Hello all - I originally posted about my Ozwald hurting his tibia in 2006, here is the original thread for anyone wanting to look at the history (it's long!) and the Neurologist we were referred to by our feline only vet diagnosed him with hyper-aesthesia and spondylosis when she treated his tibia issue:
http://www.cathelp-online.com/forums/vi ... php?t=9451
Anyway, touch wood up to now Ozwald's bi-annual wellness checkup, bloodwork, urinalysis and his latest dental 10 days ago are good. Briefly, he's 13 years old now, indoor only, enjoys food, growling at birds and arguing with his brother and sister. He's been on Cosequin for years and we keep his environment a constant 75 degrees throughout the season, however his arthritis is getting worse. His back leg shakes and although he still insists on jumping on the bed and won't use his kitty stairs, I can see he's sore and stiff. We had tried giving him very light, gentle massage but he cries and doesn't like it, so I've stopped and don't touch his back area. I keep his food, water, bed and litter box in the same area so he doesn't have to go up and down stairs. I have discussed pain control with our feline only vet, and we have put him on a short course of Prednisolone for 2 weeks to see if it helps. We have also discussed Meloxicam, but our vet says it is not authorized for feline medical use by the FDA, however it is used by many vets to relieve arthritis pain. I want what is best for Ozwald, and I was wondering what results any of you had using Meloxicam for your kitties, and if it is worth a try.
Meloxicam for arthritis?
I truly would not recommend the use of Metacam in a case like Oswald's. It isn't recommended in older cats, and it DOES have risks with extended use.
This is why it is not marketed for use for cats, please read these pages very carefully, you'll then understand why it would be very risky:
http://www.drugs.com/vet/metacam-inject ... -cats.html
http://www.bi-vetmedica.com/product_sit ... rence.html
Vets are using it off-label for some cases of arthritis. Some cats may respond at very, very low doses but we can't predict what cat WILL NOT, or what cat might suffer serious side effects or lethal effects. You especially wouldn't want to take that risk in an older kitty. Plus the fact that this is an NSAID, and cats can't metabolize many NSAIDS without careful dosing and extremely close monitoring, plus subsequent bloodwork. Long-term use of any NSAID is a risky approach. Even those vets who do use if for these purposes admit that it should only be used for mild to moderate pain, but it definately is not a risk I would take. The studies that the manufacturer have done, do suggest that the risks are not worth taking. Kidney and liver failures are the highest risks, with serious GI ulcerations a close second. Worse, the FDA's adverse reporting events suggest that deaths have occured as a result of using metacam in unique cases. I'm not saying it isn't a useful medication, it is and it can be, for specific uses only, though.
Having said that, I do have good experience with metacam in post-dentals in cats, AS LONG AS bloodwork is done prior to establish the overall health of the cat, and AS LONG AS, the dose is very very small, and no more than 3 days. (the three days are oral doses) and AS LONG AS followup bloodwork is done to monitor for any effects on the system.
Instead of metacam, I would offer the following choices to talk to your vet about. In cases of feline arthritis, when it is severe enough to warrant long-term care, a multiple approach is sometimes helpful.
Omega 3 fatty acids may be slightly helpful (fish oil), but can take up to a month or more to note any difference. Use only a brand your vet carries or recommends to you because there are too many on the market that are either poorly formulated or adulterated.
Adequan injections might be useful but require injections into the muscle, the injections might be 2-3 or so a week, then a break, then only as needed.
Buprenorphine or Tramadol (my preference would be buprenorphine), but as with any veterinary analgesic, they are not without side effects, especially in long-term use. You wouldn't want to use some analgesics long term anyway due to the risks and due to these meds only being mild pain control.
Continuing the Cosequin for Cats. The nice thing about Cosequin is that it can be used alongside most any other veterinary drug without risk of side effects or ineffectiveness of other drugs. But, do ask your vet about any medication he recommends and using Cosequin with it.
