  
  One of my cats, Rumpelmintz, injured a leg this year. (See “Blood Clot – or not”.) I was given a rule-of-thumb for use of oral Metacam in her situation of:
  Initial dose 0.2 mg/kg once daily
  Next 2 days, 0.1 mg/kg once daily
  Following 0.025 mg/kg 2-3 times per week
  
  Rumpelmintz weighed 4.2 kg
  Therefore (using 0.5 mg/mL strength):
  0.84 mg = 1.68 mL Mon
  0.42 mg = 0.84 mL Tue & Wed
  0.105 mg = 0.21 mL Thur & following
  
  Hope this helps!
  - on June 25, 2009 at 8:03 am Andi
    
    Hi Lynette
    Thank you so much for all the info.
    Obv i am horrified by all the info about Metacam on the web.
    However, I like you, have had to weigh up all the odds and have decided to keep my cat on Metacam for now.
    In your suggested dosage, it does not say how many mg that Metacam contains?
    Mine contains 0.05mg per drop, and 1.5mg per 1ml of Metacam.
    What is your suggested dosage of this per kilogram of my cat?
    Many thanks
    Andi
    - on June 25, 2009 at 10:10 am Lynette
      
      Hi Andi,
      
      I believe I do mention the strength of the Metacam I was using – and I have the dose guidelines I was given in the comments but they’re a bit buried – so I added them to the end of my original post so they’re easier to find.
      
      Per my vet, 12/10/07
      
      Initial dose 0.2 mg/kg sid
      Next 2 days, 0.1 mg/kg sid
      Following 0.025 mg/kg 2-3 times per week
      
      Therefore (using 1.5 mg/mL strength):
      Initial dose 0.2 mg/kg sid = 0.133 mL/kg first day
      Next 2 days, 0.1 mg/kg sid = 0.067 mL/kg once daily
      Following 0.025 mg/kg 2-3 times per week = 0.017 mL/kg every other day
      
      Please check my math. Basically, divide the recommended mg by the mg/mL of your solution (1.5 in your case) – and then you’ll obviously multiply by the weight of your cat in KILOGRAMS.
      
      (As a note, I prefer the new 0.5 mg/mL solution – easier to measure these small doses.)
      
      Hope this helps,
      Lynette
on December 16, 2008 at 11:10 pm Jan Kolbohm

Thank you for your response – and especially the dosage examples. Numbers do bad things to my brain, but now I can figure this out. Many thanks.
on December 19, 2008 at 12:11 am Sarah

Hi. I brought my cat into the vet this morning for UTI symptoms and turns out he has one. The vet prescribed Metacam 0.5 mg/ml along with a probiotic (Proviable) and an antibiotic (Clavamox 62.5 mg). My cat then underwent catheterization later today for a question of blockage. He received an injection of what I’m assuming is Metacam for pain during the procedure and I will have to find out for sure tomorrow and the dosing. The vet also gave me Metacam 0.5 mg/ml and I gave my cat his first dose this morning prior to his procedure…he weighs 17.80 lbs and they gave me the syringe with the lbs on it for the Metacam and said to fill it to 17 lbs….I believe this equates to 1.5 ml or 0.75 mg of Metacam, is that right? On top of the injection he received….I’m really freaking out that he may go into renal failure. He’s not eating or drinking much (which could be normal post-op behavior as he was sedated for it, but they reversed it after the procedure). All his labwork came back fine (prior to giving the meds) except his phosphorus was a bit low. His BUN was 25 and creatinine was right around 2.0. Should I ask them to repeat the kidney function and liver labs, and if so, how long should we wait to get them? He’s still acting a bit off…the procedure was 3 pm 12/18 and it’s 1:05 am on 12/19….he’s quiet, just taking everything in and he just looks funny to me…which, again, could be normal post-op behavior but I’m so worried.
on December 19, 2008 at 7:56 am Lynette

Hi Sarah,

You don’t indicate whether, by UTI, you mean “urinary tract infection” or “urinary tract inflammation”.

Urinary tract bacterial infections are VERY rare in cats (less than 5% of cases) unless they have an underlying disease (diabetes, CRF, hyperthyroidism, etc) diluting the urine. More commonly, it is urinary tract inflammation, or cystitis. For cystitis, an antibiotic will NOT help. The only proven effective treatment is feeding an all-wet (canned or raw) diet.

How was your cat diagnosed? The only way to rule out or diagnose effectively a bacterial infection is a urine culture and sensitivity – it shows whether there are bacteria, and if there are, which antibiotic will be effective against them.

Is the cat urinating?

See my post on FLUTD:
https://meowmeowmom.wordpress.com/2008/08/02/feline-lower-urinary-tract-disease/

In my opinion, you should be concerned with what is really going on with your cat – crystals, cystitis, or (unlikely) infection. If you’re feeding any dry food – STOP, it is the single biggest culprit in every urinary tract problems – and wet food is also much better for the kidneys.

Yes, your cat is on a large dose of Metacam. I tend to use Metacam in small doses for CHRONIC pain. You are in a situation of ACUTE pain. I would probably be using buprenorphine instead of Metacam in this case. However,
I was given a rule-of-thumb for use of oral Metacam in such a situation of:
Initial dose 0.2 mg/kg once daily
Next 2 days, 0.1 mg/kg once daily
Following 0.025 mg/kg 2-3 times per week

Your cat is about 8 kilograms. Therefore, I’d be giving 1.6 mg the first day, 0.8 the next two days, and 0.2 mg every other day after that.

If my math and assumptions are correct, the 17 pound dose you are giving is 0.085 mg’s of Metacam.

Metacam as an injectable is approved for ONE TIME USE ONLY in cats. Definitely check to see what injection your cat received.

Take a look at my post on arthritis for more information on treating chronic pain:
https://meowmeowmom.wordpress.com/2008/08/02/arthritis/

This is NOT (hopefully) a case of chronic pain and I’d be looking at treating acute pain – for which there are other drugs besides Metacam that could be used. See the links in my arthritis post to more information on pain management.

Again, please, if you have not already done so, get your cat on an all-wet diet.

Best of luck.
on December 19, 2008 at 10:20 am Sarah

Hi. My cat is 17 lbs, not 8 lbs. He had a urine culture done that showed bacteria in the urine, and he also had another urinary tract infection (bacteria/blood in urine) about six months ago. When the vets went in to do the cath they found my cat had a previous PU done (perineal urethrostomy) which means he had a history of blockages. There are no crystals in his urine and I had a full panel of bloodwork done on him. Everything came back perfect except for slightly low phosphorus and elevated sodium. He got a 200 cc fluid bolus sub-q and I’m going to have his blood redrawn in two weeks. He also had two x-rays that showed just an enlarged bladder, but when they cathed him the urine flowed easily and the amount was within normal limits. He’s been on an all wet food diet for six months and I just switched him to Hill’s c/d per my vet this morning.

I initially brought him to th vet because I caught him peeing outside his litter box, which is what he did last time he had the UTI.

I checked the injection this morning and they used a medication beginning with the word b…may have been buprenorphrine. I haven’t given him any more Metacam since the initial dose yesterday morning. I’m going to have his labwork redrawn in two weeks to be safe because he also has a history of stress gastroenteritis x 2 (tx’d with Flagyl and Pepcid). I’m hoping that one dose didn’t cause any damage but I’ll be on the lookout for any small changes in his behavior.
on December 19, 2008 at 10:42 am Lynette

Sorry for the type-o, I meant 8 kilograms (not pounds). 17.8 pounds is roughly equivalent to 8 kilograms.

I’m not a big fan of c/d, but I’m very glad he’s on an all-canned diet. You might want to visit some of my posts on IBD and other digestive disorders – grains such as corn (prevalent in c/d and other Hills foods) can be a trigger for GI problems.

The injection that started with b was probably buprenex or buprenorphine – pain med commonly used in cases of acute pain.

Assuming the urine sample was obtained via cystocentesis (needle inserted into the bladder) – bacteria shown in a culture does accurately diagnose a bacteria infection. It’d be nice to now what *type* of stones he had in the past – struvite or calcium oxalate. It’s perplexing that he’d have urinary tract infections if he does not have other underlying illness. Depending on his age, I’d want to see his historical T4 values and make sure they are decreasing and in the lower end of the range if he’s over 10 years old. I’d also want to know his urine specific gravity.

Best of luck.
on December 19, 2008 at 11:06 am Sarah

Hi Lynette. Thanks for your prompt reply. His thyroid levels were WNL when I got his senior screen bloodwork done in March and it will be tested again this coming March so I’ll be able to see the trend. His spec grav was WNL limits this time around and mildly elevated when he had his last UTI. I’ll monitor him closely because he does vomit regularly 1-2x/week (usually undigested food if he eats too fast) and if it increases I’ll have to switch him to a different canned food. He was getting a combination of Fancy Feast, Sheba, and Meow Mix. What wet food would you recommend?

I’m working on his medical history. I adopted him from the MSPCA in January and contacted them last night to see if they could possibly contact the previous owners for the information. I don’t know if they will comply but it’s worth a shot. He’s currently 10 years old and except for these couple minor issues he’s a happy, healthy cat.

Thanks so much.
on December 19, 2008 at 11:56 am Lynette

Sarah, that’s great you adopted an older cat! Most adopters want the kittens or the young cats (under 3 years). Few seem to realize that cats can live to their 20s, even 30s with proper care and a 10 year old cat still has a lot of love to give!

Keep in mind a T4 level within reference range does NOT rule out hyperthyroidism. T4 levels should be in the lower half to third of the range for a cat over 10, and trending downward.
https://meowmeowmom.wordpress.com/2008/08/06/feline-hyperthyroidism/

More on IBD/digestive disorders:
https://meowmeowmom.wordpress.com/2008/09/02/puke-and-poop/

Which canned food? I have an entire post on the subject. For a cat with GI issues, I’d stick to poultry or rabbit. I’d avoid fish, especially for a cat with urinary tract issues.
https://meowmeowmom.wordpress.com/2008/12/10/canned-cat-food-which-one/

Best of luck.
on December 19, 2008 at 11:34 pm Sarah

Lynette, it’s almost 36 hours post-sedation for my cat and he is still not really eating or drinking…he takes two bites of food and walks away from it, refuses to drink anything at all, and keeps pacing back and forth around the house to the door (he’s an indoor cat). He also seems on edge and hypervigilant, but he hasn’t slept much at all since I brought him home. I also have not seen him go to the bathroom at all. The vet said to bring him back in the morning but I don’t want to make a huge deal out of this if it can be typical post-sedation behavior.
on December 20, 2008 at 9:53 am Lynette

Sarah,

I’m not a vet – but if he still hasn’t urinated, I’d be worried. It could just be some residual effects of the anesthesia, but if he’s not better today I’d probably want the vet to check him out. I believe any effects of the sedation should be resolved within 48 hours.
on December 20, 2008 at 1:46 pm Sarah

Hi there. The vet changed his antibiotic to Zeniquin 25 mg once a day and also prescribed prednisolone 5 mg once a day x 5 days then once every other day til gone. He thinks the prednisone will stimulate his thirst and also help with his pain. I’m a human nurse and 5 mg is what we give to adults so I’m a little leary about giving a 17# cat 5 mg of a steroid.
on December 20, 2008 at 3:40 pm Lynette

Perhaps Clavamox didn’t agree with him, and he’ll feel better on the Zeniquin.

As a nurse, you know steroids like prednisolone have side effects – and must be weaned off slowly, as withdrawal can occur. Personally, I would never use something as strong as steroids to stimulate thirst – I’d give sub-q fluids if dehydrated. Also, if he needs help with pain, I’d give pain meds, not steroids. I do feel there is a time and place for steroids – but I don’t believe at throwing them in just for lack of something else to do.

I hope he’s feeling better soon.
on December 31, 2008 at 8:28 pm Sandra

Dear Lynette:

I wrote to you in September about my cat Glenn. I wanted to tell you and your readers that she died from meloxican (metacam oral drops) poisoning. She was a family member – my first child that I had for 15 years. I am still devastated by her death.

I remember her very last day 9/10/08. Early in the morning, I got the call from the vet asking us if we would consent to her having a blood transfusion to correct the anemia that she got as a result of her stomach lining bleeding. Also, Glenn was refusing to eat (even her favorite tuna fish!) and they wanted to install a feeding tube into her neck. This cat never refused food. They also informed me that she wasn’t tolerating the IV fluid drip and that the fluids were leaking into the area around her lungs, though they had slowed the drip and even had to decrease the daily amount many days previous to this.

The vet didn’t sound as optimistic as she had the day before. After Glenn had been in the hospital for 6 days, her bloodwork levels that had been improving were starting to degenerate again. I realized that I was being selfish and kind of torturing my cat by keeping her in the hospital where she hated being around people in lab coats. I finally decided to bring her home where she was comfortable so that I could see for myself how she was doing. The vet agreed that I could bring her home but only if I made arrangements for euthanasia for that day prior to her release.

Once we got her home, she immediately hid from us in the coat closet even though she couldn’t walk very well and was very weak. She didn’t have any life in her eyes and her breathing was very shallow. She wouldn’t accept any food. We carried her outside into the backyard that she loved. She looked miserable so we immediately brought her back inside.

I called my regular vet and asked if she could do home euthanasia. I had Glenn lay in her favorite spot on the couch near the fireplace. My cat passed even before the injection went into her body. She went very peacefully. I felt a crushing weight on my chest, broke into tears, and realized that a very important piece of my life just blew away into the air like smoke. It was a beautiful sunny day but, for me, it wound up being a day of sheer hell.

I did not give you the dosage amount because I threw the damn bottle away as I was extremely angry at myself for not doing my research before I gave her this medicine. It felt too much like having a loaded gun sitting on the kitchen counter. I also thought it was a moot point as there is no safe dosage amount of oral suspension melacam for cats. I think that quality of life is very important for animals and if they’re in pain, I think that meloxican will just make their pain worse in the long run and lead to a slow, painful death; much more slow and much less peaceful than euthanasia.

I am not a cheap person who refuses to pay for veterinary care either. I did the radioactive iodine therapy for my cat when she got hyperthyroidism at RadioCat. I spent more money on my cat than I ever did on myself. In the end, there wasn’t anything that I could do or any amount of money that I could spend that would have saved her from that god awful medicine meloxicam.
on December 31, 2008 at 9:20 pm Lynette

Sandra,

I’m very sorry for your loss. Glenn was very lucky to have you, she was obviously very well-loved.

I’ve obviously had a very different experience with Metacam. For me, Metacam bought months of time with Latifah and Omaha that I would not have had otherwise.
on January 4, 2009 at 7:02 pm Sandra

Lynette:

Thank you. I feel like my cat would still be around if I hadn’t given her that stuff. She probably would have made it to 20 at least. I would have found something else to control her arthritis pain if I could have saved her from the meloxicam poisoning. I would probably have gone with something holistic.

I think that the reason why cats have so many health problems in the first place is because of the crappy commercial pet food that we feed them. I still think about when they found melamine in the cat and dog food and all the pets that died because of it and how we still buy products from China that could be tainted. Sorry – off topic there.

Happy New Year to all you people and your cats.

Sandra
on January 5, 2009 at 6:32 am Lynette

Sandra,

I totally agree with you on the food! If you looked at any of my other posts in the “feline nutrition and health” category, you’d see many a rant on the subject. 🙂
https://meowmeowmom.wordpress.com/tag/cat-food/

The problem, as I see it, is there are *no* pain relievers for chronic pain that cats tolerate well. They have difficulty metabolizing NSAIDs (non-steroidal anti-inflammatory drugs). Fro example, aspirin is also potentially toxic. Gabapetin, a neurological drug, is showing some promise – and I used it, in addition to metacam, for my Omaha. He also received two joint supplements, glucosamine/chondroitin and Adequan. I hope it allowed him to move without too much pain in his final months.
https://meowmeowmom.wordpress.com/2008/08/02/arthritis/

I hope you have a great 2009.

Lynette
on February 4, 2009 at 5:50 pm Kate

Hello! I appreciated your article.

My little guy is a 14 lb. (6.35 kg, right?) domestic shorthair, named Albert. We didn’t know before, but he’s been dealing with a degenerative hip problem for a long time, and only in the last few days did he suddenly begin to limp severely and complain. Our vet checked him out yesterday and after discovering this problem prescribed Metacam (1.5 mg/mL, “for use in dogs”) at .4 mL q.d. for 4 days and .1 mL every other day thereafter. He told us that in some cases Metacam can cause kidney problems and took some blood. He hasn’t called me back with the results of the bloodwork yet.

I did a little math and research today. I figure I’m giving Albert about .09 mg/kg of body weight q.d. right now (I’m not filling the syringe all the way up to .4 mL), and after that it will be .02 – .03 mg/kg… (if I’ve done my math right). This sounds darn close to what the USP says the general recommendation is. What I’m wondering is (and you’re not a vet, right? Just someone with experience) whether this sounds normal to you.

