Metacam in cats

[allie and newkitty]

Hello! My current civvie has terrible chronic rhinitis. He has been on once daily 1/4 tab doxy for nine years, going to 2x a day for short periods when needed. This has worked just about perfect for controlling/alleviating any symptoms (rubber cenent snot, terrible congestion). This year our usual routine is not working.

Because of terrible URIs when he was a kitten on the streets, the structures in his nose are permanently messed up. My vet wants to start him on low-dose metacam to relieve inflammation in his nose (he can't have prednisone due to HCM), to try to help it drain. (If you are not familiar with rhinitis are options for treatment are VERY limited.)

Has anyone here used Metacam safely? I had heard bad things about it for years but apparently this low-dosing is very common overseas. I trust my vet and have been with her for decades --I am just nervous due to all my preconceptions.

 

[Lisa and Angel]

I'm in Europe, and have 2 cats on Novacam (a different variety of Meloxicam). They've been on it for years, and they're both fine with healthy bloodwork even after all that time. It's considered very safe here.

Our standard dose for cats is a maximum of 0.05 mg meloxicam per kg once daily, and we usually titrate down to the lowest effective dose. From what I understand, the US uses a much higher dose. If you stick to European dosing, you should be perfectly safe.

 

[Wendy&Neko]

It's also used in lower doses in Canada, so you don't have to go overseas for examples. I never did give it to Neko because she had CKD. More information and discussion here: Metacam ! - Is it safe?

 

[allie and newkitty]

I'm in Europe, and have 2 cats on Novacam (a different variety of Meloxicam). They've been on it for years, and they're both fine with healthy bloodwork even after all that time. It's considered very safe here.

Our standard dose for cats is a maximum of 0.05 mg meloxicam per kg once daily, and we usually titrate down to the lowest effective dose. From what I understand, the US uses a much higher dose. If you stick to European dosing, you should be perfectly safe.

Thank you, this is reassuring. i am confused about the dosing. He is about 12.5 lbs, so that looks like it comes out to 0.283. The dose I have been given is in a syringe that says 0.07 ml. Does that track? I am not sure how to math this out.

 

[allie and newkitty]

It's also used in lower doses in Canada, so you don't have to go overseas for examples. I never did give it to Neko because she had CKD. More information and discussion here: Metacam ! - Is it safe?

Thank you. I have read thsi thread and feel reassured and then second guess it. It's hard to unthink something you have been believed for YEARS, We sprayed his nose with saline and now he seems more congested, did not sneeze and is breathing through his mouth.

 

[JL and Chip]

Hi Allie — nice to see you around here again!

Our standard dose for cats is a maximum of 0.05 mg meloxicam per kg once daily, and we usually titrate down to the lowest effective dose.

i am confused about the dosing. He is about 12.5 lbs, so that looks like it comes out to 0.283. The dose I have been given is in a syringe that says 0.07 ml. Does that track? I am not sure how to math this out.

Looks like you’re missing a step.

What is the “strength” of the meloxicam you were given? The label should say it is “xx mg/ml (xx milligrams per milliliter, which is the concentration of the liquid—i.e., how many milligrams of medicine is in a ml of liquid).

Confusing, I know. We can help with the math if you provide the info on the label.

Notes:
12.5 lbs = 5.67 kg
Standard max dosing per above = 0.05 mg/kg daily
Concentration of what you were given is ?? mg/ml
Volume of meloxicam in syringe is 0.07 ml

 

[Lisa and Angel]

Thank you, this is reassuring. i am confused about the dosing. He is about 12.5 lbs, so that looks like it comes out to 0.283. The dose I have been given is in a syringe that says 0.07 ml. Does that track? I am not sure how to math this out.

I am not sure, sorry. It'd depend on how strong the formulation is that you've been given.

For example:

Dose is 0.05 mg per kg. A 5 kg cat needs 0.05*5 = 0.25mg.

My bottle of Novacam contains 0.5 mg/ml. This means the 5kg cat need 0.5ml of that liquid.

