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Metacam: This Popular Pain Management Drug Causes Kidney Failure in Cats

pain medication for catsMetacam, also known as meloxicam, is a non-steroidal anti-inflammatory drug (NSAID) used primarily in veterinary medicine to control postoperative pain and inflammation associated with orthopedic surgeries, spays, and neuters. It is in liquid form, administered either by injection or orally.

The drug in both forms is FDA-approved for dogs – the oral form is more often used to treat the symptoms of osteoarthritis in canines.

The injectable form of the drug was approved for one-time use only in cats to manage postoperative pain. The oral form was not approved for use in cats at all.

However, it is legal in certain situations for veterinarians to use medications in an 'extra label' or 'off-label' manner, which is  the case with Metacam and cats.

The drug's manufacturer, Boehringer Ingleheim Vetmedica Inc. (BIVI), at the request of the FDA, has added a boxed warning to the labels on both forms of the product:


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 request was made of BIVI after the FDA reviewed reported adverse reactions for the products, specifically many cases of kidney failure and death in cats with repeated use the drug.

Dr. Becker's Comments:

There are very few safe, effective pain relievers that can be given to cats long-term to control chronic conditions like arthritis. This probably in large part explains the extensive extra label use by veterinarians of meloxicam on kitties.

What the Metacam ‘Boxed’ Warning Means

Per the FDA's press release:

The new boxed warning on the METACAM® labels helps inform veterinarians of the serious risks associated with extra-label use of meloxicam in cats.”

So what the warning actually means is your vet can still use meloxicam off-label on your kitty, if he or she chooses.

My advice? Ask your vet if there are any alternatives.

Make Sure You and Your Vet Are on the Same Page

Make sure your cat’s veterinarian has no intention of using the drug to manage any sort of chronic condition your kitty might have, now or in the future.

Even with all the evidence of acute renal failure and death in cats given Metacam, there will undoubtedly be a percentage of vets still willing to roll the dice. Don’t let anyone take that gamble with your precious pet.

Some of the problems with the drug are the result of improper use – too-high dosages or doses given too often, for example. However, there are a significant number of cases in which the vet did everything right and a cat suffered renal failure anyway -- from a single injection of the drug.

Dr. Robin Downing, a renowned expert on veterinary pain management, said this in response to a question posed by about the boxed warning:

“ … my approach to NSAIDs for long-term use in cats has changed dramatically. I do not use NSAIDs at all in old cats with pain, whether or not they have evidence of renal disease.”

“ With greater knowledge of and access to alternatives … I just do not reach for NSAIDs any longer for this population of patients who are by definition at higher risk of renal disease.”

Alternatives for Feline Pain Management

Consider a pet chiropractor. Chiropractic treatments are affordable and can be very effective in alleviating pain and reducing joint degeneration.

How about a kitty massage? Massage can reduce inflammation in damaged tissues.

Helping your cat stretch is a good way to increase the mobility of her joints, tendons and ligaments.

Acupuncture and Prolo therapy can be tremendously beneficial for kitties with degenerative joint disease.

Adding certain supplements to your pet’s diet can provide the raw materials for cartilage repair and maintenance, among them:

  • Glucosamine sulfate with MSM
  • Homeopathic Rhus Tox and Arnica
  • Omega-3 fats, such as krill oil
  • Ubiquinol
  • Supergreen foods, such as Spirulina and Astaxanthin
  • Natural anti-inflammatory formulas (herbs, proteolytic enzymes, such as Wobenzym® and nutraceuticals)

Work with your holistic veterinarian to determine how to best treat the inflammation and pain caused by your pet’s arthritis, as well as how to nourish remaining cartilage.

Also ask your vet about Adequan injections, which can stimulate joint fluid very rapidly in pets with arthritis.