Dietary control (to maintain weight so that additional weight is relieved from the cartilage and bone causing stress), and attempts with a mild exercise program can be helpful. The exercise doesn't have to be too involved, and certainly you don't want it rigorous or anything like that. Just simple movements, extended movements, making sure he is up and about and moving comfortably at certain times of the day etc. Warmth also, is excellent for arthritic patients. We talked about this before.
As for his pet steps, maybe encourage him to use them by placing a treat or have him follow a favorite toy up the steps. Try to be consistent so that he learns the steps aren't an evil thing, but helpful. Once he gets to the top of the bed (or sofa, wherever you're placing the steps), make it something nice for him, like a warm bed, a special toy, or a treat so he can associate the steps with a pleasant experience. If he absolutely refuses his kitty steps, have you considered a kitty-ramp instead? It doesn't contain steps, it's a ramp so he just walks on a slight incline to get up to the bed. It might be that the motion of climbing the steps is uncomfortable for him and therefore a ramp might be easier for him.
As for the prednisone, I hesitate to say it, but I hope your vet is not prescribing this long term or in high doses. It is immunosuppressive when used long term, and while it can help with pain and inflammation, it doesn't truly address strengthening cartilage or bone. In a case like Oswald's, pred should be used infrequently (monitor his bloodwork whenever he's on pred), giving the body a break between uses, and considering the alternatives discussed above. Remember when using prednisone and if the vet wants to cease it's use, it must be done on a tapering down schedule, do not cease pred immediately, as it can cause serious side effects by doing so.
Here's a good site you can check out and discuss with your vet, it has all the available options for you and your vet to discuss, but please be very mindful that some of the drugs are not without side effects, and long-term use is not possible with all of them. An approach with one or two different things might be useful but your vet has to be careful which of the options he chooses, best fits Ozwald's overall health and individual needs.
http://www.veterinarypartner.com/Conten ... &A=587&S=1
Sorry so long, I just want you to be informed about the metacam. I'm not trying to say NO, don't use it, but I personally would not consider it in Oswald's case, especially due to his age. I think if there was a situation where he was so painful that he was truly reluctant to move or couldn't walk about, a temporary short-term use might be considered, but it would only be temporary and I think you might find some of the other options more useful, and safer. Some of them cannot be used together, others can. Your vet can make the appropriate choices if he wants to try a multi-approach.
This is why it is not marketed for use for cats, please read these pages very carefully, you'll then understand why it would be very risky:
http://www.drugs.com/vet/metacam-inject ... -cats.html
http://www.bi-vetmedica.com/product_sit ... rence.html
Vets are using it off-label for some cases of arthritis. Some cats may respond at very, very low doses but we can't predict what cat WILL NOT, or what cat might suffer serious side effects or lethal effects. You especially wouldn't want to take that risk in an older kitty. Plus the fact that this is an NSAID, and cats can't metabolize many NSAIDS without careful dosing and extremely close monitoring, plus subsequent bloodwork. Long-term use of any NSAID is a risky approach. Even those vets who do use if for these purposes admit that it should only be used for mild to moderate pain, but it definately is not a risk I would take. The studies that the manufacturer have done, do suggest that the risks are not worth taking. Kidney and liver failures are the highest risks, with serious GI ulcerations a close second. Worse, the FDA's adverse reporting events suggest that deaths have occured as a result of using metacam in unique cases. I'm not saying it isn't a useful medication, it is and it can be, for specific uses only, though.
Having said that, I do have good experience with metacam in post-dentals in cats, AS LONG AS bloodwork is done prior to establish the overall health of the cat, and AS LONG AS, the dose is very very small, and no more than 3 days. (the three days are oral doses) and AS LONG AS followup bloodwork is done to monitor for any effects on the system.
Instead of metacam, I would offer the following choices to talk to your vet about. In cases of feline arthritis, when it is severe enough to warrant long-term care, a multiple approach is sometimes helpful.
Omega 3 fatty acids may be slightly helpful (fish oil), but can take up to a month or more to note any difference. Use only a brand your vet carries or recommends to you because there are too many on the market that are either poorly formulated or adulterated.