From what I can find online, US oral suspensions often contain 1.5mg/ml. That means the 5kg cat would need 3 times as little ml as the 0,5mg/ml suspension, so 0.083ml of the stronger liquid.

 

[allie and newkitty]

Hi Allie — nice to see you around here again!



Looks like you’re missing a step.

What is the “strength” of the meloxicam you were given? The label should say it is “xx mg/ml (xx milligrams per milliliter, which is the concentration of the liquid—i.e., how many milligrams of medicine is in a ml of liquid).

Confusing, I know. We can help with the math if you provide the info on the label.

Notes:
12.5 lbs = 5.67 kg
Standard max dosing per above = 0.05 mg/kg daily
Concentration of what you were given is ?? mg/ml
Volume of meloxicam in syringe is 0.07 ml

Hey!!!! It's good to see you too!! I get so sentimental every time I pop in here!! It is 1.5mg/ml. Thanks so much!

 

[JL and Chip]

Notes:
12.5 lbs = 5.67 kg
Standard max dosing = 0.05 mg/kg daily
Concentration of your metacam is 1.5 mg/ml
Volume of metacam in syringe is 0.07 ml

Math:
Maximum recommended dosage would be 0.28 mg of Metacam daily
0.05 mg/kg x 5.67 kg = 0.2835 mg

Actual dose prescribed is 0.105 mg
1.5 mg/ml x 0.07 ml = 0.105 mg

So it seems that your vet is being conservative and that the dose were given is well under the maximum recommended.

I had a cat on low-dose Metacam for several years for severe arthritis and spondolysis. With the black box warning as well as the horror stories, I was ultra cautious and probably underdosed her. It helped her but in hindsight I wish I’d have bumped up the dose and been a little less guarded in using it. When she did get a larger dose (still within max dosing recommendations), her quality of life and mobility improved dramatically. Unfortunately it was at the end of her life, so too late to see longer term impact. Lost her to something other than kidney disease, and her kidney values still looked great, so maybe there is actually a safe dose.

As for the chronic rhinitis… I know you said it was due to structural issues and long term, but did you ever have her nasal passages scoped or flushed or samples taken for culture and sensitivity? Charlie had chronic issues and flushing and a C&S of the samples led us to specific oral and nasal antibiotics that made a huge difference.

Another question is whether you’ve checked the teeth. I knew a cat who had major chronic rhinitis and absolutely gross discharge, despite treatment and antibiotics. I believe she’d had a tooth rupture through into the nasal cavity. Just throwing it out there since you said the standard treatment that had always worked wasn’t working anymore. It’s always possible there’s a new variable at play.

 

[allie and newkitty]

Notes:
12.5 lbs = 5.67 kg
Standard max dosing = 0.05 mg/kg daily
Concentration of your metacam is 1.5 mg/ml
Volume of metacam in syringe is 0.07 ml

Math:
Maximum recommended dosage would be 0.28 mg of Metacam daily
0.05 mg/kg x 5.67 kg = 0.2835 mg

Actual dose prescribed is 0.105 mg
1.5 mg/ml x 0.07 ml = 0.105 mg

So it seems that your vet is being conservative and that the dose were given is well under the maximum recommended.

I had a cat on low-dose Metacam for several years for severe arthritis and spondolysis. With the black box warning as well as the horror stories, I was ultra cautious and probably underdosed her. It helped her but in hindsight I wish I’d have bumped up the dose and been a little less guarded in using it. When she did get a larger dose (still within max dosing recommendations), her quality of life and mobility improved dramatically. Unfortunately it was at the end of her life, so too late to see longer term impact. Lost her to something other than kidney disease, and her kidney values still looked great, so maybe there is actually a safe dose.

As for the chronic rhinitis… I know you said it was due to structural issues and long term, but did you ever have her nasal passages scoped or flushed or samples taken for culture and sensitivity? Charlie had chronic issues and flushing and a C&S of the samples led us to specific oral and nasal antibiotics that made a huge difference.

