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Retrospective case-control study of the effects of long-term dosing with meloxicam on renal function in aged cats
Richard A Gowan1, Amy E Lingard, Laura Johnston
1The Cat Clinic, Prahran, Melbourne, Australia. rgowan75@gmail.com
Insights
Long-term meloxicam treatment for degenerative joint disease (DJD) in senior cats showed no adverse renal effects in cats without chronic kidney disease (CKD). In cats with stable CKD, meloxicam therapy appeared to slow renal disease progression.
Area of Science:
- Veterinary Medicine
- Nephrology
- Pharmacology
Background:
- Degenerative joint disease (DJD) is common in older cats.
- Meloxicam is a non-steroidal anti-inflammatory drug (NSAID) used for pain management.
- The safety of NSAIDs in cats with chronic kidney disease (CKD) is a concern.
Purpose of the Study:
- To evaluate the safety and efficacy of long-term meloxicam treatment in cats with DJD.
- To assess the impact of meloxicam on renal function in cats with and without pre-existing CKD.
Main Methods:
- A retrospective case-control study analyzed medical records of cats treated with meloxicam for DJD.
- Cats were categorized into 'renal' (with CKD) and 'non-renal' (without CKD) groups.
- Renal function was monitored via serum biochemistry and urinalysis, comparing meloxicam-treated cats to controls.
Main Results:
- No significant difference in serum creatinine or urine specific gravity was observed between non-renal cats treated with meloxicam and controls.
- Cats with stable CKD treated with meloxicam showed less renal disease progression compared to age- and IRIS-matched controls not receiving meloxicam.
- The median maintenance dose of meloxicam was 0.02 mg/kg/day.
Conclusions:
- Long-term meloxicam administration at a maintenance dose of 0.02 mg/kg/day appears safe for cats over 7 years old with stable CKD.
- Meloxicam therapy may potentially slow the progression of renal disease in cats suffering from both CKD and DJD.
- Further prospective studies are needed to confirm these findings.
Abstract:
Medical records (2005-2009) of a feline-only practice were searched for cats with degenerative joint disease (DJD) treated using meloxicam. DJD was diagnosed by the presence of at least two of the following: (i) altered mobility (observed by the owner), (ii) abnormal physical findings, (iii) characteristic radiographic changes. The primary study cohort consisted of cats older than 7 years that had received meloxicam for variable intervals in excess of 6 months, and for which complete records were available. These cats were subdivided according to whether detectable chronic kidney disease (CKD) was present ('renal group'), or not ('non-renal group'), and, for the 'renal group', according to the cat's IRIS category. Serum biochemistry, urinalysis (including urine specific gravity [USG]), body mass and condition score were monitored regularly. Progression of CKD in the 'renal group' and 'non-renal group' of cats was compared to two groups of age- and IRIS-matched control cats not receiving meloxicam (from the same clinic, over the same time period). The study was thus a case-control design, with two study groups. Thirty-eight cats with DJD receiving long-term meloxicam therapy met the inclusion criteria. Of these, 22 cats had stable CKD at the start of treatment (stage 1, eight cats; stage 2, 13 cats; stage 3, one cat). No cats initially had an elevated urinary protein to creatinine ratio. The remaining 16 cats initially had normal renal analytes and adequately concentrated urine. The median age of the 'renal' and 'non-renal' meloxicam groups was 15.5 and 13.4 years, respectively. The median treatment duration was 467 days in the 'renal group' and 327 days in the 'non-renal group'. After titration (to the lowest effective dose), the median maintenance dose was 0.02 mg/kg/day in both groups (range 0.015-0.033 mg/kg/day). There was no difference in sequential serum creatinine concentration or USG measurements between the 'non-renal group' treated with meloxicam compared to control cats not treated with meloxicam. There was less progression of renal disease in the 'renal group' treated with meloxicam compared to the age- and IRIS-matched cats with CKD not given meloxicam. These results suggest that a long-term maintenance dose of 0.02 mg/kg of meloxicam can be safely administered to cats older than 7 years even if they have CKD, provided their overall clinical status is stable. Long-term meloxicam therapy may slow the progression of renal disease in some cats suffering from both CKD and DJD. Prospective studies are required to confirm these findings.
