Metacam For Cats – The Pros And Cons Of Meloxicam For Pain Relief

Cat Health 30 Comments

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."

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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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30 comments on “Metacam For Cats – The Pros And Cons Of Meloxicam For Pain Relief”

Link March 17, 2023
What an interesting article. I didn't know that the dosage is smaller in the rest of the world, and that the drug seems to be used with reasonable success, there. My cat was put on a low dosage of meloxicam after she was diagnosed with bladder cancer, and when I asked the vet about the warning that came with the box, she said that it's often given to cats at an altered dosage with relative safety. I felt better after that and continued to give it to her. I found out later that meloxicam has anti-tumor properties, and this was why the vet prescribed it in the first place. My cat is on an even smaller dose than listed, less than 0.1mg/kg by my calculation. She's been on it for a year, well past the usual lifespan for cats with her condition, and acts totally normal. I'm glad the vet took a shot for us, and I have no regrets.
Mia October 6, 2022
My kitty , 5 years old had constipation, and a UTI. Emergency vet gacpve an injection of Metacam followed by 4 days of oral dose. On day 3 at night, he was a bit finicky about eating, very unlike him. The next day he didn’t want to eat and seems unwell. Looked up his meds ( antibiotic and Metacam) and horrified to see how risky Metacam seems to be for cats. Did not do the 4th dose. He hypha’s an appt today to be assessed at his reg vet. Scared. My poor kitty! I hate Big Pharma and how docs and vets just do whatever they say. Like robots.
    Lisa November 8, 2022
    Our vet injected Metacam to my cat Pompadour after a surgery, without my permission, without doing any blood test to check her renal state. 2 days later, Pompadour was eating less, looking lethargic. I thought it was a little fatigue and part of post-surgery recovery. I found her dead on the morning of the 5th day. I am devastated and furious. The vet just said "her heart stopped" because she was too old (she was 12 and in perfect health)
Steve November 14, 2021
I've recently lost my 12-year-old rescue cat, who I was particularly bonded with as I had actively been his rescuer. He went in for a dental and was prescribed this stuff across 7 days, when the drug sheet clearly states it should be "up to 4" for the higher of 3 concentrations post-operatively per KG body weight. Only the lower ones are used longer. He was a strong 14lb cat and had a pre-op kidney test which was okay (although a cat can still have 69% dysfunction and it would not be recorded). Towards the end of the first week his appetite started to ease off, and across the second week he became bloated, which I made the error of assuming was constipation/gas, which he'd had before, so tried Katalax laxative. He was put down 2 weeks after his dental with renal failure. The vets tried to suggest it was a coincidental thing, a UTI happening post surgery where urine backed up from a blocked bladder and wrecked his kidneys, totalling ignoring the incorrect prescription. But it seems logically obvious from the sequence of events what actually happened, his kidneys shut down due to a double length overdosing of Rheumocam (Metacam) across the first week, that made him drink more, and then as he became terminal across the second week he developed stress cystitis and couldn't fully urinate, but by then it was already too late, his kidneys were over. Metacam is given for stress cystitis, so this bloating did not and could not happen while on it during the first week, it followed him being taken off it. No cat of mine will ever have this poison again. In the UK they dole it out as a cure-all, and the wall of denial of liability when something goes wrong means the governing body, the RCVS, do not get to hear when things go wrong, the vets all have other explanations at the ready. I rang up the practice to point out the vet's prescribing error, possibly a new vet, hoping they'd double check her other prescriptions for this drug and they said they'd raise it at a future meeting! Imagine if a doctor overprescribed a drug known to shut down kidneys and that was the attitude in the aftermath.