See, I read the heartbreaking stories on the MetacamKills.com website and I started to get all worked up and worried (even a bit mad at my vet!) about what I was giving to Albert (he has had 2 doses so far). But Albert seems to be so much better already, and I’d much rather be able to keep going with medication rather than amputate his leg, which was the only other viable option according to the vet (he said total hip replacement would be an option, only he wouldn’t recommend it for Albert).

Do you have any thoughts? I’m going to talk to my vet about it later, when he gets the bloodwork back… but I’d still like a little reassurance from somebody who’s used it.
on February 4, 2009 at 10:34 pm Lynette

Hi Kate!

I am not a vet, you are correct.

You’re also correct, 14 lb = 6.35 kg.

The rule-of-thumb my vet uses is:
Initial dose 0.2 mg/kg once daily
Next 2 days, 0.1 mg/kg once daily
Following 0.025 mg/kg 2-3 times per week

Therefore, if he were prescribing Metacam for your cat, I would expect:
1.27 mg once daily for one day, then
0.635 mg once daily for two days, then
0.15875 mg 2-3 times per week thereafter

You’re using the 1.5 mg/mL solution. (As a note, I prefer the new 0.5 mg/mL solution – easier to measure these small doses.)

0.85 ml (of 1.5 mg/mL strength) once daily for one day, then
0.42 ml (of 1.5 mg/mL strength) once daily for two days, then
0.11 ml (of 1.5 mg/mL strength) 2-3 times per week thereafter

Therefore, your vet’s recommended doses seem reasonable to me.

If you find your cat has kidney issues, or the Metacam isn’t sufficient to improve his quality of life – consider Gabapentin. It’s just recently started to be used in cats. I discuss it a bit in my arthritis post.

All drugs have risks. THOUSANDS of people die every year from Tylenol. TYLENOL – it’s not even a prescription drug. That doesn’t mean none of us should use Tylenol, ever. It means we need to be cautious with its use.

Best of luck.
on February 6, 2009 at 1:54 pm Kate

Lynette,

Thanks for your response, and for the advice on Gabapentin. Fortunately Metacam seems to be working fine for Albert. He took his fourth dose today and he doesn’t seem to be having any problems but seems to be feeling much better.

You’re absolutely right – there are many drugs out there for folks (Tylenol, Aleve) that could do serious harm to us if we didn’t use them carefully, but many of us would be in no end of pain if we chose not to use them… and its the same for our cats. We just have to weigh our options and go with what seems best.

Take care (and thanks again)!
- on February 6, 2009 at 4:06 pm Lynette
  
  You’re absolutely right – there are many drugs out there for folks (Tylenol, Aleve) that could do serious harm to us if we didn’t use them carefully, but many of us would be in no end of pain if we chose not to use them… and its the same for our cats. We just have to weigh our options and go with what seems best.
  
  Well said, Kate. I wish you and Albert all the best.
on February 17, 2009 at 7:09 pm Sandra

Dear Katie:

The metacam seemed to work fine for my cat for the first two weeks. She jumped up into her high cat perch that she hadn’t been able to reach for years. Ultimately, though she wasn’t able to tolerate the metacam. It poisoned her system in the end.

I am not a vet but I’m just going by what happened with my cat who was on metacam for two weeks. Just remember to keep watch over your cat’s bowel movements, do the bloodwork to see how his kidneys are tolerating the dosage, and if your cat stops eating and drinking, losing lots of weight, or throwing up take him into the vet. At that point, however, it may be too late.

I think that the vets can test your cat’s blood first to see if the animal can tolerate the drug. That might be the way to go so that you won’t have to endure the heartbreak that I did. Good luck.
on February 21, 2009 at 8:32 pm Stephanie

My 11 year old diabetic cat was prescribed Metacam for some joint pain on his rear leg. The first dose was .48 cc which was administered yesterday. He seems to be much better and is walking around without limping. After reading about the medicine, I’m hesistant to give him his second dose, which is .24 cc today, and for 8 more days. I read that Metacam is only supposed to be given once, and no second dose, and many people had problems after their pets received the other doses. He weighs 16 pounds – I can’t figure out if the dosage prescribed is the right dosage. Can anyone tell me if that sounds right or offer any advice? Thank you!!!
on February 21, 2009 at 8:36 pm Lynette

Stephanie,

Injectable metacam is approved for one-time use only. Oral metacam is typically used more than once.

To know the proper dose, it is imperative we know the strength of your Metacam – it comes in 0.5 mg/mL or 1.5 mg/mL strengths.

Best of luck,
Lynette
on February 21, 2009 at 9:04 pm Stephanie

Hi Lynette –

The Metacam strength is 1.5 mg/mL – there are 6cc’s in the bottle. First day was .48cc, and then .24cc once daily for nine days.

The other pain med that I found on a diabetic cat forum is Buprenex. Anyone familiar with that as drug as another option?

Thanks for the quick reply!

-Stephanie
on February 22, 2009 at 7:30 am Lynette

Stephanie,

Buprenex is appropriate for short-term use only. (For example, after surgery, a dental, etc.)

For chronic pain, the only options for cats at the present time are Metacam, aspirin, and gabapentn (Neurotin).

Metacam has risks and must be dosed wth care.

Aspirin can be toxic to cats and must be dosed with care.

Gabapentin is very new for use in cats and works very differently. It’s not a non-steroidal ant-inflammatory (like aspirin or Metacam) it works on the brain receptors to block the feeling of pain.

I suggest you visit my post on arthritis for more information.
https://meowmeowmom.wordpress.com/2008/08/02/arthritis/

As for diabetes, I have several posts on the subject and recommend yourdiabeticcat.com or felinediabetes.com.

As for the dose:

Initial dose 0.2 mg/kg sid
Next 2 days, 0.1 mg/kg sid
Following 0.025 mg/kg 2-3 times per week

1 kilogram = 2.20462262 pounds

Therefore (using 1.5 mg/mL strength):
Initial dose 0.09 mg/lb sid = 0.06 ml/lb sid
Next 2 days, 0.045 mg/lb sid = 0.03 ml/lb sid
Following 0.011 mg/lb 2-3 times per week = 0.007 ml/lb eod

Your cat = 16 lb
Therefore, I would come up with (using 1.5 mg/mL strength):
1.44 mg = 0.96 mL initial dose
0.72 mg = 0.48 mL next two days
0.176 mg = 0.12 mL 2-3 times per week following

a mL and a cc are effectively the same thing.

I am NOT a vet or a certified vet tech. I am merely discussing what’s worked for me and my cats.

best of luck,
Lynette
on March 7, 2009 at 10:47 pm linda

Hi everyone:

I don’t have any suggestions for alternative medications for pain to offer caregivers and their cats. Nor am I looking to scare the pants off anyone.

I’m just a person whose 9 year old cat, Spooky, is in acute renal failure and fighting for his life tonight after taking the drug Metacam.

On Feb. 14, his vet prescribed Metacam for a previously dislocated knee-cap that she said was “nearly healed and better overall”. I was told to continue the drug for pain management of his dental surgery on Feb. 19.

Prior to the surgery bloodwork was done and, at 15lbs, he was pronounced healthy, if not a little “heavy”. He came thru the surgery fine – no extractions, just tarter and some inflamation. X-rays showed his knee-cap was healed.

As instructed, I continued to give the prescribed dosage of Metacam on Feb 21,22, 23.

The following week (March 1st) I began to notice that Spook was sleeping ALOT and eating very little. On several occasions he vomited a small amount of white foam. Although he wasn’t hiding like he usually does when he is ill, he just didn’t seem himself. I was concerned, but because he had exhibited some of these symptoms on other occasions and nothing had come of it, I thought maybe his knee might be bothering him or he was simply “under the weather”.

Last nite however, (Friday, Mar. 6) he vomited a larger amount of white foam several times and then lay down and hardly moved. I offered him his favorite food, but he just sniffed it and turned away. Then, when he went to use his litterbox, he stumbled and seemed disoriented.

Today, with his regular vet off duty, I decided to bring him into the vet clinic anyway to be seen by a new doctor on call. After an initial exam that revealed nothing that could account for his symptoms, she did a complete blood workup.

Twenty minutes later, I was told Spook was in acute renal failure and had I decided to wait until Monday to bring him in he would probably have died. I remember her telling me that prior to the surgery, his BUN level was something like 38. That figure was now at 168! She said that his renal failure was, in her opinion, due to the Metacam and that unfortunately, this happens in a “small percentage of cats.”

When I left him at the hospital, they had started him on IV fluids and I will be at the hospital tomorrow to see him and learn if the numbers are showing even the smallest improvement. No one can tell me what his chances are of pulling through this or if there will be permanent damage to his kidneys.

My vet never informed me that this medication was not approved for cats or that one of it’s side effects is “acute renal failure.” I DID ask if I should have any concerns about this drug, but was told that the prescribed dosage was so small that I shouldn’t worry.

I am sick, angry and scared for my cat. Why are vets prescribing this medication when the manufacturer (I just learned this tonight) states in their literature Metacam should NOT be given to CATS! Why are pet owners NOT being informed of the life and death risks of this drug? I would never have given Metacam to Spooky had I known not even the FDA has approved its use in cats. Now, I’m wondering why he was given this medication so casually in the first place, since his condition was not really one of chronic or terrible pain?

Given what has happened to my previously healthy cat in this short time, my advice to anyone considering using Metacam is, if you love your cat – DON’T!!! Are you really comfortable knowing that you may be easing his pain only to kill him?

Like doctors and lawyers, vets DO overlook things and DO make errors of judgment. The numbers on other websites support this. ALL these pet owners can’t be exaggerating their experiences! I know I’m not. Being told Spooky is in acute renal failure and may die is the last thing I expected to be told today.
on March 8, 2009 at 11:11 pm William

I’m on cat watch tonight over my cat Skooter (6 Kilo – 13 lbs). Now, in my case, the vet prescribed only .4 ML of the drug and then I was instructed to wait two days until giving her .2 ML more of the drug. .4 ML of the drug was administered at 8:00pm on March 7.

Around noon on March 8, Skooter started that low painful meow, and released a hairball of brown sludge onto the carpet (not the white foam you hear about on the other sites). Next, she peed into her box as well as pooped, but then things got very strange – ultimately defecating a small light bloody spot on my son’s blanket.

I immediately took her to the vet. The vet (not our normal doctor) told me to stop use of Metacam immediately – that “some cats react poorly to pain mediacation”.

The biggest variable in the whole thing – my cat is a little aggressive when it comes to Dr’s. She needed to be gassed for an effective examination of her knee (not completely out, but enough to take the edge off) and then again for the actual examination to see if there was a blockage (basically twice in a 48 hour period). After doing my research, it seems that this gassing could have caused the same problems as Metacam’s users report.

What worries me is that she has not pooped or peed since 12:00pm March 7. I have a feeling that my cat (much to her dismay) will need to go to the vet tomorrow if we don’t have any success. Her appetite and thirst remains at normal levels though, so I am holding out hope that she uses her facilities soon as she has been eating and drinking normally all day. However – her next feeding is at 4am – so I will see if there are any changes. As of now (1:08 est), she is sleeping peacefully on her chair.

Like others – Skooter is a solid member of the family – 9 years old. She recently blew out her knee taking the corner stairs a little too fast one too many times. The Metacam was prescribed as something to keep her comfortable.

My heart goes out to those that have lost their loved ones, and to Spooky and the others that are fighting right now. They are in my prayers tonight as I keep watch over Skooter.
on March 8, 2009 at 11:12 pm William

Sorry – correction – she has not pooped or peed since around noon on March 8th.
on March 10, 2009 at 8:06 am Moriah

My cat has been battling FLUTD as well, on canned c/d, has had two blockages.

He is in very real pain when he has a flare-up and especially after removing a catheter. The pain makes him associate the litterbox with pain, and so he will go outside the box when he’s in pain. We’ve been working with the vets very hard to get the problems resolved, and he may have to have the surgery to fix blockages if he blocks one more time. I hope we can afford it.

The vet prescribed Metacam with a very straightforward warning — “We can’t use much of this or every day because it can cause kidney failure, but it will help the pain.”

So twice a week my 11 lb purr bucket gets 2 drops of Metacam 1.5 on his wet food if he has been demonstrating pain behaviors (overgrooming down there, the “panic dance” he does before going to the box if he’s hurting, exiting the box very quickly), we’re feeding him c/d canned (after the first blockage he had to be on s/d for six weeks because he had a lot of sediment in his bladder on ultrasound but it’s c/d now), and we’re looking to buy a new living room set that has removable and washable upholstery.

They are trying very hard to find a way to get him better physically, and the Metacam seems to help him a lot. No panic dance, he holds his urine longer (less frequent but larger clumps), no furious overgrooming right after going pee… he seems a lot happier, too. The vet said his ultrasounds show that the walls of his bladder have become less inflamed while taking it. He’s taking 0.03 ml/kg twice a week, so my vet prescribed a very low dose.

I have had bladder infections and I’ve known a lot of people who’ve had kidney stones, so I know how bad it hurts. I would rather die than hurt like that for God knows how long…. I think the risk is justified.
on March 11, 2009 at 3:18 pm Jetatai

My cat Fluffernutter just had a simple neuter today. He was given metacam injection during the surgery. I was also sent home with 3 pre-filled vials. The instructions are as follows:
give .42cc by mouth with food tonight, give .21cc with food next 2 nights for pain relief. I always check medicines online before administering or for myself. I am very concerned as all the posts I’ve read say nothing about administering this medication for a neuter. Should I call the vet and ask for something else? I don’t want him in pain, and he won’t need it longer than a couple days.
FYI: Fluffernutter weighs 6 lbs. 10 oz. He is 6 months old
on March 11, 2009 at 7:16 pm Lynette

Jetatai,

The name Fluffernutter is adorable!

Keep in mind there are NO PAIN MEDICATIONS that are without risk!

So, you can ask for something else if you want – Fluffernutter has already had an injection of Metacam. You can ask to switch to Buprenorphine or a Fentanyl patch… there are more options for acute pain than for chronic pain – but they are NOT without their own risk.

In my opinion, it’s a decision you have to make based on what you are comfortable with.

I’ve used Metacam for chronic pain in my cats Omaha (arthritis), Elsinore (cancer), Latifah (stomatitis and arthritis and pancreatitis), Rumpelmintz (arthritis), and Aloysius (cancer). None suffered adverse consequences. Each time I put a cat on Metacam, I KNOW there are risks – but I will NOT let my cats be in pain and do nothing.

Best of luck to you in your decision.

By the way, I’m not commenting on the dose you mentioned because unless I know the strength of the Metacam you are using (it comes in multiple strengths), I can’t comment.
on March 12, 2009 at 10:03 am Jetatai

I have decided not to give him any pain meds whatsoever. He seems fine. I, myself have no idea what the strength is, as I was never informed and have no prescribing info. My neighbor has animals of her own and when I showed her the dose they had prescribed, she was appalled. So all the metacam has met the trash and Fluffernutter seems none the worse for it. I’m sure this is a great medication for an older cat in chronic pain, But not for a healthy young cat who’s only going to hurt a couple days. Thankyou for your help and being so quick to reply to my post. By the way, His full name is : Fluffernutter Freaknasty McPhearson, get your laugh in, it extends life 🙂
on March 25, 2009 at 7:37 pm Sandy

My 7 year old cat (15 lbs) was diagnosed with oral cancer the first part of February. Our nornal vet was off that day and was seen by one of the other vets in the office. She said that even with agressive treatment (which included removing her lower jaw — NEVER would i do that!) there was a chance of it returning. She gave my sweet kitty only a few months. She did prescribe Metacam .2ml per day for the pain and said the best thing was to keep her comfortable.
I spoke to my normal vet the following week and she said that the dosage was high. She lowered it to .1ml/day.
After reading all this, I am now vey concerned. She still seems to be doing good at this point even though she has some trouble eating. I can tell that the growth is spreading though. I know my kitty will ultimately have to be put down because of the oral cancer either because she can’t eat, or has trouble breathing because of it. My heart is torn! Am I wrong to give her metacam to relieve her pain so at least the time she has left she will be comfortable? Do I need to cut back on the dosage? I am now thoroughly confused and hoping I haven’t already done more damage than good with the metacam. Your thoughts?
- on March 25, 2009 at 7:51 pm Lynette
  
  Sandy,
  
  It’s ultimately your decision. My cat, Louie, has oral cancer, and I am giving him Metacam. He doesn’t have much time left, and I want it to be as comfortable as possible.
  
  Lynette
on April 6, 2009 at 12:38 pm Stephanie

Lynette – Thanks for all the wonderful and insightful info!

Your views on pain management over doing nothing makes me feel a lot better about the choices I’m making for my Boobear, who is currently suffering from terminal Injection Site Sarcoma. I’m just trying to do the best that I can for him with what I’m given and with what little time we have left together.

I do have a question though…like many others I’m oh-so confused by the dosages/mL/etc.

Our vet has Boobear on 5 drops once a day for 5 days, and then on 3 drops once a day every other day or 3rd day (Metacam Oral Suspension 1.5mg/mL).
I finished the 5th day yesterday (Sunday) and was not planning on dosing him again until Wednesday.