Adequan injections might be useful but require injections into the muscle, the injections might be 2-3 or so a week, then a break, then only as needed.
Buprenorphine or Tramadol (my preference would be buprenorphine), but as with any veterinary analgesic, they are not without side effects, especially in long-term use. You wouldn't want to use some analgesics long term anyway due to the risks and due to these meds only being mild pain control.
Continuing the Cosequin for Cats. The nice thing about Cosequin is that it can be used alongside most any other veterinary drug without risk of side effects or ineffectiveness of other drugs. But, do ask your vet about any medication he recommends and using Cosequin with it.
Dietary control (to maintain weight so that additional weight is relieved from the cartilage and bone causing stress), and attempts with a mild exercise program can be helpful. The exercise doesn't have to be too involved, and certainly you don't want it rigorous or anything like that. Just simple movements, extended movements, making sure he is up and about and moving comfortably at certain times of the day etc. Warmth also, is excellent for arthritic patients. We talked about this before.
As for his pet steps, maybe encourage him to use them by placing a treat or have him follow a favorite toy up the steps. Try to be consistent so that he learns the steps aren't an evil thing, but helpful. Once he gets to the top of the bed (or sofa, wherever you're placing the steps), make it something nice for him, like a warm bed, a special toy, or a treat so he can associate the steps with a pleasant experience. If he absolutely refuses his kitty steps, have you considered a kitty-ramp instead? It doesn't contain steps, it's a ramp so he just walks on a slight incline to get up to the bed. It might be that the motion of climbing the steps is uncomfortable for him and therefore a ramp might be easier for him.
As for the prednisone, I hesitate to say it, but I hope your vet is not prescribing this long term or in high doses. It is immunosuppressive when used long term, and while it can help with pain and inflammation, it doesn't truly address strengthening cartilage or bone. In a case like Oswald's, pred should be used infrequently (monitor his bloodwork whenever he's on pred), giving the body a break between uses, and considering the alternatives discussed above. Remember when using prednisone and if the vet wants to cease it's use, it must be done on a tapering down schedule, do not cease pred immediately, as it can cause serious side effects by doing so.
Here's a good site you can check out and discuss with your vet, it has all the available options for you and your vet to discuss, but please be very mindful that some of the drugs are not without side effects, and long-term use is not possible with all of them. An approach with one or two different things might be useful but your vet has to be careful which of the options he chooses, best fits Ozwald's overall health and individual needs.
http://www.veterinarypartner.com/Conten ... &A=587&S=1
Sorry so long, I just want you to be informed about the metacam. I'm not trying to say NO, don't use it, but I personally would not consider it in Oswald's case, especially due to his age. I think if there was a situation where he was so painful that he was truly reluctant to move or couldn't walk about, a temporary short-term use might be considered, but it would only be temporary and I think you might find some of the other options more useful, and safer. Some of them cannot be used together, others can. Your vet can make the appropriate choices if he wants to try a multi-approach.
..........Traci
Re: Meloxicam for arthritis?
Traci, thank you so much for the links and all the time you took to answer me, and for once again giving life saving advice for the cats - we owe you nine lives, we really do. After reading through the links it seems Meloxicam is not worth the risk. I remember last year Ozwald's brother was given Metacam after he had several dental extractions and we had to do extensive testing on him before the doctor would give him Metacam, so it's clearly a dangerous drug for pain managment.
Ozwald had two syringes of buprenorphine after his dental 11 days ago - he only had a cleaning, no extractions were necessary but Dr gave it to him for pain relief and she said it would also soothe his arthritis for 2 days after. He is currently on a short term 2.5 week dose of Prednisolone 5mg (2nd time in his life - first time was a short term course after he injured his tibia) and we will not be giving it to him long term. It's 1 tablet per mouth twice a day for 3 days, then 1 tablet once per day for 7 days and then a half per day for 7 days - very strict about tapering off.