IndyJones May 28, 2021
Could this be updated to include the feline version of the oral formula? https://www.drugs.com/vet/metacam-oral-suspension-for-cats-can.html
Sandra March 11, 2021
Why would you let her suffer like that why wouldn't you just put the cat down it doesn't make sense I think sometime we're selfish and we want them around it's not right
Orlando Pip January 28, 2021
I have a 12.5 year old cat who had mouth cancer and 3/4 of his bottom jaw removed 3.5 years ago. He's been on a low dose metacam ever since as it is thought to have anti-sarcoma properties as well as anti-inflammatory and pain relief. He's full of beans, loves his food (I blend it with water) and is doing better than I could have ever hoped for. His sister has arthritis which started quite young. She's been on metacam for about 4 years. Both have regular bloods done and so far no deterioration in kidney function has been noted. I add water to her food too (mix of biscuits and pouches) to make sure she is properly hydrated. If I stop the metacam she limps, on it she doesn't...4 years of pain vs 4 years of not limping....I'd rather her have a few less years (it may not even be the case that metacam will effect her kidneys) of pain free life than her live with chronic pain. Like others have mentioned, the doses in the uk are much lower (the solution is more dilute to start with so even giving same volume, a lower dose is administered). Do read up but dont dismiss out of hand, discuss with your vet and just make sure the dose isn't too high.
    Jennifer Minkema April 12, 2021
    Orlando- I hope you see this- please, I would really like to talk to you asap regarding the surgery your cat went thru on his lower jaw. I need to decide if this is what I should do, and need to do it quick. Could you please email me? [email protected] Jenn
Ron Williamson September 29, 2020
Our cat Booboo after two doses is slowly dying. I first told wife not to give it to her. When Vet found out we were not dosing her became insistent we do. We did and regret it. She is 17 years old and just watching her die slowly.
    Brett April 20, 2021
    Meloxicam killed our 15 year old healthy cat. The vet prescribed it for arthritis. After 10 days of taking it with food she began to vomit and 6 days later we had to put her down. The Meloxicam had caused perforations in her GI that then caused sepsis. Tragic and terrible experience.
SONJA May 9, 2020
I took my kitten krazycat after it was attacked by a very large dog we took it inside it 1st vomited all its food up then he pooped but not in his litter box we noticed he was very tender on his right back leg so we then took it to the Whyalla veterinary clinic he was treated by Dr.Andrew Melville-smith he then said that my cat was just traumatized but wanted to keep him over night my poor kitten wasnt even 4 months old we were told the morning that krazy didnt survive we were then handed the bill he didnt take any xrays but he administered him a metacam injection without asking us whether he should or shouldn't proceed we were left in the dark just like poor crazy all alone we now have a bill and no cat the vet showed no empathy what so ever no apology what so ever he was told the cat was attacked yet didn't bother with xrays he has done this to many animals he was videoed by phone who witnessed him being cruel to her toy poodles but he threatened not treat her dogs and to close her account she needed her account open as her dogs had on going issues she wanted desperately to go public she couldn't but I can.
    Sandra March 11, 2021
    Sue the hell out of him
    Annie's mom February 13, 2022
    If a vet shows attitude like that then its time to find another one. And should be reported to the proper authorities of the veterinary board. We hire veterinarians when we take our precious kids with fur to them. And we can fire them! If they're notably hurting animals or not treating them properly, then they should be reported. But before you report them, get all your paperwork from the practice. That way you have evidence of what they did and didn't do with your loving pet. I'm especially grateful for my vet. She is sweet with my cat and has helped me give my old bundle of fur a comfortable life. My cat "Annie" has cancer. We are just making her comfortable enough until she has to cross the rainbow bridge.
Raven Pittman March 23, 2020
I have a 11 year old cat that has recently started having pain from arthritis the vet prescribed metacam I am concerned now after seeing all these comments is it safe for cats???
    StacyH March 31, 2020
    Don't do it! There are other things they can give your cat. I wish someone had told me what the risks were and what other options were available. My cat was only 6 and had the start of arthritis, the reason I took her to the vet was because she had been limping and I had not seen any injury take place. They prescribed Metacam for 4 days orally and the only thing they told me was that they can't use it long term because it can have bad side effects so if she did not get better we would have to look at other options. A week and a half later her she was not eating or drinking or going to the bathroom and throwing up. Took her to back to the vet and they did a blood test and found that her kidneys and liver were failing and told me they wanted to keep her and pump fluids through her to try and flush it. A day and a half later she was breathing heavily and having heart issues, still had not eaten, drank or gone to the bathroom. They did another blood test and all her kidney numbers had gotten even worse. They told me she wouldn't make it through the night and would most likely have a heart attack and even if she didn't her kidneys were too badly damaged at this point to do anything more for her. I had to make the decision to put my cat to sleep simply because I took her to the vet and followed their instructions. She was a young, happy, healthy, sweet girl and now she is gone for no reason.