My question is: 3 drops appears to be equal to 0.1 mL(+/-) when suctioned into the syringe…is this appropriate for his size (10 pounds)?

Thanks!
- on April 6, 2009 at 8:57 pm Lynette
  
  Hi Stephane,
  
  I’m so sorry to hear your Boobear has VAS. I hope you have lots of quality time with him yet, and I will hold you both close to my heart during this difficult time.
  
  I’m not a vet, but the guidelines I was given are:
  Initial dose 0.2 mg/kg sid
  Next 2 days, 0.1 mg/kg sid
  Following 0.025 mg/kg 2-3 times per week
  
  1 kilogram = 2.20462262 pounds
  
  Therefore (using 1.5 mg/mL strength):
  Initial dose 0.09 mg/lb sid = 0.06 ml/lb sid
  Next 2 days, 0.045 mg/lb sid = 0.03 ml/lb sid
  Following 0.011 mg/lb 2-3 times per week = 0.007 ml/lb eod
  
  Boobear = 10 lb
  Therefore (using 1.5 mg/mL strength):
  0.9 mg = 0.6 mL initial dose
  0.45 mg = 0.3 mL once daily for two days
  0.11 mg = 0.07 mL after that, 2-3 times per week
  
  Best of luck.
  Lynette
on April 20, 2009 at 3:11 pm Kate

Thanks for this posting – it obviously gets a lot of attention on internet searches. I appreciated the info because I keep getting mixed info online.

Marley takes it in the low does every 3 days for discomfort related to mouth surgery. I can see the difference in her when we get close to the 3 day mark.

Thanks for your help and for the balanced information.
on April 20, 2009 at 7:53 pm Lea

My kitty has terrible arthritis and has been taking Adequan injections in the muscle every two or three weeks for a year. I just found out I can give the injections SQ which is fabulous! She is doing really well and so far no side effects even though Adequan is a canine med.
on April 27, 2009 at 1:21 pm Tammy

My vet prescribed Metacam because my 7 year old cat had a slight limp when she first got up, probably a stubbed leg. Now she is in the hospital on continuous iv after only 12 doses with renal failure. I did not even know this was a possible side effect. It is a terrible drug and maybe I am just another “Crazy CAT Lady” but i love my cat that i’ve had for 7 years and i don’t want her to die. Do Not Take the Chance.
- on January 27, 2010 at 1:55 pm Lucie
  
  You’re not crazy. My dog was put on Metacam and it gave her renal failure. After a few days on IV she survived. My vet was never convinced that it was the Metacam so about a year later when she tore her ACL he said to give it to her for just a few days to bring the swelling down. She went into renal failure after 3 doses. This stuff is liquid death. Do not give it to your pet.
on April 29, 2009 at 7:59 am JJ

Hello. Thanks to all of you for this wonderful discussion!

I have three questions, please.

My elderly cat Stella went in for dental surgery yesterday. In total, she had 4 teeth extracted. While they were at it they removed 4 small mast cell tumors on her head and took an X-ray of her elbows, which revealed that she has arthritis.

3 days before the surgery she was on antibiotics (1 tablet of Clavaseptin 50mg every 12 hours). After the surgery she continues the antibiotics until we finish them (roughly 10 days). As well, she has Metacam for pain. My first question is: Can you please help me understand the dosage I’m administering? Stella weighs 14 lbs. The Metacam is 1.5mg/mL, and my directions are to give 2 drops orally once daily with her food for soreness.

What I’m most confused about, aside from whether this is a high or low dosage, is that I’m supposed to continue administering this amount daily INDEFINITELY. That is, my vet wants this to be Stella’s daily dosage to manage her arthritis pain, which I gather isn’t terribly debilitating. My second question is: I’m wondering if this prescription (administering Metacam every day and at this dosage) is the most cautious way to proceed. Obviously she must be in fairly serious pain for her dental work. But the arthritis doesn’t *seem* that severe as of yet. She limps and doesn’t like her elbows manipulated, but she still uses her scratch post, climbs into bed and on the couch, and uses her litter box OK.

Also, in case it’s relevant, I’ve started giving her probiotics for cats as of yesterday, in the hopes that this will counteract the GI negative effects of the antibiotics. My third and final question is: Is there a best time to give these (i.e. with the antibiotics or sometime between her two daily doses of antibiotics)?

Thanks so much!
- on April 29, 2009 at 10:11 am Lynette
  
  JJ,
  Generally you want to give Metacam every OTHER day after the first couple of days. Cats do not metabolize NSAIDs (non-steroidal anti-inflammatory drugs) well – and giving every day risks that the drug builds up in the system to toxic levels.
  As for the arthritis questions, I recommend you see my post on arthritis for options.
  Best of luck,
  Lynette
  - on April 29, 2009 at 12:48 pm JJ
    
    Dear Lynette,
    
    Thank you for your reply. I think I better talk to my vet about the every other day option for Metacam. I’ve read your post on arthritis. It has given me some new ideas for Stella.
    
    One more question:
    
    Can you please help me understand Stella’s dosage of Metacam? She weighs 14 lbs. and is supposed to have two drops of Metacam daily. It’s the 1.5mL bottle– I’m not sure how to calculate her dosage in mg so that I can assess whether this is a high or low dosage!
    
    Best to you and your cat pals!
    - on April 29, 2009 at 8:42 pm Lynette
      
      JJ,
      
      Two drops seems an average maintenance dose. One rule of thumb equates 20 drops with one milliliter. (Other rules of thumb I found go as high as 25 drops, or as low as 15 drops.)
      
      So, assuming 20 drops per milliliter, two drops would be one-tenth of a milliliter. Since you are using the 1.5 mg/mL strength, one-tenth of a milliliter equals 0.15 mg.
      
      Discuss the every other day option with your veterinarian. Best of luck!
      
      Lynette
on May 8, 2009 at 7:17 am Jacks Mom

Thanks so much for your in depth information regarding Metacam. My 14 year old gregarious, gray triped tiger was diagnosed Monday with terminal bone cancer in his jaw. The vet sent us home with Metacam, 1.5 strength. Jack weights 16 lbs and the vet’s instructions were to give Jack .3ml every other day for one week; then the same dose every 3rd day for the next two weeks; then a week off. He also said he didn’t expect Jack to live more than a month. AFter reading all of your information, I think you would have a better dose recommendation that the vet. (who by the way, never mentioned side effects or any negative information….in fact, no information at all).

Does anyone have a realistic progression on this disease?

I’ve nursed a kitty with kidney disease that I gave subq IV’s to for 2 years; and a kitty that had bladder blockages and on/off cystistis his whole life (maintained finally, with 1 vitamin C pill a day). I never thought of linking dry food to causing kitty diseases either, but certainly after at least 10 cats and 30 years, will consider the connection now !!

Thank you so much.
Jacks Mom (sandy)
- on May 8, 2009 at 9:04 pm Lynette
  
  Hi Sandy,
  
  I’m so sorry for Jack’s diagnosis. 😦
  
  I’ll tell you this – I have a cat now (Louie) with oral cancer – large mass in his mouth. For me, it’s most important that any time he has left be as comfortable and happy as possible. He was diagnosed in February. We have him on the 2.5# line of the 0.5 mg/mL suspension, given every other day. We’re all surprised and delighted he’s made this long. He’s eating and playing (though less) and grooming and cuddling and seems happy enough. When it gets to the point he’s not comfortable eating or doesn’t seem happy, I will ask the vet to assist him in passing over.
  
  So, if I were faced with decisions for Jack, I personally would give Metacam and whatever else may keep him comfortable.
  
  Wishing you peace and comfort during this difficult time.
  
  Lynette
on May 12, 2009 at 12:46 pm Kay

Thank you for this blog entry on Metacam. My 1 year old cat tore his ccl and the vet sent us home with Metacam, but I am a bit worried after reading all the poisoning stories. I know he must be in pain, so I have been giving him Metacam daily, but would like your opinion.

He weighs about 10 pounds. We were given the 0.5mg/mL oral suspension. The first day, the vet gave him .9mL and then told me to give him .45mL daily for 2-3 weeks. He has not had surgery to repair his knee as the vet wants to see what happens with rest, Metacam, and glucosamine/chondroitin. Do you think this is a safe amount? It seems higher than the values/examples in your replies. The vet did not mention any potential side effects.

I want to do what’s best for my cat, but with all the conflicting info out there, I’m getting a bit overwhelmed.
- on May 12, 2009 at 9:46 pm Lynette
  
  I’m not a vet, but the guidelines I was given for my own cats are:
  Initial dose 0.2 mg/kg sid
  Next 2 days, 0.1 mg/kg sid
  Following 0.025 mg/kg 2-3 times per week
  
  1 kilogram = 2.20462262 pounds
  
  Therefore (using 0.5 mg/mL strength):
  Initial dose 0.09 mg/lb sid = 0.18 ml/lb sid
  Next 2 days, 0.045 mg/lb sid = 0.09 ml/lb sid
  Following 0.011 mg/lb 2-3 times per week = 0.022 ml/lb eod
  
  Your cat = 10 lb
  Therefore (using 0.5 mg/mL strength):
  0.9 mg = 1.8 mL initial dose
  0.45 mg = 0.9 mL once daily for two days
  0.11 mg = 0.22 mL after that, 2-3 times per week
  
  It seems to me your vet recommended a conservative initial dose, but I’d be dosing every other day after three days, and decreasing the amount. However, I don’t know your cat. I haven’t seen your cat. I know for *me*, it’s important to keep my cats comfortable and pain free. You can take my thoughts and make your own decision with your vet.
  
  Best of luck.
  
  Lynette
on May 14, 2009 at 7:49 am Barbara

My darling girl Brindebella was recently diagnosed with a semi-collapsed spine (a couple of vertebrae are offset, putting pressure on the nerves and causing a LOT of pain). The vet showed me the x-ray and suggested to put her on metacalm. Well, my little girl is over 15 years and I want her to live whatever life she has left happy, painless and in comfort. Yes, I am acutely aware of the potential side effects of this drug. I also know that she will no live forever. For me it is a decision to make her remaining time as comfortable as possible. I couldn’t live with myself knowing that she was in constant pain (which made her quite aggressive towards the rest of the tribe who clearly didn’t understand where the change of behaviour came from). Now we all live in peace and harmony, Brindie sleeps again in my bed, she plays and purrs and eats well. I monitor her closely.
Indicentally she also cannot have commercial (supermarket) dry food. The problem is that it contains way too much magnesium which changes the pH of her bladder and leads to urinary tract infections. She gets a lot of wet food but also the special diet biscuits from Hills Science Diet. She loves it, has been on it for years and hasn’t had another UTI since I started to give her that food.
I wonder whether any of the people who prefer their cats to suffer arthritic pains have experience this pain themselves. Think Quality of Life!!! Chronic pain is a terrible thing and if you really love your cat, you make sure that his/her life is of the best quality. Sadly the time to say good-bye will come eventually… It is pure misery for us who stay behind but that should NEVER be a reason to withhold a drug that really works and improves the life of our little ones no end just because we are afraid of the side effects. Please think about it. And please be kind to those in your care because sadly they cannot make the choice.
- on May 14, 2009 at 10:23 pm Lynette
  
  Hi Barbara
  
  Thanks for sharing your story. You might also be interested in my post on FLUTD (urinary tract disease).
  https://meowmeowmom.wordpress.com/2008/08/02/feline-lower-urinary-tract-disease/
  
  Lynette
on May 28, 2009 at 12:27 pm Mary

I was just at the vets this morning and she wanted my cat (just found out it has IC) to take the metacam for 3 weeks only. She is hoping it takes down the bladder inflamation. My cat started out with a very bad UTI with peeing blood also. UTI went away but peeing blood stayed, having to pee all the time and only peeing tiny amounts. She has been on pain med (starts with “bu),gets a shot for flamation and has a spasm pill. My cat will only get the metacam every other day for the first week and every 3rd day after that. I was willing to give it to her until I searched the web and found those web sites where metacam killed their cats which made me to scared to give it to her. The vet told me that when cats do not pee the way they should it could lead to bladder scaring which leads to bladder kidney. I really do not know what to do. She is in pain that much I do know and there is nothing else to try because I can’t get her to take pills. The vet won’t let her be on pain meds for life either which I don’t understand since she will be in pain for life. I am worried not to give it to her and worried to give it to her. I know nothing about cats at all. Always had dogs.
- on May 28, 2009 at 8:04 pm Lynette
  
  The most important thing you can do for your cat is to eliminate ALL dry food and feed WET food only.
  
  From your description, your cat has indiopathic cystitis, which is inflammation of the urinary tract. This is exacerbated by not enough water in the diet. The ONLY proven treatment to reduce cases of cystitis is to feed ALL WET FOOD.
  
  Chronic inflammation has been linked to cancer.
  
  See my post on urinary tract disorders where I provide more information on the subject:
  https://meowmeowmom.wordpress.com/2008/08/02/feline-lower-urinary-tract-disease/
  
  Best of luck.
  Lynette
on May 28, 2009 at 12:29 pm Mary

I have a typo. The vet said it leads to bladder cancer with bladder scaring.
on June 3, 2009 at 8:15 pm michael

I lost a beloved rabbit to Metacam last December.

We adopted her after she had received a serious hip injury and although she recovered fairly well she still re-injured it from time to time, leaving her in some pain.

She had taken oral metacam without apparent ill effects on several occasions over the four years we had her, but the last time she injured her hip the vet gave her a metacam injection.

The effects were immediate and disastrous. She became very weak and unresponsive within minutes. An hour later she was limp and semi-conscious. Four hours after the injection she began having fits and she died shortly afterward.

I have since found several stories on the internet from rabbit owners who have had nearly identical experiences after dosing their rabbits with metacam (including orally).

Yes, I (now) appreciate that there are no pain relief medications for rabbits that are entirely safe, but my rabbit would have recovered naturally within a day or so without pain relief. All of the vets who had given her metacam had assured me that it was safe and gave no hint that a reaction like this was possible.

I’m very sorry I had to learn the hard way and hope that any pet owners reading this will think very hard about whether pain relief is really necessary before allowing metacam to be administered to their animals.
on June 15, 2009 at 5:23 am Susan

My little cat Gracie was on Metacam for 3 days and it killed her. Please don’t tell people how great it is, tell them they need to watch very closely the behavior of their cat. Keep them by themselves for at least 2 days and look for ANY changes.

We are still in shock over this.
on June 27, 2009 at 7:11 am Julianna

This may have been stated in the comments somewhere, and I haven’t read them all, but do the side effects seen with the use of Metacam generally occur in older/geriatric cats? My cat has had an unexplained limp and my vet prescribed him Metacam for the pain until we can figure out what’s going on. However, he’s only a 1 and 1/2 years old. While I realize that Metacam prescribed for arthritis, which generally occurs in older cats would probably be more common, I’m just curious if the bad side effects occur in younger cats as well. As I have no alternatives right now either, he will be getting his metacam. I don’t want to see my cat in pain.
- on June 27, 2009 at 8:30 am Lynette
  
  Hi Julianna,
  
  The greatest risk in using Metacam is kidney (renal) failure. This risk is greatest in cats that already have compromised kidney function – which is most likely in older cats and cats fed a dry diet (as they don’t take in enough moisture to flush toxins out of the kidneys). Kidney insufficiency does not show up in bloodwork until about 70% of kidney function is lost. Therefore, you might have a cat that has compromised kidney function – only 40% function remaining, but that function is not apparent in bloodwork, given Metacam and they go into renal failure.
  
  Especially in older cats or cats on dry diets, repeating bloodwork after starting Metacam may be advisable.
  
  To minimize risk of kidney insufficiency (and many other ailments, including urinary tract disorders, diabetes, gastro-intestinal disorders, etc) I HIGHLY advise feeding ONLY wet food to cats.
  
  Hope this helps.
  
  Lynette
on June 29, 2009 at 12:52 pm Fran

My Sand(cat) is 13 years old and have been on Lantus Injections for diabetes for 1 1/2 years now. He had his Annual Wellness Exam in January of this year and everything was fine. I took him to the vet’s this morning because he wasn’t eating enough to give him his insulin for the past 2 days so his BS skyrocketed to 410. He also has a sinus infection and was given Clavamox for it again. We have found out that his arthritus is getting worse so he was put on Metacam—1.5 mg/ml 10 ml bottle.The directions are to give him 3 drops daily in food for 3 days then 1 drop every day or 2. He is 9 pounds(he lost some weight). This dosage seemed strong to me so I only gave him 2 drops in his food today(1st time). Does this sound right to you? He was given a glucose fast test(high after no insulin for 2 days) and a limited Chemistry Panel and his Hematology Data and Chemistry Data came back fine. Just wondering what you thought about this. Thanks.
- on June 29, 2009 at 1:49 pm Lynette
  
  Hi Fran,
  
  I’m more concerned about Sand(cat)’s diabetes than I am his Metacam dose.
  
  Are you home-testing Sand’s blood glucose levels? In my opinion, that is IMPERATIVE for effective management of his diabetes.
  
