More metacam paranoia and claims

RE: More metacam paranoia and claims

Martin Atkinson — Fri, 03 Mar 2017 12:28:42 GMT

[quote user="Aine Seavers"]Which fits my argument perfectly-a cat on it for years is hardly likely to have an issue. [/quote]This is OK so long as the cat is being monitored. The danger is clients just come in for a repeat and it is dished out. I'm pretty sure I finished my cat with CRF off with meloxicam for his OA but he was in pain and miserable if I didn't give something. To an extent it is my own fault because I preferred to give him and other old cats with renal issues Onsior if they need some NSAIDs but who knows if he was going to go into terminal renal failure anyway?

There are many arguments either way but so long as it gets into people's heads that NSAIDs are not benign drugs and need to be treated with caution then that is an important start. If you've not seen a bad reaction yet, believe you will sooner or later.

RE: More metacam paranoia and claims

Aine Seavers — Fri, 03 Mar 2017 11:13:22 GMT

Many tx- The abstracts reflect my experience in 100s if not 1000s of cats over many years. That said if a lower dose works, I will change but I need more than feel good approach-I need some good evidence homeopathic tiny dose works and currently there is none.

RE: More metacam paranoia and claims

Aine Seavers — Fri, 03 Mar 2017 11:10:35 GMT

Which fits my argument perfectly-a cat on it for years is hardly likely to have an issue. The reaction may be idiosyncratic so the actual dose not an issue. My concern is hwpw they judge the lower doses to be effective-where is the data on that?. If I give something for purpose A, I want it to work-therefore I should use a proven dose -so if someone can provide me with proof the lower dose works I will be first on board-but the only proof of anything so far is my good mate Richard Malik's paper showing it had reno protective effects.

RE: More metacam paranoia and claims

Martin Atkinson — Fri, 03 Mar 2017 10:41:18 GMT

This has been discussed on other threads and my concerns have been largely dismissed but I've seen too many cats go into acute renal failure on meloxicam to ever use it routinely. Maybe I've picked up everyone else's bad luck but this is not a benign drug and for once I think the paranoia induced into students is justified. The one caveat is that those that did go into ARF generally got it early on in the course, sometimes after just one injection, which may suggest that if they can tolerate it to start with they may be OK long term. As for giving lower doses - well if it seems clinically effective then surely that is what we should do.

RE: More metacam paranoia and claims

Thomas Johnson — Fri, 03 Mar 2017 10:23:10 GMT

[quote user="Aine Seavers"]

The latest we are now dealing with is new grads from one Uni getting cats on long term metacam to come off it as 'kills' cats'kidneys. My husband reply back to them was-when exactly is this going to happen? Given the cases had been on it for years, it hasn't happened yet and those cats would have be PTS years ago for pain and aggression. The reply was to compromise then to only ever use dose at 1/3rd as that would not damage the kidneys. Where is the evidence for this? many drug reactions are idiosyncratic and not dose dependant, other drugs have non linear pharmacokinetics-what if meloxicam has non linear actions? and where are the studies showing 1/3rd of a dose works as a painkiller? We are using the drug (and taking a risk perhaps on some % of kidneys) so we really need to be making sure it can act as a pain killer. To me is smacks of 'feel good' medicine not evidence based. The law of unforeseen consequences is that it won't stop that tiny % of cats who get renal issues but will leave a heap of cats without pain relief. I would be very relieved if anyone has any peer reviewed data that shows efficacy at tiny doses.

[/quote]

I can only see the abstracts, but you might find these papers useful in showing that the risks of meloxicam use in cats with renal disease is low:

https://www.ncbi.nlm.nih.gov/pubmed/22821331

https://www.ncbi.nlm.nih.gov/pubmed/21906984