Wednesday, March 27, 2013

Question About Metacam

Jinx was given 3 dosages of metacam.
You can see I don't even know from the "prescription"
what the dosage was.
It was in this syringe.
I believe it was filled up to 1.0mL
But I won't swear to that.
The Vet gave him his first dose Monday.
She told us to give him two more doses, one on Tuesday and
one Today. So, we did.
Things have been crazy at my house and I did not check
to see if there were any problems with metacam.
There are.
So, from my research today I found that a one time injection
of metacam is deemed fairly safe.
But repeated oral dosages are not.
Metacam is safe for dogs, and part of the problem seems
to be that Vets are giving "dog" doses to cats.
(my vet said she gave her own cat this medication because of oral surgery)
Metacam is a NSAID and cats do have have the liver enzymes to
break it down and it goes to their kidneys and can cause renal failure
and death. anyone can imagine I FEEL HORRIBLE about giving this to Jinx.
He is fine at the moment.
But, I am not.

I should know better.
This isn't the first time I've had a Vet give me medication that was questionable.

Can anyone give me feedback on experiences with ORAL metacam?

Here is what the FDA says:

Animal & Veterinary



FDA Announces Addition of Boxed Warning to METACAM® (meloxicam) Labels

October 27, 2010
The Food and Drug Administration (FDA) announced today the addition of a boxed warning to the label of two METACAM® (meloxicam) products. The drug’s manufacturer, Boehringer Ingelheim Vetmedica, Inc. (B.I.V.I.), changed the label to include:
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. See Contraindications, Warnings, and Precautions for detailed information.
The label change affects:
  • METACAM® Solution for Injection, under New Animal Drug Application (NADA) 141-219; and
  • METACAM® Oral Suspension, under NADA 141-213.
Boxed warnings on prescription drug labels highlight for prescribers certain contraindications or adverse drug events, especially those that may cause death or serious harm. A contraindication occurs when the risk of using the drug in a patient outweighs any benefit. An adverse drug event, also called an adverse drug experience, occurs when there is an undesired side effect associated with the drug, or when there is a lack of effect (the drug does not do what it is supposed to do).
FDA asked B.I.V.I. to add the boxed warning based on FDA’s review of reported adverse drug events for METACAM®. FDA identified many cases of kidney failure and death in cats associated with repeated use of METACAM®.
METACAM® Solution for Injection is approved for one-time use in cats before surgery to control postoperative pain and inflammation associated with orthopedic surgeries, spays, and neuters. In the United States, the safety and effectiveness of more than one dose of METACAM® Solution for Injection has not been shown in cats for any condition.
METACAM® Solution for Injection and METACAM® Oral Suspension are approved in dogs to control pain and inflammation associated with osteoarthritis. METACAM® Oral Suspension is approved for dogs only. No safe and effective dose of the oral suspension is approved for cats.
FDA is aware that some veterinarians prescribe or use METACAM® in an extra-label manner. When an approved drug is used in a manner other than what is stated on the label, it is an extra-label (or “off-label”) use. Under certain circumstances, veterinarians are allowed to use a drug in an extra-label manner. The new boxed warning on the METACAM® labels helps inform veterinarians of the serious risks associated with extra-label use of meloxicam in cats.



    1. I didn't want to post anything about it yesterday when I saw that, because frankly, it's not my business and sometimes there aren't any other options. It's true that cats can't process ANY NSAID and my vet clinic does NOT use Metacam for cats. That said, they do use a one-dose injectable of another NSAID post-surgery. I really don't know if another NSAID would make a difference.

      If it were me, I'd stop his doses and of course follow up with tests if you see something amiss. But odds are good, I presume, that he'll be okay.

      Maybe discuss your concerns with the vet and see if there is something else a bit safer to give. Are there other types of meds (not an NSAID) that would do just as well in this instance?


      You can only do your best in the moment, and you *have*.

    2. BTW, the other drug to be wary of is Convenia, the over-prescribed 2-week antibiotic given via injection. It's "convenient" all right, but also has been known to cause serious side effects, even death in a small number of cats.

      But that's another situation.

