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The US Food and Drug Administration (FDA) recently told the makers of the pain relieving drug Metacam (meloxicam) to put a boxed warning label about the risk of renal failure when it is used for cats.

Boehringer Ingleheim Vetmedica Inc. added the warning to the labels of its Metacam Solution for Injection and Metacam Oral Suspension.

After reviewing reports of adverse reactions, the FDA said it identified enough cases of kidney failure and death in cats to justify the warning, which reads, “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.”

Metacam is often given as a shot to control painafter operations including orthopedic surgeries and spays and neuters.

But many vets also prescribe Metacam for cats in order to to control chronic pain. This is called off-label use and is very common in veterinary medicine.

“One of the problems that vets face is that there are very few pain relievers that can be safely and effectively given to cats long term,” says Ottawa, Ontario-based veterinarian Dr. Marie Haynes, author of Ask A Vet Question. “So when we have a cat with a chronic problem like arthritis, we have to weigh the pros and cons of any drug that we give.”

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, according to the FDA. Metacam Oral Suspension is not approved for use in cats.

Haynes says that although there is cause for concern about Metacam, when it is given appropriately to a healthy cat, the chances of developing kidney problems are extremely rare.

She notes that the injection dosage approved as safe in the US is 1.5 times higher than what is approved in Canada. “It may be that there are more issues with Metacam for cats in the US because of the higher recommended dose.”

In her practice, Haynes has recently stopped giving Metacam injections to cats. She uses a drug called Tolfedine, which is not available in the US. However, she adds, “any non-steroidal anti-inflammatory drug, including Tolfedine, can make a kidney problem worse.”

For cats with arthritis, Haynes says Metacam is generally the best drug to give. But other medications are available. She encourages concerned cat owners to ask their veterinarians about possible alternatives to Metacam.

[Sources: CatChannel and AskAVetQuestion]