Cat Arthritis

[leslks@aol.com]

Cutie Pie was on Metacam for six months. Since it is for dogs, Vet guessed at the dose. I gave her 1 drop every 5 days. It did not help.
Her ankle joint is very large where the cartilage grew over the years. I know she is in pain.
Do you know of something that can give her relief?

[leslks@aol.com]

P.S.
I have tried Projointin since July. Don't notice any results there either.

[Traci]

Cutie Pie is a cat, right?

Your vet dosed off-label for this, and I must advise you get Cutie's liver and kidney function tested immediately. Metacam is NOT prescribed in this manner, and there are NO studies done to determine long-term effects on cats, especially used in this manner. Please, get her to a NEW vet and get her full bloodwork done.

Ask the new vet about Cosequin for Cats, but before you use this, ask the new vet for new xrays and evaluation, because it may be something else altogether (very well could be since it isn't responding to what your vet has done). Please find a vet who is very experienced in orthopedic veterinary medicine.

[leslks@aol.com]

Yes, Cutie is a cat.
One drop every five days is a very small amount
so why are you so alarmed about her liver and kidneys? What manner are your referring to as far as the dosing. Seems like a miniscual amount.
Now that she isn't taking it I see that she seems worse. Maybe it did help.

[Traci]

If you read the other post, you saw the common dosing and that it is only dosed on a temporary measure. It is NOT licensed to be prescribed for long-term use in cats, and some cats do not take to it very well. In long-term dosing, this DOES predispose the patient to kidney or liver problems, and your vet should have told you there was that risk!! Did he recommend bloodwork tested every month or so? If not, this was negligent on his part.

Metacam is an NSAID, and as such, must be dosed and prescribed extremely carefully in cats because cats do not metabolize many of these compounds, they cannot be metabolized by the liver (least of all, most NSAIDS). When used in accordance and exactly as the manufacturer recommends, the risk is much lower. Vets who dose off-label in the manner your vet did with your cat, are vets who are taking chances with YOUR cat and her health.

Depending on the syringe size will depend on the size and original dose in the "drop". There is a difference in syringe sizes, and the "drop" can vary significantly depending on the size of the syringe. An every-5-day dose of one drop may not seem so significant, but for 6 months, that's pushing it. Not knowing the starting dose of the metacam he gave you may also be a concern. Did he drop the dose significantly, or did he use a common dose. Without knowing that, it's a guess.

I don't want to scare the daylights out of you, but there may have been much better choices your vet could have chosen. This is why I strongly advise a new vet, a new evaluation with xrays to determine the exact extent of the problem and the actual nature of the problem. It could be something else entirely, and you'd want to find that out before allowing your vet to treat without considering other things. A more experienced vet would probably benefit Cutie Pie and you considerably and would allow you to have had a second, more experienced opinion on diagnosis and treatment choices.

[leslks@aol.com]

Traci,
He didn't drop the dose significantly. One drop every 5 days is all Cutie ever took!
She actually started it Feb.2 - July 21.
No he didn't say to do blood work.
He made an educated guess. He has an excellent reputation as a diagnostician.
As far as an orthopaedic surgeon goes, I hesitate to see one since operating is what they do.
You did scare the daylights out of me. Maybe our vet isn't up to snuff. He told me there isn't anything else for cats.
I checked into Cosequin. It isn't a prescription. Maybe he only likes prescriptions. I know that when I have suggested other things for renal failure he has gone along with it. They work for us. Maybe he needs to take continuing education.
I am dumbfounded as to why he doesn't suggest anything else.
I have had such bad luck with vets; I like this one's MO.
He has about 25-30 years experience.
Lynda

Depending on the syringe size will depend on the size and original dose in the "drop". There is a difference in syringe sizes, and the "drop" can vary significantly depending on the size of the syringe. An every-5-day dose of one drop may not seem so significant, but for 6 months, that's pushing it. Not knowing the starting dose of the metacam he gave you may also be a concern. Did he drop the dose significantly, or did he use a common dose. Without knowing that, it's a guess.

I don't want to scare the daylights out of you, but there may have been much better choices your vet could have chosen. This is why I strongly advise a new vet, a new evaluation with xrays to determine the exact extent of the problem and the actual nature of the problem. It could be something else entirely, and you'd want to find that out before allowing your vet to treat without considering other things. A more experienced vet would probably benefit Cutie Pie and you considerably and would allow you to have had a second, more experienced opinion on diagnosis and treatment choices.

[Traci]

What I mean, is, the starting dose from the original bottle of metacam, and if he dosed this according to Cutie Pie's weight, or as you say, made an educated guess. If he told you nothing, then how do you know? Maybe you should ask him for the metacam insert that comes with the product. If he refuses, this is a good indication you DO NEED a new vet. 25-30 years does not make a good vet, but up-to-date education and following manufacturer's recommendations on a relatively new NSAID makes a better vet.

You don't have to see an orthopedic surgeon, see a vet with orthopedic experience. Try a well-known and large-clientele emergency clinic. You need a second opinion, to rule out the potential this could be something OTHER than arthritis, or, to at least determine the extent of the condition to know how to treat it properly. Your vet seems to be bandaiding the situation, and not really monitoring Cutie Pie at all, all with a significant risk.

