Ever heard of Metacam for cats? If you're a cat owner, you might have come across this name in discussions about pain relief for your furry friend. But is it safe? Are there side effects? These are some of the questions that often pop up.
This article peels back the layers on Metacam, also known as meloxicam, a common pain relief medication for cats. We'll explore how it works, when it's used, and what makes it a subject of discussion among cat owners.
Our cat boards frequently discuss Metacam, with concerned members questioning its safety as a choice for their cats. This guide explores Metacam and its use in cats, including side effects and risks. We want cat owners to make an informed decision about this pain relief medication for their cats.
What Is Metacam?
Metacam is the commercial name of meloxicam. Boehringer Ingelheim manufactures Metacam, a non-steroidal anti-inflammatory drug (NSAID) used for pain management in dogs and cats.
Many vets recommend using Metacam for post-surgery pain relief in cats. Outside the US, veterinarians also use it to manage pain from feline arthritis.
Metacam (meloxicam) works by inhibiting a certain enzyme - cyclooxygenase - necessary for the body's inflammatory reaction. Lowered levels of cyclooxygenase mean the tissues are less swollen. This creates less pressure on delicate nerve endings, thus causing less pain.
The Use Of Metacam In Cats
Metacam is available in an oral solution form and injectable form.
In the US, veterinarians prescribe oral Metacam specifically for dogs, primarily to manage pain associated with osteoarthritis. According to the FDA "METACAM Oral Suspension is approved for dogs only. No safe and effective dose of the oral suspension is approved for cats".
The FDA also limits the use of the Metacam solution for injection to a single dose. A black-box warning has been added to this product:
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.
Metacam is therefore usually used by American vets solely for postoperative pain management. It is typically given in a single shot during surgery. However, veterinarians around the world, including in Canada, Australia, and many European countries, use oral Metacam for pain management in cats with arthritis as well.
It is worth noting that the recommended dosage is lower in those countries. Additionally, many cats receive the medication with no ill effects.

Metacam And Cat Safety: Breaking Down The Risks
Most cats don't experience any side effects from the use of Metacam, however, as with any drug, some do. In a field study conducted by the manufacturer, 8.3% of the cats experienced elevated levels of kidney functions in blood tests. 12.5% of the cats experienced post-treatment anemia (compared with 6.3% in the control group).
In Canada, where oral Metacam is prescribed for cats, the following conditions are listed as contraindications to using the drug: Gastric or internal ulceration or bleeding; evidence of cardiac, hepatic, or renal diseases; or if there is evidence of a hemorrhagic disorder or individual hypersensitivity to the product.
As with any medication, drug interactions can be an issue. Metacam should never be administered alongside other steroidal or nonsteroidal anti-inflammatory drugs, aminoglycoside antibiotics, or anticoagulant agents.
Acute Renal Failure (ARF): A Feared Complication
Acute renal failure (ARF) seems to be the effect many cat owners fear when considering Metacam. Reports of ARF in cats were what led to the FDA issuing the black box warning for the drug.
We've had quite a few testimonies from members of TheCatSite.com about such experiences. These include one by TCS team member @stephanietx. Stephanie posted: "My Callie girl got a couple of shots of Metacam and shortly thereafter developed renal failure. After doing research, I decided to put that on my "Never give without my permission and after all other options exhausted" list at the vet's office."
ARF is a life-threatening condition and should be taken in all seriousness. That said, testimonies of ARF in cats following administration of Metacam, do not necessarily mean that Metacam is less safe than other drugs.
Many veterinarians across the globe regularly prescribe Metacam for pain relief in cats without ever seeing serious adverse reactions to the drug.
Dosage Differences: A Potential Risk Factor?
Canadian veterinarian Dr. Kris Chandroo shares his experiences with metacam in a blog post on the topic. So far, he has successfully and safely used over a thousand Metacam doses on his patients. But warns that caution should be used when deciding which cat to medicate with the drug.
"I can know within 90 minutes if a cat is a candidate for an NSAID, or if it should be not considered at all", Dr. Chandroo says. "It’s about using methods with accountability to the cats' individual requirements, and not using medications as a preset recipe. The dose is always tailored to the individual now and over time, regardless of what the box might say", he adds.
Veterinarian Dr. Marie Haynes suggests that the cases of acute renal failure reported in the US may be due to the difference in dosage instructions. In a blog post about Metacam, she says:
"I do really believe that when Metacam is given appropriately, at the correct dosage, to a healthy cat the chances of developing kidney problems are extremely rare. But, it can happen. I have also noticed that in the US, the dose for a Metacam injection for cats is 0.3 mg/kg. In Canada, it is 0.2 mg/kg. It may be that there are more issues with Metacam for cats in the US because of the higher recommended dose."
Alternatives To Metacam
Pain management in cats is challenging. Many drugs are toxic to cats, including some that humans and canines tolerate quite well.
Rare reactions can happen with any drug. For example, Tramadol, a common alternative to Metacam, can induce seizures, hallucinations, and other neurological side effects.
Buprenex (buprenorphine), a different opiate commonly used in postoperative pain management, carries its own risks. One of those risks is kidney damage. What's more, research shows that this drug has an inconsistent response in cats. This means it does not always deliver the pain relief it should be providing.
At this point, there is not enough research data to say which of the options is in fact safer for cats. Is a low dose of Metacam safer or more dangerous than the equivalent dosage of Tramadol needed for pain management?
Acute renal failure and similarly severe reactions do happen but they are rare. Also, there is no way to tell in advance which drug will induce them in a specific cat.

So, Should I Accept My Veterinarian's Recommendation To Use Metacam?
If your cat is about to undergo an operation you definitely should discuss pain management with your vet. The cat's age, chronic conditions, and current medications should all be taken into account when deciding on the drug of choice. You may prefer to have blood tests done to determine the cat's renal functions prior to the operation. With these procedures in place, hidden kidney issues will be made more apparent.
Ask your vet about hydration for the cat. A dehydrated cat's kidneys may have a harder time dealing both with the anesthetics and Metacam. Many cats tend to be dehydrated during surgery because they had not been fed for six hours prior to the procedure (sometimes longer). Make sure your vet is aware of that and plans on providing fluids before administering Metacam.
If your vet recommends Metacam you should discuss the issue of dosages with her
or him. Refer them to the lower dosages recommended in Canada and other countries and discuss the way these may affect the risk associated with this drug. If you live in the US, you may want to print out this FDA announcement about Metacam. You might also print this statement by the American Association of Feline Practitioners. These will help you discuss any off-label use of the drug.
Don't rush into saying "yes" to Metacam but don't rush into saying "no" either. Keep an open mind and discuss the options with your vet. Together you can find the best course of pain management regime for your cat.

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