mentat March 12, 2020
If on meloxicam or Onsior long-term, for chronic pain/inflammation, vets' consistent recommendation is labwork assessing kidney health (blood chemistry) and red/white blood cells every 4-6 months. Once we had kidney enzyme increases indicating chronic kidney disease, employed more treatment options and increased frequency of labwork rechecks. Many have labwork return to normal, in early kidney disease, when appropriately managed, while still treating pain and/or DJD with NSAID therapy.
mentat March 12, 2020
Cats metabolize NSAIDs like meloxicam via kidneys; dogs metabolize NSAIDs via liver and kidneys, but more prone to hepatotoxicity if overdosed. Hydration is key. We advocate and question our vets about pre-anesthesia infusion of IV fluids for multiple hours, to ensure kidneys are "fluffy and happy," prepared to metabolize the NSAID prior to it being administered. All my chronic kidney disease/insufficiency cats were also on NSAIDs at end of life, for quality of life, as their arthritis and back pain were considerations in their quality as much as their kidney health, perhaps more. Without the NSAID, they weren't as mobile, weren't as regular with appetite or elimination, and weren't as happy/social. It's a balanced decision to make with your cat's care team, self educating, inquiring, and comparing information and experiences. Onsior is a great alternative to meloxicam, but is only available as oral tablet for home administration; this was limiting for some of my cats daily dosing, whereas liquid meloxicam was very small volume and unnoticed in food or easy to syringe orally.
    Judy Jordan April 21, 2020
    Onsior is also much more expensive, running from $3-9 per pill. That makes a 30 day supply $90-270 -- out of budget for many cat owners. Apparently, metacam is used in Australia, Great Britain and Canada for ongoing treatment, just at smaller does.
jjk308 April 4, 2018
I've been using Ostilox, a meloxicam suspension for dogs, for my 15 year old cat Spot for 5 months with zero side effects. The dose is less than 1/4 of the recommended canine dose, only .01 mg. of Meloxicam per lb., about the dose recommended for cats in other countries, and Spot is doing very well on it. She was completely crippled by arthritis, simply refused to walk or even get up, and is now more limber and active than she's been in years. Apparently cats kidneys can't tolerate anything near the amount a dog can tolerate, the reason Meloxicam got a bad press for cats, but these tiny doses are both easily tolerated and effective.
    Annie's mom February 13, 2022
    My cat Annie is on Metacam. It is used for dogs only but my vet said we can put her on a low dose for her pain. She is a feral 16yr old domestic shorthair. She was a barn cat whom nobody wanted because she wasn't a good mouse killer. But she loves people. I took her on immediately. Just saw something in her and she is so loving. Doesn't even bother the birds. An occasional rabbit head though, lol. I've had her for 5 years now. Best feral cat I've ever had so far. People like to dump these poor cats out here in the country. She has a very large cancerous tumor under her arm pit. The side of tumor is almost touching her other leg.The elbow extends out, she walked with a severe limp. The lower part of her leg and paw now has atrophied and the tendons, muscles are almost gone. Her paw just flaps freely if you play with it. She trips alot. Relies on the good leg. My vet told me the tumor is cancer. I figured so. As the years have gone by its gotten considerably bigger. This past year she has cried out in pain when picked up or sometimes when walking. My vet told me surgery is an option but not a guarantee that cancer wouldn't come back. I said no. And because we both agree she might not survive the anesthesia. I agreed to make her comfortable and that I'd give her a good pampered life until God takes her across the Rainbow bridge. Medicam was discussed with the knowledge of side effects. I give her it in a syringe by mouth every 24 hours. Enough for 6lbs. She looks forward to it. She will put her good paw up on it like, give it to me!! It must taste real good to her. It's been six months. So far so good. Her bathroom habits haven't changed and she still eats and drinks well. Sleeps more often though. But its understandable. So in Annie's case, the good outweighs the bad on this medication.
