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I write this in memory of my cat Gypsy, who died
needlessly after treatment for a minor injury. She suffered acute
kidney failure following “Metacam” oral dosing. I have tremendous guilt not having researched this
drug thoroughly before its administration. If publishing this
editorial can save the lives of other cats, Gypsy’s death will not
have been in vain..
An FDA study (Adverse Drug Experience Report 2006)
shows approximately a 32% acute kidney failure in cats that are orally
dosed. Other side effects are: vomiting, diarrhea, lethargy,
decreased appetite and depression. The drug company Boehringer Ingelheim is not
responsible for misuse. The cat package insert (which I did not receive)
states: The problem starts with “Off-label Use” a practice in both human and veterinary medicine. The practitioner prescribes drugs for a purpose outside the scope of the drug’s approved label, however prescribing against “specific label directions” puts them on a very slippery slope. This is especially true with no informed consent! Be your pet’s advocate and ask: 1. Are my cat’s liver and kidney blood tests
acceptable? Metacam is justifiably not approved in Canada or the USA for oral dosing of cats. Gypsy was privately cremated June 16, 2008 at Hazelwood Acres, Thunder Bay. Submitted by:
Background Metacam & Cats This article discusses six frequently heard statements
regarding the use of Metacam in cats. #1 “Metacam is approved for cats” Metacam is marketed worldwide in three forms (injectable solution, oral suspension, and chewable tablets) and for five target species (dogs, cats, horses, cattle, and pigs). So the country issuing the approvals and the forms and target species covered by those approvals must accompany any general statements about its approval status. The following table shows the approval dates for dogs and cats in the United States.
Target Species Drug Form……….dogs & cats #2 “Metacam has been used for 10 years in Europe” Again, we need to disambiguate this statement with
more specific information from the European Medicines Agency.[2] #3 “35 million doses of Metacam have been sold” This may indeed be true, but this is likely a worldwide aggregate figure and the vast majority of these doses have been for use in dogs and farm animals. It’s better to ask more specific and relevant questions such as “How many doses of Metacam Injection for Cats have been sold in the USA?” or “How many doses of Metacam Oral have been sold for cats in this country?” #4 “Metacam has an unparalleled safety record” This may indeed be true for dogs; the
target animal safety studies[4] filed with the FDA show that dogs can
tolerate single 120X doses (where 1X = 0.1 mg/ml) and repeated daily 5X
doses for six months with no deaths. However, when four cats were given
repeated daily 3X doses for eight days, one died and another was
moribund.[5] It is therefore clear that Metacam’s safety in dogs
cannot be extrapolated to cats. Meloxicam in Cats, Route: Oral
#5 “Deaths in cats are idiosyncratic” Idiosyncratic refers to an unusual drug reaction that is particular to an individual or group. Since there are no adequate field trials for Metacam in cats, there is no data to define “usual” reactions. It is therefore impossible to determine whether the death of any particular cat is idiosyncratic or not. #6 “There’s nothing wrong with off-label use” Off-label drug use is a widespread practice in both
human and veterinary medicine; however, prescribing directly against
label directions (i.e. do not use in cats) is not common. Off-label prescription of Metacam for
cats is especially problematic in Canada, where other NSAIDs (ketoprofen
and tolfenamic acid) have approved labeling for short-term repeated use
in cats. References: [1] Product sheet: Metacam Solution for Injection for
Cats Boehringer Ingelheim Vetmedica, Inc. (revised October 2004) [2] Metacam European Public Assessment Report [3] Flexicam European Public Assessment Report [5] Freedom of Information Summary for Supplemental
NADA 141-219 (Metacam 5 mg/ml Solution for Injection for Cats (28
October 2004) [6] FDA Adverse Drug Experiences Report (10 July 2006) [7] Off-Label Prescribing, Maxwell J. Mehlman, J.D.
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