  Also, what are you feeding Sand? Studies have shown a low-carb WET diet most effective in treating diabetes – in fact, more than 60% of diabetic cats no longer need ANY insulin when fed only low-carb CANNED food.
  
  Please see my posts on feline diabetes – I’ve worked with nine diabetic cats – and got the majority off insulin ENTIRELY. The remainder were well-managed on low doses.
  
  https://meowmeowmom.wordpress.com/2008/08/04/feline-diabetes-beliefs/
  
  https://meowmeowmom.wordpress.com/tag/diabetes/
  
  Lynette
on August 2, 2009 at 7:09 pm Mary

Our cat Tony had a brawl with the local tomcat and had to have some infected wounds on his leg flushed out and cleaned up(no stitches).
He was sent home with an antibiotic and 5 syringes of Metacam oral suspension,to be administered once a day for 5 consecutive days.
We gave him 4 daily doses before I heard about Metacam and it’s side effects.
We didn’t give him the 4th dose.
Tony is 10 yrs old and weighs 10 lbs

The label says “Metacam Per Ml for feline (1.50 ml)” and the dosage marked on the syringe was 0.3cc/ml

He seems fine right now,but what should we be looking for in terms of side effects?

Thank you,
Mary
- on August 2, 2009 at 8:57 pm Lynette
  
  * The most common side effects of meloxicam are nausea, appetite loss, vomiting or diarrhea. If any of the above are noted, meloxicam should be discontinued and the pet brought in for a liver enzyme and renal parameter blood test. In most cases, the reaction is minor and resolves with symptomatic relief, but it is important to rule out whether or not the patient has more than just a routine upset stomach.
  * If a patient has borderline kidney function, NSAIDs should not be used as they reduce blood flow through the kidneys. It is also important that NSAIDS not be given to dehydrated patients because of this potential side effect. This is particularly true in cats.
  * The hepatopathy side effect (usually occurs within the first 3 weeks of use).
  
  http://www.veterinarypartner.com/Content.plx?P=A&A=1752
  - on August 3, 2009 at 12:15 pm Mary
    
    Thank you.
    I know he did have the bloodwork done first and it was normal.
    
    He has shown none of the symptoms you mentioned,just a bit more sleepy than usual.
    
    He had the Metacam on Jul 29,30 and 31.
    - on August 3, 2009 at 1:58 pm Lynette
      
      Sleepiness can just be relief from the pain. (It’s hard to sleep when you’re in pain – and so when that pain is relieved, you may tend to “catch up” on your sleep.)
      If it persists and you’re concerned, you can take him back for repeat bloodwork.
      Lynette
on August 4, 2009 at 9:47 pm Belinda

Hi,
I am so glad to read your post! I have a 19 year old cat who suffers from arthritis but is otherwise healthy. She has been on a very low dose of metacam for 3 years! She gets 0.7 ml every 3 days. I have tried lowering the dose and stopping and she really limps and is in a lot of pain. I would rather have her around for a shorter amount of time and be in less pain.
Thanks,
Belinda
- on August 5, 2009 at 1:59 pm Lynette
  
  Hi Belinda,
  
  I’m glad Metacam is working well for your cat.
  
  You might want to visit my post on arthritis for other ideas to keep your cat comfortable:
  https://meowmeowmom.wordpress.com/2008/08/02/arthritis/
  
  Best of luck,
  Lynette
on August 9, 2009 at 5:00 pm Gerald Wood

I have just lost my 11 year old boy to Metacam, he had a pulled joint on a back leg ,went in for xray,vet administered the drug and gave us a three day supply for his food, he died two weeks later with renal failure,rehydrating him did not save him, he had his blood tested before the xrays and was (in the vets words) perfect no abnormalities in any organs,

a waste of a life…gutted..poor baxter !!

Gerald
on August 12, 2009 at 5:21 pm Mindie

Yes, all pain medications have their risks, but the owner should be told about the risks before hand so that they can make an informed decision. In your case, where your cat is in agony and there are few other options, then it makes sense to take the gamble with Metacam. Quality of life is more important than quantity, but in many cases the risk does not make any sense, particularly when the pain is expected to last only a short time (like with post-operative situations).

My cat had an infected tooth pulled. She was not in chronic pain. She was given one injectable dose of Metacam and then I was sent home with 4 .2ml syringes of oral Metacam to be given over the course of the next 4 days. I was not told that there could be any problems or that I should keep an eye on her to check for signs of potential kidney failure. My cat nearly died as a direct result of Metacam (I had the bloodwork done before her surgery and her kidneys were fine) and is now going to be in daily pain for the rest of her life. I have spoken with the folks who make Metacam and was assured that my cat was given a “conservative” dose. My vet has told me that he seriously reconsidering his use of this drug, particularly in cases like mine where the CAT WAS NOT IN CHRONIC PAIN. She is considerably worse off now than she was before, requiring daily sub-q fluids and injections. She is only 6 years old. This could have been avoided if she’s been given buprenex (or even no pain medication at all).
on September 1, 2009 at 8:04 am Jessica

My 4 month old, 5.5 lbs kitten Remy went to our vet for his castration procedure. The vet sent him home with 3 doses of 1.5ml Metacam. He was to be given .48cc (1 dose) per day for three days after the surgery to help with the post surgery pain. On the last day of his dose at around 11:30PM he had symptoms of vomiting, non-responsive behavior and he was very lethargic. This was not the typical behavior of our very rambunctious kitten. I rushed him to Emergency vet that next morning to find that he had acute renal failure. His blood levels were sky-high. He has been on IV fluids since Sunday morning, so far his potassium has come back to normal but his BUN and Creatinine are still elevated. His creatinine leval alone is pretty much double what it is considered normal for a cat. While I do agree that side effects come with every drug and that maybe this side effect is not common, but the fact remains that we should have been warned of the associated risk. In addition, we were not told that this drug is currently off-label for cats (http://www.fda.gov/downloads/AnimalVeterinary/Products/ApprovedAnimalDrugProducts/DrugLabels/UCM050395.pdf). When I spoke to the surgeon on Monday he made it seem like they give this drug out to cats like it was a tuna treat. My second point is that the neuter surgery is non-invasive and maybe didn’t need to be given a dose of this drug every day for three days. Maybe the instructions should have been to give the drug to Remy as needed, one dose if you see signs of pain or discomfort. Maybe this is the best option for cats in need of pain management for chronic pain, but certainly the vet has the responsibility in the same way a human doctor would have to relay the possible side effects to human patients, no matter how remote the possibility.
on September 1, 2009 at 3:36 pm Gill

Hi, today I took my cat to the vets after a week of worrying at her changed behaviour and toilet habits.

She hasn’t looked ill but I’ve been worried… she’s 14. Last year it took us 6 months to nurse her through pining for her sister (whom she appeared to hate! Nonetheless she grieved for her). Sophie has some kind of episode every time her owner, my elder daughter, goes back to Italy from a visit. It seems as though she enjoys the drama of a trip to the vets!

Anyway, Sophie has had some stiffness for several years now – nothing she can’t handle, and she is a little overweight (though a large-built cat). She doesn’t look her age and today, as always, the vet remarked on her ‘young-looking’ teeth – she has all her teeth and they’re in excellent condition.

He suggested, as we’ve discussed before, that we try her on Metacam. She certainly was in enough discomfort earlier in the year to respond to a lower litter-tray (she’d been weeing next to it). I’ve agreed to a trial.

Sophie has just had the first (double) dose this evening. She is like a different animal – relaxed again, content, curled up… after what I’ve read here, I shall certainly try giving her a lower dose than recommended (I do that with painkillers myself, take as little as possible). But at 14, I believe it’s worth giving this a try to improve her quality of life.

I am very sorry for those of you who have lost beloved pets to this drug, and I hope I don’t join your ranks. But even if I do, I can’t regret giving Sophie a chance to have a better time while she’s here. I love her so, so much that it brings tears to my eyes to think I’ll lose her one day; but I am happy to give her some time without discomfort in the meantime. (My mum’s cats all lived to their twenties, so I try not to cry TOO much just yet in case it’s VERY premature!)
on September 2, 2009 at 5:19 pm Mindie

Gill, the difference is that you are making an informed choice and choosing to take the risk to give Sophie a better quality of life. I never had that choice.

Jessica, please consider joining the Yahoo CRF support group (http://pets.groups.yahoo.com/group/Feline-CRF-Support/). It sounds like you got medical attention pretty quickly, so it’s entirely possible that your kitten will have a full recovery. “Double the normal level” of CREA is not all *that* bad. Cats on the CRF list have recovered from much worse.

You may also want to consider filing an Adverse Drug Reaction report with the FDA.
on September 6, 2009 at 10:33 am Holly

I found your site after researching Metacam for feline arthritis this morning. You have great information that is balanced with the pros and cons of using Metacam and I have found it refreshing.

My Sammi, 17-year-old female tuxedo cat, has been on Metacam for nearly three years now and is not showing any adverse effects, physically or in her blood work. She was started on the lowest dose and is now up to three times a week of the .5 strength.

Without the Metacam, she can hardly walk and screams in pain if I try to pick her up. I am choosing to continue the Metacam because it does give her a better quality of life.

Thank you for giving the pros and cons on Metacam. I have a great vet who also informed me of them and keeps a close eye on her. You’re right on target!
on September 7, 2009 at 11:33 am Marlene

Not only is my obese cat, 10 y/o Smooch, weighing in at 20 lbs. on Metacam, my Macaw has been on Metacam for either arthritis or injury to her foot and she’s done fantastic. For my Macaw the vet prescribed that.

Smooch just started the Metacam as his limping on his L front leg is worsening. He’d walk a few steps, stop, and lie down. He’s doing better on low-dose Metacam, 3 drops/1.5 mg/mixed in food. It does need to be mixed in food. Metacam is a nsaid and that, including for people, needs to be mixed in food.

I’d rather have him pain free with a shorter life span, if that happens at all, then in pain for heavens knows how long.
- on September 7, 2009 at 5:48 pm Lynette
  
  Hi Marlene,
  I hope the Metacam works well for Smooch and Macaw.
  Please also read my post on feline obesity/ideal weight maintenance:
  https://meowmeowmom.wordpress.com/2008/11/28/obesity/
  Lynette
on September 22, 2009 at 12:12 pm Darija

Thanks for the great information! I was concerned when our vet prescribed Metacam for my arthritic cat, as he didn’t elaborate on the pros and cons at all and said to give to the 10 lb mark once daily til the bottle was finished. I think I’ll be giving it to her less frequently after a few day but at least I’m not afraid to use it now. And I’ll try the supplements too. Many thanks!
- on September 22, 2009 at 2:57 pm Lynette
  
  Darija,
  
  That is a HUGE dose of Metacam.
  
  By comparison, Rumpelmintz (my cat) gets the TWO pound line every OTHER day.
  
  PLEASE double-check that dose with your vet! That does NOT seem right.
  
  Lynette
on October 7, 2009 at 7:03 am Jim

I came across your site when a co-worker mentioned that Metacam had helped her cat and it might work for my arthritic cat Sissela (a 15 year old, 14 pound Brown Tabby.) We took her to our vet (who has been treating our pets for over 20 years) and had her evaluated.

Step 1 was blood work; her kidney function was excellent, so we got the Metacam in early July. The dosage is 1.5 mg/ml; she started at 0.42 ml for 4 days, then 0.06 ml twice a week (Sunday and Wednesday, for convenience sake.)

Her blood chemistry was retested after she’d been on it for a month (mid-August); her kidney function was still excellent. She’ll be tested again in February.

Result: a much happier, more mobile pet!
on October 8, 2009 at 11:24 am Karen

My cat was given Metacam for cystitis/urianary tract problems and we are just finishing up th esecond bottle. He takes it every other day, .05 mg and he is just fine. I decided since I rent I can’t keep him if he is peeing all over the rug so I chose quality of life rather than having to put him to sleep or try to give him away. I can’t lie about his problem and nobody will take a cat that pees. I say each person has to do what they can live with. I can’t live with putting my cat to sleep or giving it away but if Metacam will allow me to keep him longer I’m gonna do it.
- on October 8, 2009 at 11:44 am Lynette
  
  Hi Karen,
  
  I would urge you to read my post on urinary tract problems:
  https://meowmeowmom.wordpress.com/2008/08/02/feline-lower-urinary-tract-disease/
  
  The SINGLE best thing you can do to help with urinary tract problems/cystitis is to stop feeding ANY dry food. Feed wet food only.
  
  There’s more in the full article (link above), but here’s one quote:
  
  “To date, of all treatments evaluated, the only one that has been associated with a statistically significant difference in recurrence of clinical signs in cats with FIC is feeding moist food (> 60% moisture). ”
  
  Source: Management of Feline Lower Urinary Tract Disease, S. Dru Forrester, DVM, MS, DACVIM
on October 13, 2009 at 1:00 pm Baudlady

Thanks for all your posts. My cat, Mufasa, is a 15 1/2 year old Persian who has survived two bouts of cancer (mouth and he had to have one eye removed). He also suffers from arthritis. Some times he will eat all his food with the Cosequin so I am looking for something that I can give orally as he takes pills or liquid meds well. I know both bouts with cancer he was given Metacam and his arthritis pain improved significantly. From his last senior wellness exam he is deemed a healthy kitty except for the past cancer and the vet says he is such a strong kid that he should be around for a few more years.

I am wondering if I should put him on the Metacam to help with his arthritis pain. Of course with two bouts of cancer I was fully prepared to say goodbye to my baby so at this point quality of life. The current vet took over the practice and I am not sure I like him as much. Mufasa has been going to “cat only” vets most of his furry life. (even had kitty acupunture which worked great when he could barely walk)

It is funny because sometimes he races around wanting to be chased and other days he walks across the room slowly.
- on October 13, 2009 at 6:24 pm Lynette
  
  Baudlady,
  It does sound like Metacam is an option you should discuss with your veterinarian.
  You can give glucosamine/chondroitin (such as Cosequin) orally. I just use the over-the-counter version sold for human use, as it’s less expensive.
  Lynette
on December 1, 2009 at 1:32 pm Marisa

My cat had blockage in his urinary tract after I borrowed really cheap dry food from my neighbor when we ran out, he at first wouldn’t eat it (cats know I guess) but then did for a day or two. He came through surgery fine, and at the follow up appointment my vet said he was still inflammed and prescribed metacam, one drop every other day, for the rest of his life. He also put him on dry urinary tract food that I have to buy through them, forever. Is this safe, I saw that you said he should eat wet food, and everything about metacam said it was for pain. I doubt one follow up a week after surgery, due to poor food he was given would justify this drug/diet, forever. Any thoughts?
- on December 1, 2009 at 8:15 pm Lynette
  
  Marisa, your cat should absolutely be on an all-wet diet. NO DRY FOOD. I cannot emphasize this enough.
  
  It’s possible, even probable, that on an all-wet diet the inflammation will subside, and the Metacam will no longer be necessary.
  
  Metacam is a NSAID – non-steroidal anti-inflammatory drug. It’s used for pain and/or inflammation.
  
  Best of luck,
  Lynette
on January 10, 2010 at 5:38 pm Piseag Bheag

I note that a lot of reported cases of “Metacam poisoning” also had other procedures prior to doseage with Metacam. Many drugs can worsen renal failure already present at a subclinical level in a cat or dog, or rise to toxic levels because the kidney cannot clear them from the system quickly enough. Being under anaesthesia *can* reduce the blood flow to the kidneys and exacerbate subclinical renal failure.

A significant number of elderly cats will have some degree of renal damage. The big problem is that it’s not always easy to detect this even with blood tests.

This doesn’t mean that your cat shouldn’t or can’t have a general anaesthetic, or Metacam, or any other medication, just that you have to weigh up the benefits eg pain relief, removing painful teeth, getting a proper diagnosis and appropriate treatment, with the risks, a small risk that something may go wrong. Sometimes the definite consequences of *not* treating are worse than the potential side effects of medication or procedures. A general anaesthetic may be necessary but require some differences to a normal young healthy cat.

Anyone who is worried should discuss it with their vet. Your vet should have your beloved companions best interests at heart, if not, change vet
- on January 10, 2010 at 9:40 pm Lynette
  
  Good points. I believe renal insufficiency does not show up in bloodwork until cats have < 20% kidney function remaining.
  
  Correction – when diagnosed (urine specific gravity is low and BUN and creatinine are elevated), generally 30% of kidney function is LOST.
  http://www.felinecrf.com/tests0.htm
on January 13, 2010 at 12:08 pm Ahuva

A cat isn’t diagnosed with renal insufficiency until 2.4) to 12+ (severe renal insufficiency) two weeks later, clearly there is a problem. The makers of Metacam have acknowledged the risks associated with the use of their product and compensate people whose cats have had adverse reactions. My cat was young and healthy before being given Metacam.

I can see the point of saying that Metacam is worth the risk in chronic pain situations and shouldn’t be taken off the market. I do not see the point in claiming that Metacam doesn’t have the potential to cause renal insufficiency when the *manufacturer* admits that it does. There are also warnings about its use in Plumb’s veterinary handbook.

No one is served by misinformation.