[leslks@aol.com]

Traci,
I had the Metacam insert with the bottle I got from him. The original dose was 1 drop every 5 days. He did not start higher and lower it. That is what it always was.
He did work at the Emergency Clinic before opening his own practice. The cardiologist there is who recommended him saying he was the best diagnostician he knows.
I agree he didn't do the best for Cutie in this instance.
What else could it be if not arthritis in the joint?
What I am giving her now I think is helping. The joint is getting smaller.
It didn't get bad overnight so will take awhile. I will try it longer.
Thank you for your input.

[mamabear]

I have to say that I would be disscusted that a Vet treat cat with dog medicine. I wouldn't take medicine that stated that is was not approved or tested yet for a women if it were only for a man so why would i do it for my pet?

I read up on this through hte drug company. THey were approved in the UK where most of the medicines were given. It clearly states that

"Metacam Oral Suspension is only licensed in dogs. At the current time, options for long term pain management in cats are very limited."

It also states that the injectable drug INJECTABLE drug was approved for cats in the UK in 2002.

It also states that USA has approved the drug for dogs as well and is being used via prescription.

Has this dr. taken xrays and if so what was his final diagnosis on it?

Was there blood work done to make sure she was healthy enough to take ANY drugs or start ANY drug regimen before hand?

Knowing this drug was NOT for cats especially since the pharmaceutical company clearly states the oral ISN'T for cats ,did he take blood work on her prior to this to make sure he had accurate numbers to compare before starting any drugs?

I understand that you want the best for your kitty and the kitty's pain. It is just horrible to see our babies in pain. We will do anything to see me with less pain. But at what cost.? Do your homework and it's ok to continue what ever you want but make sure you know the facts before doing so.

First thing to do is make sure kitty has a really good check up and if old a geriatric workup as well. xrays, blood work, check teeth and fur and food intake.

Speaking of food intake what food do you have kitty on?
are kitty's teeth ok or need a cleaning, are they red and inflamed or infected? Go ahead go check....I'll wait... If they are bad why didnt vet say something about it. This is one thing that needs to be addressed if it is a problem.

Did he do xrays and if so what did they indicate and did they indicate more than just a problem with arthritis?

If he diagnosed arthritis did he do other stuff like MRI or U/S as well of the joint?

Is kitty limping on this joint?

I must say that cats are very independent animals and will hide their pain if need be.

We care and want to help you with what ever you ask. We truely want you informed correctly and shame on your Vet for not doing so . And trust me I am being nice with my words ..... I can not stand Vets who do not inform and just blow off our questions.

If the vet does not like non prescription drugs then ask him why? It is your RIGHT to get the best care for your cat. And he can not give you a proper reason aside from "i dont like it" then tell him to take a walk. Does he have a good thing going with the pharmaceutical company for Metacam?

keep us posted and ask questions. I am not up to date with medicines for cats or dogs but I myself have arthritis and have since i was a teenager. It is painful and I hate it but I have it better than most so i dont complain about it. I keep active and try to exercise my hands to keep them working even on days when they hurt like heck. I am not sure what therapy might be available to help your kitty or other regimens to help you but I am sure there are people here who can help you with that.

Prayers so you find the right solution for you and your kitty kitty!

[Traci]

Let me elaborate a bit further. Metacam comes in different strengths when it reaches your vet, depending on what strength of the metacam he ordered, he would then dose according to weight/days to be given, etc. What matters is the originial dose start, then calculated to body weight. If the dose is too high, and given too frequently, then there are risks. Since the manufacturer does NOT recommend long term use for metacam in cats, this is considered "off-label" use and any problems associated with or reactions as a result of dosing in this mannner will not be gauranteed by the manufacturer. Alot of vets don't bother to tell their clients they are using drugs off-label like this, and when they do not tell the client, the client has little recourse (other than to attempt to sue the vet, good luck with that)

According to another post you made about Cutie Pie at the start of this problem, it appeared then that your vet was bandaiding, and not getting to the true cause of the problem. He's doing it again now.

I will once again, suggest strongly that you seek the opinion of a feline vet who has experience in orthopedics or even an orthopedic veterinary surgeon who has much more experience that what your vet appears to have. What else could it be? It could be anything from a malformed bone, to edema of a joint, to severe arthritis to even neoplasia, to a severe joint problem. Only a qualifed orthopedic vet/surgeon can determine that. I do however, feel in all honesty you need an orthopedic vet to evaluate Cutie Pie with xrays and comprehensive exam to determine the extent of the problem, this is the only way it's going to be treated effectively. Surgery may or may not be indicated, that has to be at the discretion of the orthopedic vet/surgeon.

The problem is giving corticosteroids, pain medicine, NSAIDS and not truly treating the problem, those are bandaid approaches. If it can be corrected, wouldn't it be worth it to seek that valuable opinion/recommendation from a vet more qualifed? Your vet may be a good diagnostician, but what has he done for Cutie Pie really? Is the problem resolved? Is it long-term management? No, and No. She and you deserve much better than that.

Cosequin for Cats by the way, is a neutraceutical, and it has a well-established margin of safety, has been quality researched and has a good record of safety with other medications. It doesn't work for all cats, and it does take time to expect results (usually within 6 weeks), but for those cats who respond to it, it's worth it.

Your vet owes it to Cutie Pie and you, to have at least referred you to someone more experienced than he, so a full, complete evaluation could be done on the joint or bone. Since he hasn't, you have to take it upon yourself to take action with getting an opinion from a qualifed orthopedic vet/surgeon. It doesn't sound like your vet has done much of anything really, except to prescribe pain releivers, NSAIDs and corticosteroids, all of which are potential risks for any cat. Please ask yourself, doesn't Cutie Pie deserve better?