    3. In Europe, oral Metacam is given to cats, but with cautionary advice. I know vets here in Finland who think it is an excellent drug for pain medication, but not for long term use. In the UK it was also used - again not long term. I believe there have been some very rare but tragic cases of acute renal failure after one dose, but this is exceptional. I have used metacam after surgery with my cats, and still have a bottle of it for emergency pain relief in my fridge. I would not hesitate to use it as a one off for a cat with no history of renal problems.
      Karin, Äiti of Punapippuri

    4. My vet has given Metacam injections to my cats but not orally. Mr Jinx is on a very short course so he should be okay. Just make sure you give him the Metacam with food.

    5. Well, first of all... I second fuzzy tales... "You can only do your best in the moment, and you *have*."

      ANd second of all, your vet is certainly aware of the side-affects but still deemed it a viable option given the situation.

      With Whitey, and a few of my dogs in the past I have second guessed myself after the fact. In the end I truly know I made the bet choices I could at the time. And I have no doubt that is true for you as well.

      Try not to worry. It won't change a thing but your stress level and blood pressure. =)

      big hugs. xoxo

    6. mom ta jinx...we can hope that yur vet noez what her iz doin and de three day dosage iz.. and waz.. enuff.. to help jinx WITHOUT causin side effects oh any kind....

      call de vet N voice yur concerns and as hard as it will be; try knot ta stress round jinx coz him will pick up on this...

      purrhaps extra food at a meal time will or if he could drink mor water ...we R sorree we dont noe any thing bout metacam .....but can give ewe sum advise on CONVENIA...

      while it may in fact have helped thousands of other kittehs N pups...R mom will never allow it ta bee used again

      it iz an antibiotic that is given so kittehs N pups due knot have ta bee iz time released; working up ta two weeks

      BUT and type this BUT az big as ya can

      it stays in de system for TWO MONTHS and once in... can KNOT be removed in any way shape ore form

      me mom wuz KNOT told eye wood be given it and we won't go inta that.. coz thiz post iz knot about me rite now, its about jinx....

      but pleaz pleaz PLEAZ think twice N mor bout lettin de vet give ANY ONE convenia...

      We will ask st francis ta watch over jinx triple double triple time


      sauce of fishbone

    7. Btw, you have a photo there of a 1cc (or 1ML syringe... so if you went up to the .01 at the bottom of the syringe, you only gave 0.1ML which is just a few drops. If you pulled the plunger all the way to the top, to the 10, then that would be 1ML) I am guessing you gave 0.1 ML doses - which is what I gave my cat in the past.

      My vet prescribes metacam all the time and never sees side effects. he keeps it oral and keeps the dose small and as short of a duration as possible. Yes, there are a lot of problems with metacam, and it is not my first choice of pain relievers, but I would not have you panic over 3 0.01 doses. Be aware yes.. keep an eye on absolutely.. but you were prescribed a pain reliever, so you should be doing that anyway.. (if you gave the whole syringe, panic.. call your vet immediately and get some tests done)

      I gave it to Ollie when he was dying with cancer. I would give it again if I felt the need. I would strongly prefer to use bupernex as there are fewer side effects with it, but all medication has the potential to cause problems.

      The down side of all of the wonderful information on the internet is there is so much inflammatory information out there.. the metacam site is metacamkills..

      don't panic, if you are still concerned call your vet and see if there is an alternative you can give. There is nothing wrong with doing so.. do not feel bad or guilty, you vet works for you, you pay for his time and supplies..

      Fuzzy Tales is right about convenia though. My vet gave it to my cat with out consent and I nearly beat him over the head... I'm also looking for a new vet because of it. It is one shot that lasts two weeks, so if your cat has a reaction there is no undoing it. From what I have read the antibiotic can be too effective and it kills all of the good bacteria in the gut.. the stuff you need to process the food etc.. When I find another vet I will absolutely have a no-convenia sticker on my files...

      and a "we must discuss metacam before dispensing"

    8. No experience with that drug here, but I just wanted to give you a BIG HUG. I think you did the right thing - your vet should know what he's doing. I would call him however and tell him what you found out. He must have had a specific reason that he gave it to Jinx. I'd certainly question it - it also reinforces the fact that you are somewhat knowledgeable about medications. It's good to question vets and doctors!

    9. It is good for you to be on top of things about this. Don't worry too much about it. Long term NSAIDS are also contraindicated for humans due to the kidney function, but that does not mean they aren't extremely beneficial medicines. The Mom's daughter is a doctor and when Dad was put on NSAIDs for several WEEKS she said there was some concern about kidneys but he was fine. Three doses is a rather short course. And just a "pain killer" is not going to address the inflammation. (we don't know what a relative's cat was given for pain with his bladder, but we are pretty sure it was not an NSAID. But you would certainly be on good footing to raise it with the vet.