People need to know that they should have blood work done before any procedure and then discuss the risks involved with the proposed treatment. They also need to request and read the drug information sheet so that they can make the appropriate decision for their pet.
- on January 13, 2010 at 12:29 pm Lynette
  
  Ahuva wrote:
  “I do not see the point in claiming that Metacam doesn’t have the potential to cause renal insufficiency when the *manufacturer* admits that it does.”
  
  I agree, Metacam most definitely has the potential to cause renal insufficiency/failure.
  
  I believe I say as much in my post, when I state:
  
  “Does Metacam have risks – SURE! ”
  
  and
  
  “I realize some cats have gotten sick and even died from use of Metacam – and my heart breaks for them and their caregivers, and I certainly do not intend to make light of their losses.”
  
  “No one is served by misinformation.”
  
  I agree.
  
  I am very sorry your cat suffered as a result of the use of Metacam.
on January 18, 2010 at 4:56 pm Ahuva

Lynette, I was reacting to Piseag Bheag’s remarks which seemed to indicate a belief that renal failure was already present in those cats and that Metacam was not responsible. I was trying to point at that it is possible to accurately evaluate the renal function of cats with bloodwork and that young, otherwise healthy cats have gone into renal failure as a result of metacam use.

I agree that your post makes an important point. It certainly took me out of a “Metacam should be taken off the market” frame of mind!

The statement “I believe renal insufficiency does not show up in bloodwork until cats have < 20% kidney function remaining." is misleading, however. It seemed to imply a belief that it was not possible to detect deterioration in the kidneys via bloodwork until the cat has renal insufficiency. In fact, it is possible to track the movement of BUN and CREA in a normal cat while it is still healthy and watch those numbers gradually rise as the cat ages long before the cat gets to a point where the cat is considered to have renal insufficiency.
- on January 18, 2010 at 5:19 pm Lynette
  
  Ah, I see. I’m sorry I thought they were directed at my original post.
  I corrected my earlier comment – CRI appears in bloodwork when > 30 % of kidney function is lost.
  The difficulty in detecting CRI is that obviously BUN and Creatinine can be elevated for reasons other than kidney insufficiency. It’s best to evaluate the combination of BUN, Creatinine, and urine specific gravity.
  One of my cats was diagnosed with CRI based on an ultrasound. Her blood and urine levels were generally normal… but an ultrasound showed one kidney was virtually non-existant. Just a nub.
on January 19, 2010 at 1:33 am Piseag Bheag

Ahuva, I did not say that Metacam was not responsible. ALL drugs have side effects – there’s always a risk of things going wrong although it may well be more liely with some drugs than others.

My point was that it’s not ALWAYS responsible when things go wrong and that people who are worried about Metacam should discuss it with their vet. There isn’t a licensed alternative that lasts more than a few hours at a time on a single dose, or that is licensed for long term repeated use. This is a really difficult situation to be in when faced with a cat in pain.
on January 21, 2010 at 9:05 pm Holly

My 14 yr old cat suffers from severe degenerative arthritis and has been on Metacam for about a month. He is taking the 0.5ml Metacam and the vet told us to give him 10ml every day. After reading information on multiple websites I called another vet for a 2nd opinion. She was obviously shocked at the dosage and said only give it to him every 3-4 days. So that is what we did. But so far after over 30 days on the medication we have noticed no change in his condition. My husband decided to increase the frequency to every other day to see if that would help and still no change. We are taking him to the vet that told us to not give him as much to see if we have any other options at this point. If not we are going to have to opt for putting him to sleep. I hate to do it and the thought is tearing me up but he is in so much pain even with the medication that he has to be carried up the steps, he can no longer jump up on the couch and lately has been spending all of his time under our bed. So far he has not suffered any ill effects from the medication but it does not seem to be helping either.
- on January 22, 2010 at 6:58 am Lynette
  
  Holly – I’m so sorry you’re going through this.
  Before giving up, I’d give gabapentin a try. See my post on arthritis.
  https://meowmeowmom.wordpress.com/2008/08/02/arthritis/
on February 2, 2010 at 3:58 pm Lynn

I also read all the ‘Medacam kills cats’ website and almost lost my mind trying to decide if I should even try it on my 19 1/2 year old cat. She was diagnosed with a mass at the top of her kidney and spots in her lungs. I read every website, thread and another posting on Medcam I could find. My cat was also suffering from kidney disease which made the decision even harder. My vet connected me with a pet oncologist and I learned there are two additional steps you can take to help your cat handle the Medacam. First, give your cat food when they take the Medacam to avoid throwing the med up. Secondly, I gave my cat an IV three times a week so she wouldn’t have kidney failure. I started at 0.7 mL of Medacam for 3 days and went down to 0.2 mL for the remainder of the time. She did wonderfully and began acting like a young cat again including tossing gifts out under the Christmas tree to find a sleeping spot. Her kidney function actually improved with the IV three times a week. Unfortunately, a few weeks ago the cancer won and I lost my little girl. Knowing what I know now and learning about giving food with the drug and IV’s throughout the week, I’d do it again in a second. She did wonderfully on Medcam and there’s no question in my mind it was the best thing for her.
on February 2, 2010 at 7:04 pm Kristine

Thank you to all for the informative information about Metacam. I just started my soon to be 14 year old female maine coon, Kattarina on Metacam every other day yesterday 2/1/10 and was really nervous after reading all the scary stuff out there including metacamkillscats. Lots of scare tactics. I too go to an all cat vet and my vet who I have a lot of faith in saved my cat 9 years ago when she developed hemolytic anemia. I came very close to losing her then. She has been on prednisolone every 3rd day since then and is in perfect health – blood work and all since I just took her to the vet for her bi-annual check-up last Friday. Kattarina has started limping on her right hind leg due to arthritis. I love her as if I gave birth to her myself and I want to keep her around as long as possible. My hope is that Metacam will work well for her with no adverse reactions. I have another blood draw scheduled for 2/10/10. Please wish us luck! And good luck to those who are using it with out incident. My heart goes out to all who have lost their pets because of Metacam.
on February 5, 2010 at 10:37 am Lulu

Hi, hank you for all of the valuable information about using Metacam you have shared! I must now arite and sk your opinion re: my own kitty’s situation!
6 year old Rufus was diagnosed with a (first ever) urinary tract infection on 01-16. He was prescribed a 2 week regime of Clavamox antibiotic at 125 mg tablet 2X daily with food AND Metacam liquid at 15ml, a 15lb dose 1X daily with food. The vet said to disregard the statement on the Metacam box that said ‘For Dogs’, as they prescribed it for cats regularly and never had any problems.
Rufus looked to be steadily improving until 01-27 when he began vomiting several hours after eating and taking these drugs. On 01-28 he was taken back to the vet, the urinalysis showed the infection was somewhat less but not cleared up, a urine culture was sent to the lab to see if a different antibiotic was appropriate, and I was told that the vomiting was a reaction to the Clavamox. He was prescribed Metoclopramide Syrup 20ml 2X daily administered 30 minutes before eating to help settle his stomach. The Clavamox & Metacam were to be continued until the culture results came in in 3 days or so. Rufus continued vomiting every day between meals (very little to no food, just clear liquid like stomach acid?), but on 01-30 the Metacam ran out so he was only given the Clavamox. Rufus seemed to feel worse after one day without the Metacam.
On 02-01 the urine culture results showed no growth so the vet said that Clavamox was the appropriate antibiotic and it was just a really severe infection, and refilled the prescription for Clavamox and for the Metacam for 2 more weeks. Rufus seemed to feel better upon receiving the Metacam again.
On 2-02 I took Rufus back to the vet and had them do xrays to see if stones were present. The results were negative. The vet said Rufus just had a bad infection that was taking longer to get rid of, and prescribed at least 4 more weeks of Clavamox and Metacam. Rufus was still vomiting clear liquid, usually at about 3AM every morning.
We are still following the prescribed daily regimen: Metoclopramide Syrup 30 minutes before morning & evening meals, then after eating he receives a 15lb dose of the 15ml strength Metacam (morning only) and a Clavamox tablet crushed and mixed with a little chicken broth (he will only take it by syringe in a liquid).
On 02-04 he stopped the early morning vomiting and it has not re-occurred to date. He does seem lethargic and sleepy most of the time.
Rufus weighs 15 lbs. Do you think he is getting too much Metacam?
Thanks!
Lulu
- on February 5, 2010 at 11:07 am Lynette
  
  Hi Lulu,
  
  I personally suspect the 15 lb dose is okay for a VERY SHORT TIME FRAME (2-3 days) but should be reduced after that.
  
  See my dosing notes above:
  Therefore (using 1.5 mg/mL strength):
  Initial dose 0.09 mg/lb sid = 0.06 ml/lb once daily
  Next 2 days, 0.045 mg/lb sid = 0.03 ml/lb once daily
  Following 0.011 mg/lb 2-3 times per week = 0.007 ml/lb every other day
  
  Adjusting this for Rufus’s 15 pounds:
  Initial dose 1.35 mg sid = 0.9 ml once daily (about 30 lb line)
  Next 2 days, 0.675 mg sid = 0.45 ml once daily (about 15 lb line)
  Following 0.165 mg 2-3 times per week = 0.105 ml every other day (about 3 lb line)
  
  Example, cat = 10 lb
  Therefore (using 0.5 mg/mL strength):
  0.9 mg = 1.8 mL first day (about 20 lb line)
  0.45 mg = 0.9 mL once daily, second and third days (about 10 lb line)
  0.11 mg = 0.23 mL fourth day and every other day thereafter (about 2 lb line)
  
  PLEASE read my post on urinary tract disorders. If your cat is not already on an all-wet diet (NO DRY FOOD) he should be put on one immediately to prevent further urinary problems, which can be life-threatening!
  https://meowmeowmom.wordpress.com/2008/08/02/feline-lower-urinary-tract-disease/
  
  Best of luck,
  Lynette
on February 23, 2010 at 3:33 am Nick

Hi Lynette, thank you for hosting this informative blog. I found your site by Googling metacam cat risks. My cat was prescribed 1.8 mL per day for three days (0.5 mg strength) to help treat a bacterial urinary infection. I don’t know if I should give it to him because of all the scary things I’ve read, but I want him to get better. He’s pretty chunky (18lbs) so I was thinking I’d give him his first dose tomorrow as scheduled, then follow up the next two days with smaller doses (0.9 and 0.23) as your notes indicated. I was considering giving the first dose directly orally and then mixing the subsequent doses in with his wet food. Does this seem like a reasonable course of action? He’s my sweet little kitty – I would be crushed and would never forgive myself if something happened to him. I just want him to feel better soon!
- on February 23, 2010 at 7:00 am Lynette
  
  Hi Nick,
  
  I would urge you to read my post on urinary tract problems:
  https://meowmeowmom.wordpress.com/2008/08/02/feline-lower-urinary-tract-disease/
  
  The SINGLE best thing you can do to help with urinary tract problems/cystitis is to stop feeding ANY dry food. Feed wet food only.
  
  There’s more in the full article (link above), but here’s one quote:
  
  “To date, of all treatments evaluated, the only one that has been associated with a statistically significant difference in recurrence of clinical signs in cats with FIC is feeding moist food (> 60% moisture). ”
  
  Source: Management of Feline Lower Urinary Tract Disease, S. Dru Forrester, DVM, MS, DACVIM
on March 10, 2010 at 10:43 am Diane

Hi, Lynette. Thanks so much for posting this information. We’ve been using Metacam on our Romeo because it’s the only thing that can alleviate his pain. He was a stray that we took in a number of years ago. He’d been hit by a car which resulted in a shattered pelvis and hip socket. Romeo gets along quite well, but the arthritis he now has in his back causes him a great deal of pain. We know there can be risks with Metacam, as with any other drug, but in Romeo’s case, the benefits far outweigh the risks. He flies up and down the stairs, runs around the house like a kitten, and easily jumps from one piece of furniture to the next. He’s living the good life! But when he’s not on the Metacam, his pain is so intense that he hides under furniture, hunches over in the sphinx pose, and pants. We know Romeo had a hard life before he wandered up to our house in the country. Evidence of that was clear when a pellet was found lodged in his neck during an xray. We’ll do what we can to make Romeo’s last years with us as pleasant as possible. In Romeo’s case, Metacam=life.
on May 5, 2010 at 3:57 pm Debbie Fisher

Hello, I think the most important thing to remember when using metacam or any other medication for that matter is that medicines come in different strengths and must be dosed appropriately. I work in the human nursing field and dosing mistakes are more common than you’d think. Be very careful and double check the dosage with your vet. Remember an mg. is not the same as an ml. It is somewhat confusing having the two strengths of metacam as the original bottle for dogs is three times stronger. Make sure the Vet knows which one you are using when inquiring about dosage.
At times benefits outweigh risks. I am currently using metacam for an inoperable jaw tumour in my 15 year old cat. It is really the only option I have to allow his pain to be controlled so that he is able to eat and enjoy what time he has left with me. My vet has prescribed .1ml. – .3 ml daily, it depends on your situation and you need to have some faith in your vet’s educated opinion though never be afraid to ask questions or verify something.
- on May 5, 2010 at 5:17 pm Lynette
  
  Good points, Debbie. I hope your remaining time with your precious feline friend is quality time, and I hope the knowledge you gave him so much love brings you some comfort during this difficult time.
on May 13, 2010 at 11:11 am Debbie Fisher

Hi Lynette, I just read all this blog and see you lost a cat “Louie” to oral cancer. Was it SCC? My cat Benny has this dreadful disease as well. Was just wondering if you had any good suggestions or helpful hints in dealing with this that I could use. Am still playing around a bit with his Metacam and also Buprenex as needed. He seems pretty normal right now though has lost weight due to trouble eating. Seems to have some times that are better than others. I ordered some ES Clear, a herbal supplement as well which I have just started him on as I figured why not?
It is a pretty terrible disease with a pretty poor prognosis but just want him to be as happy and comfortable as possible. Thanks, a fellow “crazy cat Lady” 🙂
on May 16, 2010 at 4:11 am Sue

Hi my cat is on metacam not sure of the dosage as the syringe lets you fill it up to the weight in kg’s of the cat. I give her a bit less (for a cat weighing 4kg’s instead of 5) and every other day. She is always so sick – not hair balls just brown liquid. It worries me so much but my vet says with out the metcam she would be in such bad pain. She ended up on a drip and we said our goodbyes when she first had it. She seems happy enough but it can’t be good for her being so sick all the time. My vet says in the uk matacam is licenced for cats – it’s different from the dog one and I shouldn’t worry about all the stories on the internet. I wish I knew if I was doing the right thing giving it to her.
on May 16, 2010 at 6:36 pm lucie

Brown liquid! It is probably the Metacam. Get your cat off of it and get a new vet. There are other drugs (non-NSAIDS) available.
on May 23, 2010 at 8:15 pm Ahuva

Sue, is your doctor doing periodic bloodwork to keep track of your cat’s condition? If not, I would ask for a full CBC. The risk with Metacam is that it might cause her kidneys to shut down. If this is happening, then it will show up in your cat’s bloodwork. If your cat’s bloodwork is fine, then you are probably doing the right thing by giving it to her.

If you can afford it, I would ask your vet to do a full CBC every 6 months to a year to give you and your vet a better insight into what is happening with your cat (and to catch it early if she starts having a problem– with Metacam or anything else).

No one on the Internet can diagnose what is causing her to vomit brown liquid. It could be the Metacam, but it could also be something else. I would urge you to have some tests done to see if you can find out.
on June 27, 2010 at 6:09 pm patti

I’m just one more who has had a positive experience with Metacam in 2 of my kitties. One who had acromegaly – a brain tumor that causes diabetes and severe spinal arthritis and one who had an abdominal tumor. Both were on other pain meds too but it seemed it was the Metacam that helped them the most. Within a day or 2 of starting it – they seemed so much more comfortable. Merlin (acromegaly) was on Metacam for 4 months and Lance (abd. mass) for 1 year -with no change in their kidney values. Both had good quality of life till the very end.
I am sorry for those that have had bad experiences with this drug but I strongly feel there is definitely a place for use of Metacam and people shouldn’t freak out at the mention of it. The pet mom/dad definitely needs to be educated about it and work with their vet and read up on what other options that MIGHT be better for their special kitty. But like Lynette mentions – and I too am a nurse – ALL drugs have side effects – ALL can can cause awful things to happen. In the medical world tho – there are 5 vital signs – temperature, pulse, respirations, blood pressure and PAIN and I am one for definitely keeping my patients pain in control!
Thanks Lynette for having this discussion!
on June 29, 2010 at 1:33 am Dawn

Hi Lynette, I’m hoping you can help me with a dosing issue with my 14 year old cat. He is suffering from lumbosacral pain (disc completely gone, bone against bone), with severe arthritis and trouble walking (he is in lots of pain). Metacam was prescribed by my vet and he was doing very well until about 3 weeks ago, so here is my question. My vet is very uncaring and belittles me when I ask any questions (I am looking for a new vet and have chosen not to deal with him any more after his last episode of rudeness), the first 2 small bottles of metacam did not contain any prescription labels, seems like he took it from a larger bottle and put the liquid into a small plastic dispenser (hand delivered it each time). I was unaware that different strengths were available. My latest bottle of metacam from this vet came from a hospital he works from and is labeled as: 1.5mg/ml. I want to make sure I am giving him the correct dose of this new metacam. He is 18 lbs (yes, I know he is overweight), and he is getting 0.05 daily. The doctor suggested 0.1 every other day but my cat is so drugged after taking that dose, he can barely lift his head. Also he seems to get better pain relief from a daily dose. Since I don’t know if the previous bottles were 1.5mg/ml or 0.5, does this dose seem correct? On occasion it seems he needs more, but just not sure if I can give him more. I actually think my vet is rude to cover up for the fact that he doesn’t know enough about the medication. Without the metacam he can’t walk at all and would most likely not be here, so I am grateful that he is getting some relief and is still with me. Thanks for your help and support.
- on June 29, 2010 at 8:59 am Lynette
  
  Hi Dawn!
  
