Meloxicam for cats

Meloxicam is approved by the U.S. Food and Drug Administration (FDA) as a one-time injection in cats to relieve pain and swelling due to spays, neuters, or bone or muscle surgery. Giving more than one dose or any use of oral meloxicam are both contraindicated in an FDA-mandated black box warning on all animal versions of the drug. Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) similar to ibuprofen or aspirin. It is one of only two NSAIDs FDA-approved for use in cats, but it’s only safe when given as a single-dose injection. If more than one dose is required, veterinarians will use robenacoxib, but only for short-term treatment that lasts up to three days. 

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What is meloxicam used for in cats?

In cats, meloxicam is used as a one-time pre-operative pain relief injection before spaying, neutering, or orthopedic surgery. More than one dose is contraindicated because it carries a significant risk of sudden kidney failure. So, although meloxicam and other NSAIDs can be given safely to dogs for chronic pain relief due to osteoarthritis, long-term use of meloxicam is not recommended.

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Spaying, neutering, orthopedic surgery

Spaying and neutering are the most common surgeries performed on cats. One study estimated that at least 80% of household cats in the U.S. are spayed or neutered. Meloxicam is FDA-approved as a single injected dose before ovariohysterectomy (spaying) or castration (neutering). It can also be used as a single injection before orthopedic surgery, such as surgery on a joint or ligament. 

The FDA contraindicated additional doses or the use of meloxicam oral suspension such as, brand-name Metacam. Although veterinarians may still use it off-label, the American Association of Feline Practitioners (AAFP) and the International Society of Feline Medicine (ISFM) recommend veterinarians get written permission from the cat owner before any extra-label use of meloxicam in a cat.

As an NSAID, meloxicam works by blocking enzymes called cyclooxygenases (COX-1 and COX-2). These enzymes synthesize chemicals called prostaglandins that initiate the process of swelling and pain after an injury. In cats, the meloxicam injection is a pre-emptive treatment for post-surgical pain and swelling. Other pain relief drugs may also be used before or immediately after surgery. Following surgery, the cat will probably be sent home with other pain relief medications or therapies.

Is meloxicam safe for cats?

Meloxicam is safe for cats as a single one-dose injection before surgery. Multiple doses are contraindicated because of the risk of kidney failure and death. Currently, only two NSAIDs are FDA-approved for use in cats: meloxicam as a single-dose injection and robenacoxib for up to three days of doses. No NSAID is safe to give to a cat over the long-term.

Meloxicam decreases blood flow to the kidneys, so even a single dose can cause mild kidney dysfunction. Because of its adverse effects on the kidneys, meloxicam and other NSAIDs may be too risky to give to a cat with kidney disease. Kidney problems are also a risk for dehydrated cats or low blood pressure. To avoid these risks, veterinarians will perform blood tests before giving the cat meloxicam.

Meloxicam has not been considered safe for cats four months of age or younger.

Meloxicam should not be used in cats allergic to meloxicam or other NSAIDs.

Side effects of meloxicam in cats

In clinical trials, the most common side effects of a single dose of injected meloxicam in cats were:

• Post-treatment anemia
• Renal dysfunction (as measured by increases in serum blood urea nitrogen)
• Injection site pain

Other side effects are possible, including:

• Gastrointestinal issues such as vomiting, diarrhea, and loss of appetite
• Lethargy
• Behavior changes

The most serious adverse events of meloxicam in cats are usually due to giving the cat repeated doses. These include:

• Renal failure
• Death

Interactions of meloxicam with other pet meds

Other pet meds interact with meloxicam, so tell the veterinarian about other medications, supplements, and vitamins the cat is receiving. A veterinarian is less likely to use meloxicam if the cat is taking certain types of drugs, such as:

• Other NSAIDs
• Corticosteroids like prednisone or dexamethasone
• Diuretics
• Nephrotoxic drugs, such as aminoglycoside antibiotics
• Blood pressure drugs called ACE inhibitors
• Anticoagulants
• Methotrexate

Meloxicam dosage for cats

The recommended meloxicam dosage for cats is 0.3 mg/kg, and it is given as a single injection beneath the skin before surgery. Additional doses of meloxicam or other NSAIDs should not be used for pain control after surgery.

Can cats overdose on meloxicam?

Because veterinarians inject meloxicam in cats as a single dose before surgery, a meloxicam overdose is unlikely. It is unlikely that the veterinarian will send the cat home with one or more doses of oral meloxicam. If so, follow the veterinarian’s instructions carefully. Repeated doses of meloxicam can cause serious kidney problems, so an overdose will contribute to that risk. If an overdose is suspected, discontinue the medication and contact the veterinarian.

Can I give my cat meloxicam every day?

No. The FDA has approved meloxicam as a single dose only before surgery. The veterinarian may send a cat home with oral meloxicam. Still, treatment guidelines specify that the veterinarian spells out the risks and gets a signed agreement from the cat owner before prescribing multiple doses of meloxicam. 

How to give your cats meloxicam

Meloxicam is a subcutaneous injection administered by a veterinarian before surgery.

Meloxicam alternatives for cats

Although meloxicam is FDA-approved as a single-dose injection for cats before surgery, veterinarians have a safer choice for multiple days of therapy: Onsior (robenacoxib). This NSAID is administered as a single tablet or injection before surgery, and then the cat is sent home with more tablets for a maximum of three doses over three days.

The World Small Animal Veterinary Association (WSAVA) advises veterinarians to use multiple therapies to treat post-surgical pain in dogs and cats. In this way, pain is managed by targeting several different pain mechanisms. Veterinarians will choose the medications they believe are most appropriate for your cat’s situation, but they are likely to send the cat home with more than one drug or therapy. Meloxicam is a “pre-emptive” pain reliever—it’s given before anesthesia to reduce pain after the surgery. 

In addition, postsurgical pain can vary widely among cats. Some cats may need more pain relief than others, so doses or therapies may need to be modified in the days following surgery. Cat owners should be aware of the clinical signs of pain and distress in a cat and contact the veterinarian if the cat is not responding well to the drugs or therapies. 

In addition to short-term use of NSAIDs such as robenacoxib, post-operative analgesics for cats include:

• Opioids 

Tramadol is a common choice, but the bad taste may make it hard to give to a cat. 

• Gabapentin

Gabapentin is an anticonvulsant that is safe in cats and can be prescribed in a broad range of doses. This makes it a good choice if the cat has more pain than expected.

• Amantadine

Amantadine is an antiviral medication. It reduces the nervous system’s transmission of pain signals.

Alternative pain relief therapies that don’t involve drugs include:

• Cold therapy
• Acupuncture
• Massage
• Stretching

If interested, ask the veterinarian for advice about using these alternative pain treatments.

Summary

Meloxicam is an NSAID that is FDA-approved as a single-dose injection to treat surgical pain in cats, but the FDA does not consider repeated doses of meloxicam to be safe in cats. A single-dose meloxicam injection may be appropriate if your cat is getting spayed, neutered, or undergoing orthopedic surgery. However, veterinarians have another FDA-approved NSAID that is considered safer for cats and can be used for at least a few days following surgery.