Another question is whether you’ve checked the teeth. I knew a cat who had major chronic rhinitis and absolutely gross discharge, despite treatment and antibiotics. I believe she’d had a tooth rupture through into the nasal cavity. Just throwing it out there since you said the standard treatment that had always worked wasn’t working anymore. It’s always possible there’s a new variable at play.

Thank you so much. I really appreciate it. I wish I had known about low-dose metacam when Newkitty had such terrible arthritis. We treated with Bupe & laser but I wish I had had this in my arsenal. I had no idea every other country was using it.

We went ahead and gave him his dose. He is sleeping with his head propped up now, I texted some videos to her. I don't know if that is common for extreme congestion or if we now need to worry about pneumonia.

He had his nasal passages scoped and cultured back in 2015 and the doxy has done an amazing job of keep symptoms down since then, just once a day (25mg) dosing, with the doubling up here and there as needed to knock down any flares, so we've never had to pursue doing it again. This is the first time in nine years that nothing is working. We may have to go that route but have been hesitant due to his HCM.

He she did look in his mouth and his remaining teeth looked good. We had most of them pulled several years ago. Did you ever see Charlie sleeping with his head propped up (like on a box, Christmas tree stand--it's still up, please don't judge me )?

 

[allie and newkitty]

Notes:
12.5 lbs = 5.67 kg
Standard max dosing = 0.05 mg/kg daily
Concentration of your metacam is 1.5 mg/ml
Volume of metacam in syringe is 0.07 ml

Math:
Maximum recommended dosage would be 0.28 mg of Metacam daily
0.05 mg/kg x 5.67 kg = 0.2835 mg

Actual dose prescribed is 0.105 mg
1.5 mg/ml x 0.07 ml = 0.105 mg

So it seems that your vet is being conservative and that the dose were given is well under the maximum recommended.

I had a cat on low-dose Metacam for several years for severe arthritis and spondolysis. With the black box warning as well as the horror stories, I was ultra cautious and probably underdosed her. It helped her but in hindsight I wish I’d have bumped up the dose and been a little less guarded in using it. When she did get a larger dose (still within max dosing recommendations), her quality of life and mobility improved dramatically. Unfortunately it was at the end of her life, so too late to see longer term impact. Lost her to something other than kidney disease, and her kidney values still looked great, so maybe there is actually a safe dose.

As for the chronic rhinitis… I know you said it was due to structural issues and long term, but did you ever have her nasal passages scoped or flushed or samples taken for culture and sensitivity? Charlie had chronic issues and flushing and a C&S of the samples led us to specific oral and nasal antibiotics that made a huge difference.

Another question is whether you’ve checked the teeth. I knew a cat who had major chronic rhinitis and absolutely gross discharge, despite treatment and antibiotics. I believe she’d had a tooth rupture through into the nasal cavity. Just throwing it out there since you said the standard treatment that had always worked wasn’t working anymore. It’s always possible there’s a new variable at play.

Just registered your reference of nasal antibiotics for Charlie. Can you please tell me more about that?

 

[Veronica & Babu-chiri]

Babu has suffered of rhinitis all his life, one of the perks of his breed, it's probably not as critical as the one your baby has but still when he has a flare what I've done and has always helped him is give a "shot" of sterimar in each nostril, as best as I can, some of it gets sprayied all over but the part that goes in does the job and a "shot" of rhinocort aqua (nasal Budesonide) also in each nostril I give this treatment once or twice a day depending on how bad the flare is.

Given the fact that everything is given in his nose and inhaled is a lot less agressive on his body

This was prescribed to him by a vet many years ago, when we started using this treatment we went for 15 days twice a day then another 15 days once a day, now as soon as I see the first sybnthoms I start the treatment and I usuallly only need a cuople of days or a week tops

And one thing that has helped lessen the flares and that I use regularly is Jackson's Galaxy "Easy breather" it does really help is not just marketing