  As noted in my post:
  
  Therefore (using 1.5 mg/mL strength):
  Initial dose 0.09 mg/lb sid = 0.06 ml/lb once daily
  Next 2 days, 0.045 mg/lb sid = 0.03 ml/lb once daily
  Following 0.011 mg/lb 2-3 times per week = 0.007 ml/lb every other day
  
  cat = 18 lb
  Therefore (using 1.5 mg/mL strength) maintenance dose
  0.011 mg/lb x 18 lbs = 0.198 mg / 1.5 mg/ml = 0.132 mL dosed every other day
  
  So, your vet is recommending a typical dose. It’s better to dose every other day than to dose every day. Cats metabolize pain medications poorly and they can build up in the system – thus the “day off” is recommended.
  
  Best of luck. I’d recommend also reading my post on arthritis for other information.
  https://meowmeowmom.wordpress.com/2008/08/02/arthritis/
on July 15, 2010 at 3:44 pm Dana Guess

Hello,
I just took my 7-8 year old, cat, Ms. Kitty (13.1 lbs) to the vet for a UTI. She has always been prone to them, but hadnt had a flare-up in almost 3 years. They did an ultrasound & a film of her bladder, noting that she had quite a number of crystals in her bladder. They gave her a long acting, antibotic injection, pushed fluids thru the night, put her on a prescription diet & gave me a small amount of Metacam for pain when she starts passing crystals. The script says 0.2cc’s every other day, beginning tomorrow. Looks like enough for maybe 3-4 doses at most. Of course, my husband, who likes to research everything, did a search on the Metacam. Of course, horror after horror stories pop up.
So, now I am concerned about giving this med to my cat.
Does this seem like a normal dose for a cat her size & for the issue she is having? I know the pain associated with passing crystals, I suffer from kidney stones myself regularly. I don’t want her to suffer but would it be better to let her go without pain meds while passing them? 0.2cc’s seems like small amount for my fat lil girl & it is only every other day for probably less than a week…
I’m so tore on what to do.
Thank you for taking the time to read this..
Dana
- on July 15, 2010 at 3:59 pm Lynette
  
  Dana,
  
  Whether or not 0.22 cc’s is the right dose depends on the STRENGTH of the solution you are giving – 0.5 mg/mL or 1.5 mg/mL. I have the doses noted above, based on which strength it is.
  
  For urinary tract disorders, the single biggest thing to think about is WATER!!!! Cats need to be on an all-wet diet (NO dry food) ESPECIALLY cats with urinary tract issues. Think about persons with kidney stones – most important to drink fluids (and get enough vitamin D). Please read my post on the subject:
  https://meowmeowmom.wordpress.com/2008/08/02/feline-lower-urinary-tract-disease/
  
  Best of luck,
  Lynette
  - on July 15, 2010 at 4:44 pm Dana Guess
    
    Funny, the prescription diet they put her on is dry. I was told that the food would, hopefully, dissolve the crystals. I the hadn’t even thought of the water needed in her diet. I knew she needs water to keep her bladder flushed out so that, hopefully, crystals do not form at all. I will be switching her to wet food asap.
    This bottle doesn’t even have what strength the metacam is. It was apparently drawn from the main bottle & placed into a prescription bottle. All I have are their written instructions on dosage & the name of the med written on the bottle. Guess I will be giving them a call tomorrow.
on July 22, 2010 at 5:11 am Ahuva

Dana,

By now you’ve probably already made the decision whether or not to give the Metacam, but just let me through this out there– Metacam can cause problems even when a “safe” dosage is given. Everything depends on the cat and how sensitive he/she is to NSAIDs.

I would not, personally, give Metacam for a UTI. There are other, more expensive but safer options out there such as Buprenex. Why take the chance? Yes, Burpenex (which can be given as a pill or as an injection), is more expensive– but it is a whole lot less expensive than potential kidney failure. I stopped calculating my costs when they hit $6,000 because it was just too depressing– and I’ve only been treating my cat’s kidney failure for 14 months.

In my opinion, the time to consider Metacam is when a cat is suffering debilitating pain that nothing else will help (such as cancer, severe arthritis, etc).
on July 22, 2010 at 1:59 pm JD

Hi Lynette,

I had a question about dosage of Metacam. My 14 pound cat is on Metacam for arthritis. The first vet who prescribed it gave her a dose of 2 drops at a strength of 1.5mg daily. The next vet gave her a dose of 3 drops at 0.5 mg daily. Now I have 1.5mg strength again with the directions to give her 0.37mL by syringe.

I know that the dosage went from medium, to fairly low, to higher than ever. Can you please give me some idea of how much more medicine my cat is receiving now (0.37 mL of 1.5mg)?

How would I dose her using the mL measure if i wanted to return her to the dose of 3 drops at 0.5mg? Roughly how many mL would that be at 1.5mg strength?

Thanks for your help!
- on July 22, 2010 at 2:18 pm Lynette
  
  Hi JD,
  
  Assuming two drops is roughly 0.1 mL:
  two drops of the 1.5 mg/mL strength = 0.15 mg
  three drops of 0.5 mg/mL strength = 0.05 mg
  0.37 mL of 1.5 mg/mL strength = 0.555 mg
  
  First of all, PERSONALLY I would not be dosing more than every OTHER day (every two days). Cats do not metabolize NSAIDs (non-steroidal anti-inflammatory drugs) well. Dosing every other day gives the drug time to clear the cats’ system/organs and avoid toxic buildup.
  
  If you wanted to dose according to the general rule-of-thumb:
  
  Therefore (using 1.5 mg/mL strength):
  Initial dose 0.09 mg/lb sid = 0.06 ml/lb once daily
  Next 2 days, 0.045 mg/lb sid = 0.03 ml/lb once daily
  Following 0.011 mg/lb 2-3 times per week = 0.007 ml/lb every other day
  
  cat = 14 lb
  Using 1.5 mg/mL strength, the recommended maintenance dose is 0.154 mg, or 0.103 mL or the 1.5 ml/mg solution two to three times per week (.011 / 1.5 x 14)
  
  You may also want to visit my post on arthritis. There are additional supplements, etc, you might want to consider.
  
  Best of luck,
  Lynette
on July 22, 2010 at 4:29 pm JD

Lynette,

Thanks so much for your help understanding the dosage change. It looks like the current vet prescribed roughly 3x more than the general guideline you describe for 1.5mg strength Metacam.

I recall mentioning to my vet the issue of whether to give Metacam daily or to allow some days in between doses to allow the medicine to be metabolized. I’m not sure I agree with him, but this is what he said. He said that when it comes to managing pain, as with humans, it is best to keep the pain level consistently low. If the medicine is interrupted then the pain returns and becomes harder to manage. He made an analogy with humans. If you treat a headache just as its beginning the pain reliever is more effective. If you take the pain reliever when the pain is peaking it is less effective.

I just wondered what your thoughts are on this rationale for daily dosages. I know that you feel that allowing time between doses is better for protecting the liver and kidneys, but what about the trade-off with managing the pain?

all best,

JD
- on July 22, 2010 at 5:03 pm Lynette
  
  JD,
  
  I do understand the logic behind your vet’s dosing – I would personally be concerned given this isn’t a human – it’s a cat, and they are known to metabolize NSAIDs poorly.
  
  You might want to consider using gabapentin instead, or in addition to, metacam. It does allow for daily dosing as it is not a NSAID – It works very differently, blocking the brain’s pain transmitters, so the pain still exists (it isn’t an anti-inflammatory) but the brain doesn’t recognize the pain.
  
  I describe gabapentin and other options in the arthritis thread I mention in my prior comment.
  
  Best of luck
  Lynette
on July 24, 2010 at 11:29 pm Liz

Lynette,

Just thought I’d pass on the following info from my experiences with Metacam. 12 y/o 18 lb. female siamese-mix missed her target one morning jumping up, and landed straight on her rump. Couldn’t walk. Long story short, after 2 days of x-rays and ultrasounds and visits with an orthopedic vet, was recommended to take her to a neurologist at U.C. Davis. More x-rays, ultrasounds adn MRI scan followed. Turns out she herniated a disc at L4. Put her on “bed rest” for approx 6 weeks. Subsequent to release from treatment, vet at U.C. Davis put her on Metacam to treat the severe arthritis that was found in her hip. His instructions were to follow the dog maintenance dosing, but to only give it to her 3 days on and 4 days off, so that it would completely clear her system. Her regular vet had done a baseline blood-work at the time of the injury to prepare for using metacam following treatment, and recommends blood work every 6 months to monitor liver and kidney functions. Metacam has been a godsend. In line with what awesome vet from U.C. Davis had indicated I could expect, she does have a bit more “pep” the three days over the weekend she gets her meds, and is a bit quieter the 4 days she’s off it, but she’s got far more energy now than she did a couple of years ago. i’ve gotten about 2.5 pounds off her in the 6 month time, so she’s at about 15.5 lbs, and regular vet has told me to reduce her dosing by 1/3, so I’m dosing her at the 10lb level for a dog, using the 1.5 ml formula — so about 10 drops worth three days on and 4 days off.

Hope the info is useful.
on July 29, 2010 at 12:20 pm Robin

Hi Lynette,

I am so happy that I found your website!

My precious 7 year old Oscar kitty was diagnosed with a VAS in January. The tumor is located in between his shoulder blades so we decided not to operate. Our vet (who we love an respect) simply told us ‘it is a bad tumor, in a bad place’. This was 8 months ago and Oscar continues to do well. His appetite is still hearty (I am giving him an immune boosting supplement), however he has slowed down a lot. He can still walk and jump, but does so sparingly, with a slight limp.

I made the decision last weekend to start giving Oscar Metacam. This was an extremely hard decision to make because at 6 1/2 years Oscar was diagnosed with the very early stages of kidney disease. (Since then we have managed this with a low protein diet.) My vet prescribed .3 ml (1.5 ml formula) daily. After reading your website, I have taken it upon myself to give Oscar what your vet has suggested for a 10 lb cat (Oscar is about 12 lbs).

I have to say the Metacam seems to have made a difference. It took several days, but Oscar is moving around more and yesterday started to play again.

I know that Metacam is not without risk, but in Oscar’s situation, terminal cancer, if I can make him comfortable for the last few months of his life, then it is worth taking the chance.
- on July 29, 2010 at 12:27 pm Lynette
  
  Hi Robin,
  
  Thank you for sharing Oscar’s story. You might also want to read my post on kidney disease.
  https://meowmeowmom.wordpress.com/2008/11/21/kidney-disease/
  
  Best of luck,
  Lynette
  - on July 29, 2010 at 12:56 pm Robin
    
    Hi Lynette,
    
    Thank you for your post on kidney disease.
    
    We feed all of our cats wet food, with some dry food as a ‘treat’. However, I do have a few kitties who are hard food junkies and won’t eat as much wet food as I would like them to eat.
    
    It still amazes me how many vets still recommend mostly dry or only dry food diets for cats. Their reasoning? Dental issues. They insist that dry food helps prevent periodontal disease and wet food causes periodontal disease. Online, I have yet to find anything negative about feeding cats wet food.
    
    Thanks again, Lynette. I look forward to reading more of your informative posts.
    
    Take care,
    Robin
on July 30, 2010 at 4:22 pm claire

hi my 10 year old cat was prescribed metacam on monday, today is friday. she is on the 0.5ml metacam and i was told to give her the dosage of 3.75 kg on the sryringe equivalant to her body weight once a day. does this sound right as all she seems to be doing is sleeping? she is still eating and drinking as normal, she will go out to do her business but comes straight back in to sleep. my 1 year old cat seems to know shes not right as he keeps cuddling in to her.
- on July 30, 2010 at 4:25 pm Lynette
  
  Claire,
  
  That’s a pretty high dose. I would double check with the vet to make sure:
  1) the amount is correct
  2) you are supposed to be giving it that often – typically it is dosed every OTHER day (not every day)
  
  The sleeping may not be a problem – if a cat has been in pain, it often can’t sleep well. Once the pain is relieved, it may be sleeping because now it can because it is more comfortable.
  
  However, I would double check that dose as it is unusual to give a cat metacam daily.
  
  Best of luck,
  Lynette
on July 31, 2010 at 3:27 am claire

thanks lynette, im going to ring my vet to check, shes become very vocal this morning, keeps meowing and wants to be close to me, this concerns me as shes not a particularly loving cat usually, shes never been a lap cat but today all she wants to do is curl up on my knee.
on July 31, 2010 at 11:49 am kevin

For what it’s worth, one of my cats has been prescribed by Metacam, 1 drop of the 1.5mg/ml suspension for three weeks to alleviate pain from struvite crystals. This is her second go-round, as she had the same issue last year and was on it for 3-4 weeks. I’ve been very careful with the dosing and it’s done well for her, as measured by her willingness not to think outside the box when urinating. I’ve observed no adverse side effects.

I read the warnings on the web sites, but I trust my vet. I’m also allergic to all NSAIDS myself, including aspirin, so I understand that individuals have adverse reactions to generally safe drugs.
on July 31, 2010 at 11:56 am kevin

PS: my cat with struvite refuses to eat wet food (tuna included!). Can you translate your post about its importance into cat so that I might share it with her?
- on July 31, 2010 at 12:17 pm Lynette
  
  Hi Kevin,
  I’m going to quote myself here:
  
  Palatability: Some owners reply with a “kitty doesn’t like canned food, kitty likes dry”. You know what? Some children don’t like vegetables or home-cooked meals, they like pizza and hamburgers. That doesn’t mean we should just feed them what they want.
  
  Conclusion: Work with kitty. It took me months to get all my cats off dry food completely – you can do it too. Dr. Lisa has some great tips on transitioning dry food addicts to wet food.
  
  Best of luck,
  
  Lynette
on August 5, 2010 at 2:53 am claire nunns

hi lynette, just a follow up to my post the other day, i spoke to my vet and she said to continue with the metacam as prescribed. last night ginger was extremely sick and it contained blood, spoke to my vet and she said to stop giving her the metacam as it may have irritated the lining of her stomach, i have an app with a different vet later on this morning i will keep you posted.
claire
on August 7, 2010 at 3:19 am Josa

Hi Lynette,

Metacam every other day so that it doesn’t build up to toxic levels? That really jumped out at me-my kitten (Bandit, 4.6lbs, 17weeks old), was prescribed Metacam 0.5mg/ml filled to the 1mark(or half of 2 because there is no 1mark on the syringe), daily for 7days following a fracture. I gave her 2 doses and she’d had one by injection at the clinic, before i realised something didn’t seem right with her and googled the medication because I was given no insert or leaflet about it nor any verbal info. She was extremely lethargic, barely eating/drinking and having increased difficulty with holding herself up with her back legs, almost crawling. Her fracture is in her front left leg.

After seeing the horror stories about Metacam I decided to not give it anymore, and from 24hours after the last dose she has been much better indeed. My vet (by phone) said if she was having side effects she would be fine to come off it as it was only for pain relief and she should have had enough after three days, and that as she is only small is was probably likely she would have some side effects. Why he initially told me to give it to her for 7 I have no idea. It would have been nice if he’d told me this beforehand.

Until I saw your blog I thought this was an awful drug, however it is obvious that in the right situation the benefits outweigh the risk. Personally I don’t the risks are worth it for a fracture which isn’t terminal or ongoing, if that makes sense, and am glad I’ve stopped giving it to Bandit, especially seeing her sudden improvement from not taking it anymore. I hope I haven’t damaged her tiny body already by giving it to her. Fingers crossed she stays well, and thank you for your very informative blog 🙂

Josa
on October 4, 2010 at 9:07 pm Sarah O'Brien

My cat just got neutered on 9-28-2010 and declawed. I was told to give Metacam to Nike once a day, and I did. On 9-30-2010 Nike started breathing fast, and the vet came over and fixed him. Well later that night Nike started breathing fast once more, with pain full meowing. I drove him to the hospital, and on the way there he stopped breathing. I smacked him to startle him to breath some more. The doctor did all he could do, but I had to put him down. His lungs filled up and he started throwing up blood and white stuff. All his veins collapsed, so they could not even put an IV on him. Nike was only 5 months old.
My other month 6 female cat Adidas was in the ICU for two day because of Metacam as well. Both my cats got spayed and neutered on the same day. So much for doing the right thing.
on October 7, 2010 at 5:22 pm K.J. Wallace

Hi Lynette

I must be one of the lucky ones. My 17 year old, 17 pound male tabby has been on Metacam for three (yes 3!) years…10 drops per DAY of 1.5 strength. He has regular blood work done, and has the liver and kidneys of a much younger cat (all normal as of June 2010).

