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Dear Christopher Cat

Phoebe, my 12-year-old cat, has been taking Metacam for her arthritis. I also give her Cosequin for Cats and an omega-3 fatty acid fish oil supplement.

My veterinarian told me the manufacturer of Metacam recently advised against giving the oral medication to cats for prolonged periods, and she recommended I gradually discontinue it. Unfortunately, without Metacam, Phoebe is in pain, even though the Cosequin and fish oil do help somewhat.

What can you suggest?

Christopher Responds

I take Metacam for the same reason Phoebe does, and I’d be very uncomfortable without it.

Injectable Metacam is approved for single-dose use in cats by the U.S. Food and Drug Administration. However, the agency has not approved prolonged use of oral Metacam because it believes the drug causes an unacceptably high incidence of side effects in cats, particularly kidney damage and stomach/intestinal upset.

Conversely, FDA’s counterparts in Europe, Australia and New Zealand approve of prolonged use of oral Metacam in cats at a daily dose that is half the dose recommended for dogs in this country.

The International Society of Feline Medicine (ISFM) and the American Association of Feline Practitioners (AAFP) agree. Their guidelines on the use of Metacam and related drugs were published in the June 2010 issue of the Journal of Feline Medicine and Surgery.

To read the guidelines and their jointly-prepared client handout, click here.

The ISFM and AAFP recommend giving Metacam with food and ensuring adequate water intake. In overweight cats, dosing should be based on the cat’s ideal lean body weight.

Let your veterinarian know about Phoebe’s discomfort, and talk with her about the benefits and risks of continuing Metacam. Ask her to test Phoebe’s blood and urine periodically to ensure that her kidneys and other organs are functioning normally. Monitor her activity, mobility, grooming and personality to assess her comfort.

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