Has your vet recently prescribed meloxicam for your pet? Are you confused about why your pet needs it, or whether it is a good idea to use it? Are you nervous about your pet suffering medication side effects? These are all perfectly normal concerns- allow me to address them. Hopefully by the end of this article you will feel more comfortable with your pets medication regime!
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What is Meloxicam?
Meloxicam (known by a wide range of brand names) belongs to a group of medications known as non steroidal anti-inflammatories (NSAIDs). You will probably be familiar with NSAIDs that are in use in human medicine; such as Ibuprofen and Diclofenac (in fact I have heard many pet owners describe their pets meloxicam as “doggy nurofen”!). While these human NSAIDs can be toxic to dogs and cats (so please don’t be tempted to use them!), meloxicam and other licensed NSAIDs for dogs and cats have been in use for many years. And much like their human equivalents, are generally very safe.
How does it work?
If this was a shampoo ad, Jennifer Aniston would now be saying “concentrate, here comes the science bit!” (sorry for the dated reference for anyone under 30!). Pain and inflammation are caused by chemicals called prostaglandins. When an area becomes injured, prostaglandins produced in this area cause the area to become inflamed (characterised by heat, swelling and an increased blood supply which causes redness). It also activates pain receptors which send chemical signals to the brain, which cause us to feel pain.
NSAIDs work by inhibiting the production of enzymes called cyclo-oxygenase (COX), which are a vital part of the biochemical pathway that produces prostaglandins. So, if fewer COX enzymes are produced, then fewer prostaglandins are produced, and this leads to less pain and inflammation.
Do NSAIDs have side effects?
One of the downsides of inhibiting COX enzymes, is that as well as regulating pain and inflammation, COX enzymes also help with other things, such as protecting the stomach and intestinal lining from developing ulcers, promoting blood clotting and promoting normal kidney function. Therefore, inhibiting these enzymes does come with a risk of a slightly higher incidence of stomach ulcers, blood clotting problems and kidney problems. However, these risks are very small. They are more likely to happen in a pet whose stomach lining or kidneys are already compromised. In a young, healthy animal the chance of this small inhibition of COX enzymes actually having enough of an effect to cause a clinical problem is very low indeed.
Furthermore, in recent years, a lot of research has gone into making these medications safer and safer. It was found that there are actually two main COX enzymes, known as Cox-1 and COX-2. COX-1 is mainly responsible for maintaining stomach lining, kidney function and clotting. Whilst COX-2 is mainly responsible for inflammation and pain. So, by making these medications more selective in which enzymes they inhibit, we can make sure that they have much more of an effect on COX-2 than on COX-1. And therefore limit any unwanted effects to a very low level. Meloxicam was one of the first NSAIDs on the market to preferentially inhibit COX-2 over COX-1. So it was much safer than earlier NSAIDs that came before it.
What does this mean in practice?
Ok, the science bit is over now, I hope I didn’t lose too many of you there! What this means in practice, is that we can very occasionally get an upset tummy as a side effect of meloxicam. But in most cases, this will be mild and will get better by itself without any further treatment. Mild changes in blood clotting are very unlikely to make any difference at all to your pet unless they already have a clotting disorder or are on another medication that inhibits clotting.
We do need to be a bit careful when using meloxicam in pets that we know have kidney disease, or those whose kidneys may be compromised (for instance due to dehydration). However, this doesn’t mean that meloxicam should be completely ruled out in pets with kidney disease. In fact a recent study in cats with stable kidney disease and arthritis showed that a group of cats who were given daily meloxicam to treat their arthritis pain actually lived longer than the group who did not have it! This is likely because not being in pain due to their arthritis meant that they moved around more (which is good for quality of life). And they ate and drank more due to being more content; which is good for the kidneys and may have prevented the kidneys from going downhill as quickly as they may have otherwise.
What conditions is meloxicam used for?
Meloxicam can be used for a very wide range of conditions. Basically anything that causes inflammation and pain could benefit from use of an NSAID. Probably the most common use is in pets who suffer with arthritis or other orthopaedic conditions. It can also be used post operatively in pets who have had routine surgery, to provide pain relief and stop them from feeling tempted to interfere with their wounds. If your pet is suffering with pain anywhere (from their eye to their toes!) you can expect them to possibly be prescribed meloxicam.
Which pets should not take meloxicam
As a general rule, your pet should not take meloxicam if they:
- Already have a known or suspected stomach or intestinal ulcer.
- Are dehydrated or have suffered blood loss.
- Are currently taking steroid medication (steroids can also increase the chance of stomach ulcers. So both of these taken together would increase the risk too much)
- Are pregnant or lactating.
- Have acute or unstable kidney disease (as mentioned above, NSAIDS can be used with care in well managed, stable chronic kidney disease)
While occasionally vets may prescribe the medication for some pets in these categories, this will only be after a careful consideration of the risks and benefits, which they would normally have explained to you.
I hope this article has improved your understanding of this very important and commonly used drug. And that you will now feel confident giving this drug to your pet if prescribed by your vet. Many pets have had their quality of life transformed by this medication. It has enabled them to live much longer, happier lives than they otherwise would have. Us vets prescribe meloxicam multiple times, every single day. It is one of the backbones of our arsenal of weaponry against pain and discomfort in your pet!
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