I recently moved, and had to change vets. The new vet will not prescribe Metacam as of this month, due to the black box warning just put out by the manufacturers of MC.

My options now….expensive food for joints sold only at the vet, (which is not going to happen as I have 4 cats, 3 of which are under 3 years of age), and they are all grazers; or injections once a week for four weeks, then boosters every 6 months.

I realize he’s led a great life, but he’s enjoyed pain free life on MC. Just sad that it is now “black box” and most reputable vets will not prescribe for cats as an NSAID.
- on October 7, 2010 at 7:26 pm Lynette
  
  K.J.,
  
  consider gabapentin – for more info, see my post on arthritis.
  
  Lynette
- on October 7, 2010 at 8:31 pm JJ
  
  Hi K.J.
  
  Can you tell us more about the black box warning you were referring to in your post? Any information would be great! Thank you!
  
  JJ
  - on October 7, 2010 at 9:21 pm K.J.Wallace
    
    Apparently the makers of MC put out a warning to all vets as of the 6th of October, warning that MC is not to be prescribed for cats, ever.
    
    You can go to their website (just google Metacam cats warning) and you’ll find it. I looked it up after the vet refused to dispense any more.
on October 8, 2010 at 8:52 am Lynette

Hi K.J.,

I’m unable to find the information you mention – that Metacam is “not to be prescribed for cats, ever”

Note a “black box warning” does NOT necessarily mean a drug should not be used “ever”. E.g., depoprovera, a common form of birth control, has a black box warning. That warning is that they caution against using the drug for more than two years, continuously, due to risks of calcium loss.

Here’s information I could find:

Published in June 2010:

“Boehringer Ingelheim has launched a cat-specific presentation of Metacam Injection combined with a new indication which permits the company’s existing oral suspension (0.5mg/ml meloxicam) to be used for up to four follow-on days.”

http://www.vetsurgeon.org/blogs/veterinary_news/archive/2010/06/21/18411.aspx

On the manufacturer’s Metacam site:

http://www.metacam.com/index.php?option=com_content&view=article&id=57&Itemid=102#aidc
on October 28, 2010 at 7:44 am Jen

Hi Lynette,
I am wondering what your thoughts are since now there is this black box warning that says Metacam should not be for long term use.

“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.”

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

Do you think the alternative you mentioned gabapentin is a good alternative. Any thoughts on this new black box info?

I always appreciate your thoughts!
- on October 28, 2010 at 8:46 am Lynette
  
  Hi Jen!
  
  Thank you SO much for providing that link.
  
  My thoughts:
  
  1) As always, risks have to be weighed against benefits. There are risks with any drug, especially pain relievers for cats as cats do NOT tolerate NSAIDs well as they metabolize them slowly and rather unpredictably, so they easily build up to toxic levels. However, I personally will NOT tolerate my cats being in pain.
  
  2) It depends a lot on what you’re dealing with. A terminal illness like cancer? A chronic complaint like arthritis? An acute situation like surgery?
  
  3) I think gabapentin is worth consideration. It can be pricey, I had to have it compounded for my Omaha, which adds to the cost. However, while it hasn’t been used much in cats and thus is still rather experimental in my opinion, so far no side effects are known other than possible sedation/sleepiness.
  
  4) Steroids can be an option in some cases (like my cat Rumpelmintz). They have risks as well (diabetes, skin tears, etc) some of which can be mitigated by the proper diet (see 6 reasons not to feed dry food and other posts on nutrition).
  
  Best of luck!
  Lynette
on October 30, 2010 at 1:30 pm K.J.

An update on my 17 year old arthritic boy. I went with the injections once a week for four weeks since Metacam was not going to be an option. By the middle of the second week, 4 days after the 2nd injection and 3 weeks off Metacom, he literally could not move. I had to carry him up and down the stairs…he looked pitiful. He also dropped 500 grams in less than 2 weeks.

I dragged him back to the vet, and had a long chat. Upshot, he’s back on the metacam 8 drops every day (1.5 strength), and starting to wean him back to every other day, and he’s back to jumping up on furniture, eating and playing with the other cats.

I didn’t think the medication would have made that dramatic a difference, but it did. I’ll continue using it.
on December 4, 2010 at 3:10 am Debbie

Hi,
My 12 year old male cat has been gradually slowing down over the last year. A month or so ago, it got suddenly worse, and he was clearly in pain (sitting in a funny posture, only moving about when really needed, not even scratching at the scratch post (which was his favourite thing). I took him to the vets, and they gave him Metacam. after a few days, he was doing much better, looking happy again, and moving about a bit more. After about 6 days, he started vomiting. The first day, I didn’t take much notice, since cats are prone to this once in a while, but then, I checked on the internet and realised it could be the Metacam. I stopped it, and there was no more sickness, but he was clearly in pain again. I did some internet research and sent off for some liquid glucosamine (Flexwize – a human supplement also recommended for animals) and after 2 days, he showed real improvement again (guess that would be the fish-oil included). Now, after 2 weeks, he is running around like a kitten (more than he has for years) and his coat looks fantastic, really glossy. He’s always had dandruff – that’s totally gone. I’d been so worried that I wouldn’t find anything to make him comfortable, and I had been sceptical about a supplement having much of an effect, but it’s worked better than I hoped, I’m so happy (and so is Sid!). It does contain Sodium Benzoate, which isn’t the best of additives, but I don’t think as risky as Metacam (I know that other feline veterinaly products sometimes contain this, so it can’t be that bad). So please don’t lose hope if you cat can’t tolerate metacam – there is hope. The metacam syringe came in handy, anyway, for giving him the Flexwize!

Debbie
- on December 4, 2010 at 6:43 am Lynette
  
  Hi Debbie,
  
  If you read my post on arthritis, you’ll see glucosamine is a supplement I recommend. You might be interested in my other recommendations.
  
  I’d also suggest you read my post on dry food. Interestingly, Cornell has suggested a link between dry food and arthritis.
  
  Lynette
on December 4, 2010 at 3:23 am Debbie

Forgot to add, that he’s very fussy about food, and mainly prefers dry (or only Gormet Gold Pate, but only eats a little each day!). Some time ago, I changed his dry food to Applaws, which has no cereals, only meat and veg (because I was worried abou diabetes).
- on February 17, 2011 at 12:30 am Debbie
  
  Update – two and a half months later, Sid is still only on Flexwize (I give him half a ml once a day, no Metacam) and he’s still charging about. He has the odd day where he is a bit more stiff, but nothing like he was when I initially took him to the vet and it doesn’t stop him getting on with things. He has two meals of wet food a day, and Applause dry biscuits (no cereals or sugars) left out for if he needs a bit more. Also, he’s now started to jump high fences again, which he had stopped months ago. Really do recommend trying one of these liquid complexes (but not the ones with aspirin or willow bark – toxic to cats) for arthritis – tackling the arthiritis itself, rather than masking the problem by reducing the symptoms.
on December 30, 2010 at 7:46 am Sandy

My cat is about nine years old. She suffer from mammary glands cancer one year ago. We let her do the surgery and remove one side of the mammary gland. However, the cancer come back recenty and the cancer is aggressive. The vet said that it is not possible to do any surgery. My cat have a big wound on the mamary gland but the vet only told us to give her 10X petcamsolution 0.2ml/day. My cat look like painful recenty. I really want to increase a little bit the dosage of petcam. My cat is not possible to go out to see the vet now. I just want to know the safe dosage for 10X petcamsolution. My cat is about 3kg right now. My english is not good but I really hope that you can understand.
- on December 30, 2010 at 10:22 am Lynette
  
  Sandy,
  
  I’m so sorry about your cat. 😦
  
  I have never used PetCam. It appears the strength may be 1.5 mg/ml? (I don’t know if it comes in other strengths.)
  
  IF the strength is 1.5 mg/ml (please check!)
  The maintenance dose recommended would be 0.05 mL every other day, which is less than you are giving now. I would not increase the dose without speaking to your vet. Perhaps you could call?
  
  Best of luck,
  Lynette
  
  My math:
  
  The dose instructions I was given:
  Initial dose 0.2 mg/kg sid
  Next 2 days, 0.1 mg/kg sid
  Following 0.025 mg/kg 2-3 times per week
  
  So that would mean, for a 3 kg kitty
  Initial dose 0.2 mg/kg sid x 3 = 0.6 mg per day
  Next 2 days, 0.1 mg/kg sid = 0.3 mg per day
  Following 0.025 mg/kg 2-3 times per week = 0.075 mg
  
  Following 0.025 mg/kg 2-3 times per week = 0.075 mg / 1.5 mg/mL = 0.05 mL
on January 2, 2011 at 7:42 am 2010 in review « Life of the Lintee Bean, f.k.a. Crazy Cat Lady Blogging

[…] Metacam August 2008 161 comments 3 […]
on January 25, 2011 at 2:50 pm Leslie

Hi,

I am reading all of this today as I am taking my cat in tomorrow to get kidney/liver tests etc. prior to possibly taking Metacam. And of course I am very wary of it.
He was diagnosed with bone cancer, located near the base of his tail and went through 12 radiation treatments.
He is doing very well, although he has pain in that area when he goes to lie down etc., but severe pain only when he has to go #2. That is what has me considering pain meds, as it kills me to hear him howl in pain once a day for something that should be painless.

The long term for his life expectancy is not known. His quality of life otherwise is presently very good, he still enjoys our company, exploring the house etc. I will ask the vet LOTS of questions about dosage and try to sort that out with what I have read here.
Thanks
- on January 25, 2011 at 2:53 pm Lynette
  
  Best of luck, Leslie.
  - on January 28, 2011 at 10:25 am Leslie
    
    Hi Lynette,
    
    My vet recommended the .5 strength and .3 ml every day. My cat is 9.08 pounds. Does this sound in line with the guidelines you have learned?
    Thank you,
    Leslie
    - on January 28, 2011 at 8:18 pm Lynette
      
      Hi Leslie,
      
      Standard dosing recommendations seem to call for 0.23 mL every OTHER day (not every day).
      
      Personally, I’d go with every other day. Cats do not metabolize NSAIDs well, and dosing every other day mitigates possibility of it building up in their system.
      
      However, I’d also find it very important that your cat have quality of life for whatever time he/she has left. So, if that means taking more risks with Metacam – or exploring other options like Gabapentin or Tramadol – I would go for it.
      
      Best of luck,
      
      Lynette
      
      My math:
      
      Dose recommendations I was given:
      
      Initial dose 0.2 mg/kg sid
      Next 2 days, 0.1 mg/kg sid
      Following 0.025 mg/kg 2-3 times per week
      
      *** *** ***
      
      1 kilogram = 2.20462262 pounds
      
      Therefore (using 0.5 mg/mL strength):
      Initial dose 0.09 mg/lb sid = 0.18 ml/lb once daily
      Next 2 days, 0.045 mg/lb sid = 0.09 ml/lb once daily
      Following 0.011 mg/lb 2-3 times per week = 0.023 ml/lb every other day
      
      cat = 9.08 lb
      Therefore (using 0.5 mg/mL strength):
      1.6 mL first day
      0.8 mL once daily, second and third days
      0.21 mL fourth day and every other day thereafter
on February 16, 2011 at 11:23 am debbie

My cat is about 20 years old. In January she had her teeth cleaned and some pulled, because she started not to eat. That was only because her blood work was good. I was still having trouble with her not eating, to find out my other cat was not letting her move around the house freely. When she came home from the vets I guess with that smell on her, things changed. So I got her somewhat together but she started not to eat again. I noticed her legs were bothering her. Came on fast but they say cats don’t let you know there in pain, so I’m assuming thats what happened. So I took her to the vets and they are giving her metacam for this and also a appetite suppliment. But before this was given to her she was really on an empty stomach. So now it has been only three days and I haven’t noticed a difference in her walking. But she crys and doesn’t still want to eat. She will not get up to eat, I guess she hurts. I’m thinking her stomach hurts. I’m feeding her with a syringe a couple times a day but still can’t get enough in her. I ordered syn flex also. What do you think of this product? The company says it won’t hurt to give her. I want her out of pain. If she doesn’t come around in another day I am going to have blood work run again, maybe her kidneys are failing, thats why she won’t walk. What are your thoughts. Thanks
- on February 16, 2011 at 11:27 am Lynette
  
  Debbie,
  If your vet has not already done x-rays, I’d get them ASAP. Something is definitely wrong with your cat. Bloodwork isn’t showing anything, perhaps x-rays will reveal an issue.
  She HAS to eat. Hepatic lipidosis (fatty liver disease) can come on very quickly with inadequate protein intake. It’s unlikely you’ll be able to syringe feed enough to maintain her protein needs. She may need a feeding tube if this isn’t resolved very soon.
  Lynette
on February 16, 2011 at 6:36 pm JD

Dear Lynette and All,

Just wanted to share my story and see if anyone has any advice for my kitty situation.

My 16(?) year old cat Stella has arthritis and had been on Metacam for about 2 years at varying doses, sometimes every day, sometimes every other day. Recently she developed a skin condition on her neck, head and shoulder areas that had her itching like mad. So I took her in. They weren’t sure what is causing the rash, but she was prescribed a course of the steroid Prednisone (5 days at 1ml, 5 days at .5ml, then every other day at .5ml).

She also had blood work, which may reveal early stage kidney disease. Her creatine was at the highest end of normal but she had some elevated enzymes and other possible indicators. The vet decided not to renew the Metacam prescription and even if all was well with the blood work, the vet said that given the black labeling of Metacam for cats recently, I would have to sign a waiver before she could give me a prescription. So, the idea is to put her on Buprenex, an opiate derivative, once she has finished with the Prednisone.

I must say that out of the three (Metacam, Buprenex, and Prednisone) my cat seems happiest on Prednisone. I’m not sure if this is because she feels relief about her skin condition or if its anti-inflammatory effects are significant enough to improve her arthritis more than Metacam or Buprenex. It could also be that the Prednisone is increasing her appetite, and since she’s eating more she’s feeling better. Too many uncontrolled variables to tell, I guess.

The vet did not tell me that Buprenex isn’t good for cats with kidney problems. I found that out on my own. So I’m wondering whether it’s possible that the vet isn’t very confident that my cat has early stage kidney disease, or if she was just being sloppy in describing pros and cons.

Anyhow, if anyone has any advice about dietary interventions or other things that might help keep the early stage kidney disease at bay, I’m all ears. I’m feeding her wet food only (Wellness grain free) and giving her some omega-3 fatty acids. I’m not sure if there’s something else I can be doing for her.

Thanks and take care!

JD
- on February 16, 2011 at 9:43 pm Lynette
  
  Hi JD,
  First, I’m glad your kitty is on an all wet diet! 😀
  I’d try feeding only the poultry flavors of Wellness, and see if that helps. Some cats do not tolerate beef or fish well, as cows and fish aren’t natural prey for cats.
  If the pred isn’t sufficient to maintain relief, I’d consider gabapentin for pain. I talk more about gabapentin in my post on arthritis.
  I’d also look at thyroid levels. One symptom of hyperthryoidism is a poor coat/skin conditions. Check out my post on hyperthyroidism. T4 levels within range do NOT rule out hyperthyroidism. The T4 values have to be evaluated in that they should be decreasing over time – and other conditions (like kidney issues or other ailments) can deflate T4 values.
  Best of luck,
  Lynette
on March 3, 2011 at 11:07 am Tammy

Does anyone have any experience with Peroxicam? My 10 year old cat has an adeno carcinoma tumor in his colon. He was diagnosed 9 months ago. The tumor was removed only to grow back 2 months later.

He is down to 6 pounds and is given laxatone, lactulose, and butter in an attempt to keep his stools soft, as well as 100 ml of vitamin and electrolyte spiked fluids daily. He is also given anti nausea and appetite stimulating meds. No blood work has been done recently to determine his current liver and kidney function.

According to our vet, Peroxicam, like other NSAIDS, can be used as a tumor suppressor by affecting the tumor’s vascular supply. Why it wasn’t recommended months ago is beyond me.

He is pretty fragile; I’ve read the horror stories here about Metacam.

He’s been a happy little boy but I can tell bad days are just over the horizon. In fact, two weeks ago I had made the decision to let him go when he pulled a 180 on us and made a surprising comeback. We had just started giving him the anti nausea medication, and that combined with lots of prayer was our last minute miracle. I’m torn between hoping Peroxicam can give him a few more months of quality time and worrying that it will make things worse in a hurry.