I will add Omega 3 fatty acids to Ozwald's diet and carry on with the Cosequin. If he shows signs of becoming worse I'll ask the vet about Adequan and Buprenorphine.
Ozwald has always been a small kitty and has weighed 8.5 to 9 pounds his entire life with me. He has quite a healthy appetite but he's never been a big eater. I have noticed that he gets a lot more active at night, and he trots up and down the stairs stalking his two senior playmates and playing in the kitchen. It seems that the pain is less at night for him - during the day he sleeps in my office mostly, and when he stretches his back leg shakes. He also seems to have good days and bad days - some days he is frisky and rampant and others he's more lethargic, it doesn't appear to happen more in cold weather. I always make sure he's got a nice warm kitty bed and he lies in his patch of sun daily when it comes through the window, the house is always comfortably warm.
Thanks for the tips on getting him to use kitty stairs - we'll try the methods! Ozwald still loves his treats and if he hears the cupboard opening he comes trotting fast. This is one of the things I use to cheer him up and I figure out that as long as he gets excited about treats and does his Ozzie trot dance the pain is not too unbearable for him.
Last night he was quite frisky and active, and this morning he seems cheerful and is mewing for chin rubs. I think the Prednisolone is helping.
Thank you for your help - arthritis is such a tricky thing to treat, and the action we'll pursue will not have anything to do with Meloxicam, I was worried about it and your info and links have confirmed the doubts. It's not worth the risk.
Ozwald had two syringes of buprenorphine after his dental 11 days ago - he only had a cleaning, no extractions were necessary but Dr gave it to him for pain relief and she said it would also soothe his arthritis for 2 days after. He is currently on a short term 2.5 week dose of Prednisolone 5mg (2nd time in his life - first time was a short term course after he injured his tibia) and we will not be giving it to him long term. It's 1 tablet per mouth twice a day for 3 days, then 1 tablet once per day for 7 days and then a half per day for 7 days - very strict about tapering off.
I will add Omega 3 fatty acids to Ozwald's diet and carry on with the Cosequin. If he shows signs of becoming worse I'll ask the vet about Adequan and Buprenorphine.
Ozwald has always been a small kitty and has weighed 8.5 to 9 pounds his entire life with me. He has quite a healthy appetite but he's never been a big eater. I have noticed that he gets a lot more active at night, and he trots up and down the stairs stalking his two senior playmates and playing in the kitchen. It seems that the pain is less at night for him - during the day he sleeps in my office mostly, and when he stretches his back leg shakes. He also seems to have good days and bad days - some days he is frisky and rampant and others he's more lethargic, it doesn't appear to happen more in cold weather. I always make sure he's got a nice warm kitty bed and he lies in his patch of sun daily when it comes through the window, the house is always comfortably warm.
Thanks for the tips on getting him to use kitty stairs - we'll try the methods! Ozwald still loves his treats and if he hears the cupboard opening he comes trotting fast. This is one of the things I use to cheer him up and I figure out that as long as he gets excited about treats and does his Ozzie trot dance the pain is not too unbearable for him.
Last night he was quite frisky and active, and this morning he seems cheerful and is mewing for chin rubs. I think the Prednisolone is helping.
Thank you for your help - arthritis is such a tricky thing to treat, and the action we'll pursue will not have anything to do with Meloxicam, I was worried about it and your info and links have confirmed the doubts. It's not worth the risk.
Re: Meloxicam for arthritis?
Well, do print out the page from the last link I posted, and go over it with your vet, he can discuss the options with you and together, you can make a decision on what might be best, and safest, for Ozwald, he might even have his own ideas, since I'm sure he has feline arthritic patients and can discuss with you his experience with those patients, what seems to work well, what doesn't, etc. Always remember to take his age into account with any medication, and be prepared for bloodwork on occasion to monitor liver and kidney values. Your vet can break down the bloodwork to just test those specific enzymes or he might prefer a CBC on occasion, which would probably be cheaper than full profiles all the time.
..........Traci