jennyr July 19, 2016
My Dushka has just developed a urinary infection. The vet I saw this morning (not my regular one but a member of the practice) wants me to give her Metacam to relieve the pain. He knows I am against it and said that the last time I raised this they had a practice meeting to discuss it and did some research, which at least means they took me seriously. But their conclusion was that in Europe the Metacam for cats is at a lower dosage than the US version and has been demonstrated to be safe. He refused me any alternative, saying the Metacam is safer. I brought it home prior to doing some more research. Having read up a bit more, I will not give it to Dushka, who already has severe renal issues and is on kidney meds and diet, prescribed by this same vet 6 months ago! Faced with the alternatives of high risk AKF and 3 days of diminishing pain, I am afraid I have opted for the latter.
tarasgirl06 March 15, 2016
My family, on both sides, did/do not believe in allopathic medicine or in taking drugs, except when absolutely necessary.  That said, of course it is very hard for those of us who share life with beloved cats (or kids, or any others in our care) to know they may be in pain and not try to alleviate that pain; but because of the level of risk these drugs ALL carry, I would not use them.  (Btw, one time I was in pretty bad pain and took a Tramadol.  It made me "stoned" for 3 days.  No more for me!)
otto February 27, 2016
No metacam for my cats, ever. Perhaps in a nothing to lose situation. But if there was "nothing to lose" I'd be setting kitty free of suffering anyway. I don't believe it is safe and am shocked at the casual use of it, especially in the UK.
    Martin November 9, 2020
    My cat (13yo neutered tom) has been on this for well over one year now. He has had a heart murmur from birth as well as breathing and fluid in lungs. He has shown no adverse reaction for Metacam and has blood tests every six months. Perhaps I'm fortunate, but it has restored a great deal of his agility. Of course I would rather have some magic cure-all potion that has not side effects but that is not going to happen. For now Oscar is living a near normal life; better that than crippled. MJW - UK
kittens mom February 19, 2016
http://livertox.nih.gov/Meloxicam.htm  This came up while researching antibiotic induced liver failure in cats.
rickr February 18, 2016
Quick follow-up.  I spoke to my vet.  She said that most of the issues with Metacam date from the release of the drug and were related to improper dosing - especially on older cats.  She assured me that as long as I stay at the recommended dose the risk is minimal. I feel better now.   
rickr February 18, 2016
Thanks for the clarification.  The article is well balanced - it wasn't scary.  I just worry about my cats, especially when one of them is out of sorts.  I will talk to my vet.  I trust her.  She is generally conservative about treatments and medications.  I am surprized, though,  that she didn't mention anything related to Metacam.  In fact, when Archie was in for a checkup recently, she said that it is very safe and that she has used it with great success. 
Anne February 18, 2016
I didn't mean to be scary. Every drug has potential side effects and risks. Metacam isn't different in that regard.  You should discuss this with your vet though. In the US it's off-label use to prescribe oral metacam for cats and that's something your vet should have mentioned. Depending on the dosage, it can actually be fairly safe, compared to the alternatives. 
    Patti Thompson March 6, 2021
    My cat was "diagnosed" with cancer feb 23. Picked up prescriptions the following saturday-ear mite and war flush along with meloxidyl. After reading about the warnings i still have not given it to him, using cbd oil right now instead. Your article has just added to my guilt, and confusion. He has the growth on jaw and i know this is bad. I dont want him to hurt. And thank you for the statement regarding how the vet should have discussed this with me.then again she was in the exam room all of 6 or 7 minutes, said she was going to go write up a care plan, and i didn't see her again. So...
rickr February 18, 2016
Gosh.  What a timely and somewhat scary article.  My cat only vet recently prescribed oral Metacam for my tabby Archie,  He is receiving physical therapy for some spinal issues.  Metacam was recommended to help control the inflamation.  I didn't think much about it.  Since Metacam is not a steroid, I assumed the drug would be safe.  He loves taking it; in fact, on more than one occasion he has carried the box to me, suggesting he wanted a dosage (every other day).   Now I am concerned.  The box does not show the black label warning mentioned in the article, but the instructions (which I didn't read at the time) do say for dogs only.  I need to have a conversation with my vet.  The only warning I was given, was to make sure that he is eating and drinking, which he is.

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