Any feedback someone may have regarding Peroxicam in felines would be appreciated.
- on March 3, 2011 at 12:06 pm Lynette
  
  You may find this study of interest, Tammy:
  
  http://winnfelinehealth.blogspot.com/2010/07/adverse-effects-of-piroxicam-in-cats.html
on March 31, 2011 at 10:15 pm vicki s. wausau wi. 3/11

printing out the 72 pages I see today. My beloved Aboo is 14 years old and is now not eating or drinking since his vet took him off of gabapentin. He had been on it for almost 2 months.It was supposed to replace the phenobarbitol for organ reasons, but I was to keep him on BOTH untill otherwise. End result, my cat has been overmedicated to the point of him becomeing dehydrated. It didn’t help much in me turning up the thermostat any time he stood in front of the register. I love my companion with all my heart, and was ready to make that call.. then I am told to make him suffer and I feel horrible. How much time do I have with him? He is in pain, and I want to help. At least when he was high, he had an appetite. Now I don’t feel so bad that I decreased his double dose a bit from time to time. Day three of no appetite that I can see. Just putting my thought to text. Aboo’s next vet visit is sat.Please pray for him/us. Thanxmuch
- on April 1, 2011 at 6:48 am Lynette
  
  Vicki,
  I wish you peace with the difficult decision that lies ahead. It’s always so difficult to watch a loved one in pain.
  Lynette
- on April 7, 2011 at 12:19 am Abby
  
  Hi,
  I would try looking up anything natural and herbal to help. You need to do your research, don’t just go by what one site says, check with numerous sites if possible (check for interactions with other herbs and things/ start with small amounts etc. ) I have treated my pets in this way before and they have benefited from the information I have found. Sometimes it is amazing the things that can be treated naturally. Start by searching for natural ways to treat________….and go with one of the most severe symptoms. I hope you find something that will help. Thoughts are with you!
on May 17, 2011 at 3:13 pm Bev

My cat, Logan has been on metacam and it helped him tremedously. He has arthritis and had also injured his hip. He has had no ill side effects, except for the pity begging he learned while injured.He is taking a supplement called Sasha’s Blend, it is all natural glucosamine derived from green lipped mussels and other sea creatures. He has done amazingly well on it. He has also recently been diagnosed with diabetes.
And my other cat, Hector is on metronidazole .27mls twice a day for liver shunt. I have read that metrnidazole is not recommended for younger cats as it can affect them neurologically. Hector is 11 this year, just found his shunt last year. He has been fine on the metron. Just adding my two cents.
Love the blog!!
- on May 17, 2011 at 4:44 pm Lynette
  
  Thanks Bev!
  I have a few posts on diabetes, if you’re interested.
  Best of luck!
  Lynette
on May 31, 2011 at 11:48 am Phil

Hi–
My calico, Andie is almost 16, and they found a very early-stage squamous cell carcinoma under her tongue. They tried to surgically remove it, but the biopsy showed that the removed tissue has a dirty edge. Andie has been getting a daily low dose of cyproheptadine for 5 years, due to a lingering low appetite after having an allergic reaction to the Tapazol (she subsequently got the radioactive iodine treatment, which fixed her hyperthyroidism). I’ve given her 1 dose of the metacam, in the hope that she might benefit from its possible anti-cancer properties. I had a devil of a time getting her to eat much starting the next day, even with the cypro. She was prescribed the correct dose of the Metacam (believe me, I checked very carefully after reading this site–thanks!), every other day. I haven’t given her another dose since that first one, as I’m worried about the appetite issue. She only eats wet food, and drinks VERY LITTLE water, as she gets her moisture from the food. I’m concerned about the Metacam/dehydration/renal failure issue, as I’m afraid she won’t get enough moisture if she won’t eat. I’m getting her kindney functions checked this afternoon, to make sure nothing unpleasant happened with that first dose. Do you think I’m being reasonable about the appetitie issue? I’m leaning towards cancelling the Metacam, and just keeping her happy for whatever time she has left (though that means treating her like I have every day for the past 15 years). Thanks. This is heartbreaking.
- on May 31, 2011 at 1:14 pm Lynette
  
  Phil,
  
  I’m so sorry your Andi has cancer. 😦
  
  My Louie had oral cancer, and I opted for antibiotics and pain medication. Since Louie was diabetic and FIV+ (both of which make steroids an undesirable option), I opted for Metacam. However, if I was faced with your issue, I would consider a steroid like prednisolone (steroid) in lieu of Metacam. The steroid will act as an anti-inflammatory and can also stimulate appetite.
  
  Best of luck.
  Lynette
on August 27, 2011 at 9:34 pm Roberta Lambert

Bengal just turned 14 in March; he was diagnosed with Vestibular Disease (Dizzy Kitty) 4 years ago. A series of steriod treatments, a 7 day round every 6 months or so, kept his symptoms under control. Right after we lost his companion, Patch, to kidney failure, he needed another round of steriods. Within a week, he diplayed the same symptoms Patch had suffered and I feared kidney failure. As it turned out, the steriod had pushed Ben into full blown diabetes. He began insulin immediately and has lived with the disease for over 2 years. As he can no longer tolerate steroid therapy for the Vestibular Disease without hospitilization to monitor his sugar, he has bad days but mostly good ones. Soon after his 14th birthday, he started bleeding from his rectal area. I rushed him to the vet to discover he has a tumor and the vet suspected it was probably malignent. After a 2 hour trip to the nearest feline oncologist, my greatest fears were realized. My sweet Bengal has cancer and prognosis was poor without immediate treatment, Options offered surgery (which would likely result in his inability to control elimination), radiation, chemotherapy and a new drug therapy were explored. The oncologist prescribed Metacam 1.5 in a dose of 1 ml. every other day to reduce inflamation in hopes of stopping the bleeding/seeping from the area affected by the tumor. In the end, after many sleepless nights and discussions with his primary care vet, I decided against any treatment for the cancer. With his advanced age, diabetes and vestibular disease, the available cancer treatment options only offered a high risk of losing all quality of the life in the time left for him. I am happy to say that 5 months later, he is doing just fine. The tumor is growing away from his anal canal instead of blocking it. The Metacam has kept him comfortable, helps to keep the bleeding to a minimum and eliminated most all of the symptoms of the vestibular disease. I have read all the information and have accepted the risks. If this medication can keep my dearest companion comfortable and happy through these last precious months, then there is no true risk.
- on August 27, 2011 at 10:01 pm Lynette
  
  Roberta, thank you for sharing your story.
  Lynette
on August 29, 2011 at 5:57 am Phil Brown

Roberta–I made the same decision for my Andie, who’ll be 16 next month. She was diagnosed with squamous cell tumor in her mouth in April, and given “weeks or months”. I gave her one dose of the Metacam, with grave reservations. I never gave her another, for the reasons you cited above. 4 months after diagnosis, Andie is as much a kitten as ever, and I’m thankful for the “good time” for her (and me!). Best wishes…Phil
on September 4, 2011 at 8:38 pm Lee Ann

I really need help with dosing…my cat was given this and is deathly ill…i can not figure out if i was given the correct dose or not…can someone please help me????
- on September 5, 2011 at 8:28 am Lynette
  
  Lee Ann, if your cat is deathly ill you need to take it to the veterinarian immediately.
on September 5, 2011 at 6:13 pm Lee Ann

My cat has been to the vet …she was hospitalized for 5 days…i just don’t know if the metacam did this or not…come someone please answer some questions for me…my email is leeanncohen@hotmail.com
on September 5, 2011 at 6:28 pm Lee Ann

My math is terrible at this point…i keep going over and over these numbers..my cat was given 0.4 of the 1.25 metacam on the first dose…she is 16 pnds. ..i am confused…i’m seeing this would be the dose for the lesser solution of metacam which means i gave her 3x too much?????
- on September 5, 2011 at 6:48 pm Lynette
  
  For a 16 pound cat, the initial dose would be
  2.88 ml of the 0.5 mg/mL strength, or
  0.96 ml of the 1.5 mg/mL strength
  If you’re using the oral syringe that comes with the Metacam, there’s “pound” lines – it’s about the 30 lb line for the initial dose.
  
  As far as I know there, is no “1.25 metacam”… there’s a 0.5 mg/mL strength or a 1.5 mg/mL strength.
  
  If your cat was given 0.4 mL of the 1.5 mg/mL strength, that is within the guidelines. That doesn’t mean she’s not having an adverse reaction to the Metacam… or something else. You didn’t mention why she was given Metacam in the first place. Was she given only a single dose?
on September 5, 2011 at 7:04 pm Lee Ann

I’m sorry i haven’t slept in over a week..this has been a nightmare….i meant to say the 1.5 strength….She was given the single dose the day she had a tooth pulled…and a drop the next night..the next day she wasn’t “right”…i’m sorry this is so long…i took her back that next morning…they listened to her and said she was okay and she would come out of it…that same night i still wasn’t happy and another vet there checked her out ,,,he said the same thing…the next morning i took her back again and my vet listened to her..checked her temp..said she was okay..she was 16 and had been put under and it would take a little longer to be back to normal…(in the meantime this was thursday and she hadn’t eaten since i dropped her off on monday night)..On friday morning i was like a crazy person…when the vet opened i was there…her body temp and blood pressure was low..she was literally dying…after in house bloods they determined she had autoimmune anemia…(the whole time i kept thinking metacam and kidneys …BUT the kidney values were okay..and the cat had preop blood work so her red count was fine also…They gave her steroid shots and in the prior days we had been giving sub q fluids…the vet kept her and put her on iv fluids…by sunday they knew she wasn’t absorbing the fluids…in comes the internist and abdominal ultrasound…fluid in the abdomen…in comes the cardiologist…heart failure…When i brought her on friday my vet did and ekg and xray…they were fine…so much for ekgs and xrays.
Now the cat…Sunshine is on heart meds…she was on high prednisone which we know is bad for the heart…we tried to lower the pred…5 days later her pcv dropped and we had to raise them again…now from the steroids she has become diabetic…i’m living a night mare and i just keep praying this isn’t my fault from giving the metacam.. One tooth being pulled has become a living nightmare…i have had this cat since she was 2 days old…she was 16 in July..
YOU ARE SURE I DID NOT OVER DOSE HER ON THE METACAM????
thank you so much,
if i sound like a crazy desperate person…at this point that is exactly what i am.
- on September 5, 2011 at 7:16 pm Lynette
  
  I’m so sorry – what a nightmare. My cat, Ralphie was on prednisone for years for anemia/low pcv. Fortunately, once I adopted him and put him on an all-wet diet he recovered and we could wean him off the pred.
  Best of luck!
on September 6, 2011 at 5:02 am Lee Ann

From what i’ve read online i gave a dog dose of the metacam to a cat…i should have given the amount i gave in the lesser concentration of the 0.5 strength.
Would the one dose of what i gave cause the cat to go into such an anemic state…her pvc was 19. There is on doubt it was one of the drugs they used because again..her preop bloods were perfect.
on September 6, 2011 at 5:30 am Lee Ann

meant that her pcv was 19
on October 19, 2011 at 5:31 am tramadol hgc

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on November 2, 2011 at 5:01 pm Ingrid

Thank you for putting things in perspective!
Wish everybody had so much common sense, those activists drive me crazy…
on January 16, 2012 at 7:13 pm Mark Brennan

I am another pro-Metacam, pro pain-free cats.

After being bombarded with emails from people on the Yahoo CRF group telling me my vet was killing my cat after allowing him to give my cat Clapton Metacam, despite being stage 4, he had to have a much needed dental requiring fragments of bone & tooth removed from his gums (due to a previous botched job by another vet). We had to let him go shortly afterwards. I don’t know if the Metacam was too much for him but we had no choice as one of the fragments was necrotic and in danger of spreading to him jawbone, My vet said he would be in agony if it wasn’t for the Metacam and vetergesic.

This year, one of my other cats, Alice got to the point with her arthritis whereby the corta-vet and a heated infra-red bed weren’t enough to keep her comfortable. I had a long talk with my vet who assured me that the latest studies indicated that as long and the kidneys are healthy to begin with and dosing is done carefully, it is perfectly safe to give long-term oral Metacam. We were due for a blood test soon anyway, but this week Alice developed a water infection along with an eye infection – I have no idea why as she is an indoor cat. The results of her blood tests after 8 months solid use of Metacam were “a clean bill of health” – he said her urea was 0.1 above high-end of normal but he didn’t think it was anything to be concerned about. The icing on the cake was that her Thryroid was 3.4, despite a year ago being on the high end of normal.

I find it very worry when I see warnings given on cat forums every time the word Metacam is used. I think it is a wonderful drug that has given many cats (and dogs) a quality of life they never could have had in the past.

I hope some time in the future there is a safer alternative, but in the meantime, I plan to use it when my vet advises, even if it means a shorter but pain-free and contented life for any of my cats. Happily in this case Alice will continue to do well.
- on January 19, 2012 at 3:54 pm Mindie Kaplan
  
  Any vet who says: “I had a long talk with my vet who assured me that the latest studies indicated that as long and the kidneys are healthy to begin with and dosing is done carefully, it is perfectly safe to give long-term oral Metacam.” either doesn’t read the package inserts on the medications they dispense or is lying. Period.
  
  The FDA doesn’t put a black box warning on a product without good reason. A vet CANNOT guarantee that a cat will not ever develop kidney problems from repeated Metacam use.
  
  The decision on whether or not to give a cat Metacam needs to be made by weighing the current quality of life, what (if any) alternatives are available, and the possibility of kidney failure. Sometimes Metacam will be the best (or only) choice. Sometimes it will not.
  
  But my cat got a “usual” dose according to the makers of the drug and nearly died as a result (and has cost me more than $30,000 in medical bills with no end in sight).
  
  Some cats will be fine and other cats, given the exact same dose, will die. That is why they put the black box warning on Metacam in 2011. Any vet who guarantees you that YOUR cat will be safe is exposing themselves to a potential lawsuit. I’m glad you got a good result. I hope you continue to get good results because CRF is hell…. an excruciatingly stressful and expensive hell.
  - on January 19, 2012 at 9:35 pm Ingrid
    
    Study oct. 2011: Retrospective case-control study of the effects of long-term dosing with meloxicam on renal function in aged cats with degenerative joint disease.
    http://www.ncbi.nlm.nih.gov/pubmed/21906984
on May 22, 2012 at 1:03 am Sharon

Thank you for this balanced, informative blog. I too was horrified to learn that I may be endangering my beloved cats life by giving him Metacam. Max is 16yrs old, healthy, weighs 13lb and has, fairley recently, developed pain from, in my vets opinion, the onset of spondoloysis (he observed on Max’s xrays some light bridging of calcium between the vertebrae). However the change in him after just a few days after an initial injectioin at the vets and then daily dosing on between 5 & 6 on the Metacam syiringe was remarkable. Before he was stiff in his movements and avoiding stairs and, at times even finding it difficult to step over into his litter tray.

Still I am concerned, my vet left me with the instruction to daily dose 6 on the Metacam syiringe, but I have already reduced this as stated above. I should also state I am using the 0.5mg/mL strength. We have been using for 16 days and Max is due to go into a cattery for 14 days this week, should I reduce this dose to between 4 & 5 on the syiringe every other day (or even less)? I plan to take him to the vets for blood work upon my return to the UK ( He was checked before the administration of this medicine and found to be in rude health :o) except for the painful joints)

Many thanks
on June 20, 2012 at 11:31 am Laurie

hi,

Charlie has scc, inoperable. He has had 2 four shot radiation treatments to date and his tumor has not grown. When his mouth starts to show necrosis, a shot of methylpred works absolute wonders on him. He plays, eats, bites his sister, cuddles, purrs and loves life. His doctor suggested I start him on Metacam, .15 ml every 3 days for pain and POSSIBLE tumor remission. I am terrified. When he is doing bad, I say, I’ll give it a shot, it’s a 50/50 that it will stop his cancer. When is he feeling good, I say no way. I know the the methylpred does not stop cancer, the metacam may. What a dilema. Suggestions?
on June 20, 2012 at 11:33 am Laurie

sorry, he weighs 19 pounds.
on June 20, 2013 at 9:21 pm Mia

Thank you for this post. My elderly kitty has just been diagnosed with a degenerative disk disease; and has just been prescribed Metacam. I was so upset after finding all of those warnings on the internet, and so confused about what to do. I called the vet, who was understanding, but still, of course, left the decision up to me about what to do.You really helped me sort this out. I agree with you. I know that now, Thank you so much.
Mia
on June 20, 2013 at 10:08 pm Mia

Lynette.
My cat has had an injection of the Metacam at the vet’s office. We were also sent home with oral metacam ( 1 drop each day). Is it still advisable to continue with the oral drops ( or is the risk too high after having that injection; I don’t understand this one time dose thing; or if this is ok to follow with oral metacam)? I don’t quite understand that part. Your thoughts/advice would be greatly appreciated.
- on June 21, 2013 at 7:35 pm Lynette
  
  Mia,
  I haven’t used the injectable form of Metacam. For using the oral form, I’d follow the protocol I wrote out above – which decreases the dose from daily to less frequently.
  Lynette
  - on June 21, 2013 at 7:55 pm Mia
    
    Lynette. Thank you so much. You have helped me sort this out during a difficult time, and I appreciate it so much.