    10. Sometimes vets do things or prescribe things without really explaining them to the humans, and I don't like that (plus they NEVER explain things to us kitties!). I bet Connie (Tails from the Foster Kittens) is right, and you probably don't have anything to be really worried about. So don't beat yourself up, but don't be afraid to ask questions whenever your vet suggests a course of treatment.

    11. Vets get busy and don't realize which of their clients want *all* of the details on potential side effects, etc. and which just want medicines and to get out the door. There are BOTH kinds of veterinary clients, and I'm sure that you're going to let yours know that you prefer to know all of the details about side effects and information about every medication and treatment from now on.

      Don't feel bad. You did the best you could with the knowledge you had. As others have said in previous comments, metacam is prescribed as Mr. Jinx took it in Europe, just not in the US. Here in the states, I have given metacam off-label orally in small doses over a fairly long period to a kidney-compromised cat for arthritis pain when nothing else helped. My vet and I went around and around, and sometimes, it's the best option on hand, even if there are risks. There are so few effective pain medications for cats.

      If you're concerned about Mr. Jinx, get him tested for side effects to his kidneys and talk to your vet about it. And don't beat yourself up. Mr. Jinx needs you to be positive to help him feel better!

    12. I wish I had some advice, but we have no experience with that one either. No bad reaction is a good thing and don't beat yourself up for trying to help.

    13. I think Connie is right...a short course of metacam is probably not something to be overly worried about. A few years ago, my vet gave Ernie metacam...I think it was one or two dosages...and he was fine.

      I would talk to your vet about it, if your really concerned about it.

    14. Don't know anything about this, but want to send you huge purrs and purrayers. It sounds like lots of the posters above have good info.

      We are purring that Mr. J feels better every day and won't even need any medicine soon XOXOXOXOXO

    15. We all know you're a great and loving cat Mom and others have given advice we don't have but just know you are doing your best. Big hug to you and purrs to your boy to heal fast!

    16. I've never heard of this medication before, but if it were me, I'd be looking for another vet. Not necessarily because that medication was prescribed, but because it has a potential for serious side effects that weren't disclosed or discussed before hand. And it sounds like this isn't the first time that has happened. How can you properly care for your cats without communication between care givers? At the very least, you should have be warned to look out for certain side effects & then know what you needed to do if you saw them.

    17. BTW, please don't beat yourself up! You are clearly trying to do your best, and who could ask for more? Every kitty should have such a caring, loving mom like you.

    18. When Tinker's chin swelled he was taken in the back for blood work, when they brought him back he had already been given a Convenia injection to cover 2 weeks, after that if it swelled again they gave me Buprenex. This happened last June and again in September. April 20th of last year he had dental work done, removed 2 back teeth and cleaning then given Clavamox.
      Whenever any of the Boyz are sick or on meds I give them extra fluids by syringe in the mouth. All their food is canned or fresh.
      I had not heard the 2 week injection before.
      When I had adopted TyGr they wanted me to go to this certain Vet for his first check up and altering. When I brought him in to be altered they came to take him for the day.......You should have been there to see the faces when I said, "Ty stays with me till it is his turn. I said, he is not a pet, he is family!" The Vet came to the desk and said, sorry we do not work that way......I gathered up My boyz carrier and said B-Y-E!!!
      The Vet I usually use is opened 24/7 every day of the year. They care for every animal you can think of and have loads of experience since animals come from long distances to get treated there due to their opened hours and the dozen Vets that work there. I will discuss the Convenia injection and the metacam that Tinker had when ICE gets his blood work done soon.
      We do the best with what knowledge we have at that time......Stay well Jinx=^Y^=

    19. Oh my Cod..I know how frightened and worried you must be but you have excellent advice here. Please know that you did the best you could with a whole heart full of love and concern and trying to help your baby. Be at ease..he will be alright.XXOO

    20. We don't have experience with Metcam, largely because we go to a natupathic vet. However, we can't fault you for following your veterinarian's advice--that's what they told you to do and so you did. There's nothing wrong in that. At this point, I'd call and ask and see what they say with your questions.


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