Hi everyone, I'm new here and have been really happy to come across this site. I haven't had a chance to peruse the site properly so forgive me if my question has already been addressed repeatedly and I'm just being redundant!....

But anyway, here goes:


Our 5 year old cat developed pyometra (a uterine infection) and had to undergo emergency surgery a month ago...She developed symptoms of cystitis afterwards and the vets prescribed metacam for five days. They had already given her two injections for post operative pain prior to prescribing the oral metacam, but I don't know what those injections involved (were they also metacam or some other drug-I don't know?)...Anyway, I followed through on the prescribed metacam ( a 5-day course) and the cystitis symptoms didn't clear up...I went back to the vets and they did a urinalysis and found some abnormal results ( some protein and white blood cells). They thought it was continuing inflammation due to the surgery and prescribed another two-weeks course of metacam to help calm it down....

I wasn't actually concerned at all until I noticed that she was becoming really lethargic after each dose. Then I looked up the drug online and saw all the scare stories....Anyway, I'm really concerned now because they never did any blood tests on her to check her kidney function before prescribing her the metacam and from what I've read, oral metacam is dangerous with repeated use ( I have no idea if metacam was the injectable they used on her post surgery and again a couple of days later?...)...

...Anyway, I'm feeling really distressed about what to do and find myself really distrusting these vets but not knowing if I should! It actually took repeated concerted visits on my part to finally convince them she was sick in the first place with a uterine infection- they kept telling me she was pregnant and I kept telling them it was near impossible and that something was wrong but they still kept saying she was pregnant! ...Anyway, after that experience, I have just lacked trust in them and have questioned their competence. Now, after reading about the risks of metacam, I'm worried all over again! Ugh, we also live in a small town so there are not many options as far as seeking a second opinion go .....

I've discontinued the metacam for the time being, just because I'm so freaked....

Does anyone have any ideas about this?....I'm so sorry for the long long post, I'm just a freaked out cat owner!!

Thanks so much in advance for all your help!

Suzanne

There are plenty of anecdotes on the web regarding Metacam and I understand why you are frightened. In the states the oral version was withdrawn and only the injectable version allowed.

I happen to believe it is a very useful drug when used properly and suspect many of the problems arose from a difference in dosing instructions here and in the USA. Problems here may well have arisen because of a misreading of the correct dosages. They are not complicated but if a vet sees one figure without reading all the instructions they could end up giving too much.

Here's a link to the correct dosage by injection - note it's 50% higher dose for a one-off injection without any oral follow-up which could be one area for error.
NOAH Compendium of Animal Medicines: Metacam 2 mg/ml Solution for Injection for Cats - Dosage and administration

and here's a link to the oral version
NOAH Compendium of Animal Medicines: Metacam 0.5 mg/ml Oral Suspension for Cats - Dosage and administration

Follow-up treament after injection should be for up to four days, not five and for longer term treatment the daily dose is half that of short term, post op care. Armed with this information you should be able to have a more equal 'discussion' with your vet.

Thanks for all the information havoc, I really appreciate it.....She's been on a three drop/day syringe dosage- I'm going to have to figure out how that translates into ml/kg of the actual medicine, wish me luck there!... Yes, she's seen many different vets at the same clinic and it's very possible that any one of them could have overlooked what the other vets had given her dosage/injections-wise....I went and found the printouts for her vets bills and found they'd given her two injections of meloxicam (5mg/ml), one before surgery and the other two days later, then the five day oral course and a week later another two week course....It's just frustrating because I don't know if they've made a mistake or if that amount is considered safe...I'm going to have to buck up and talk to them about it next time I go in...in the meantime, she doesn't seem in pain from cystitis any longer so the metacam is stopped...

thanks again for your help havoc

I too would have stopped if I'd been in your position. This isn't like an antibiotic which must be continued so working out a minimum necessary dose or even stopping completely isn't going to compromise things to a disasterous extent even if your vets are right.

When I've used it for post op pain relief I am very careful with dosage and I never give it 'early', ie there must be at least 24 hours clear from dose to dose. If I were ever in a position where it was suggested for a longer term I think I'd be discussing dosage interval with my vet and be prepared to slip a day when necessary. There's nothing magic about 24 hours other than it happens to be convenient for us humans.

Hope your cat is better soon and please keep us updated. It sounds quite similar to mine at the moment so would be interested to see the outcome for your cat. My cat had a dental done so was given injectable metacam afterwards. Few weeks later she was drinking more than normal then pee'd on my bed, bloods normal and urinalysis also revealed white blood cells and protein in urine. Over a month later and multiple dipstick tests on her urine and nothing has changed despite 2 different antibiotics and a 5 day course of metacam. She's now on a special diet and further tests will be done on her urine next week.

I made a thread about mine and someone suggested that despite clear bloods she may still have CRF.

Have you noticed your cat drinking any more than usual?
Whatever the outcome I would really appreciate if you could update us as it's really wrecking my brain trying to get to the bottom of bunty's problem and your case does sound similar to mine.

Hi dee-o-gee,

I will definitely keep you updated...I've also been worried about kidney problems because I've read that protein and white blood cells in urine can indicate kidney disease (but it can also just indicate inflammation or infection I think)...have your vets done any blood tests on your cat? (unfortunately, mine haven't, but if they do I will give you the results)

....From what I've read, urinalysis tests CAN tell you if the kidneys aren't functioning well. There's a test to do with urine concentration which can tell if the kidneys are struggling....It's called something like specific gravity test or something...If they did that on your cat and it came back normal, that would be very reassuring! I don't know if they did it for our cat, I'll be asking at her next appointment...

To reply about water drinking: She had been drinking a lot of water but has since cut down....

I hope you keep me updated as well and that your cat is feeling better too!


Edit: Woops, I just went and read the thread you started and found that your vets had done all those tests I mentioned! ...I wonder, did they comment at all on why his/her urine might be dilute? ...hope they find something out in the culture they're performing...

She just said that the urine being dilute would tie in with her drinking more, ie. she drinks more so urine is more dilute.

I too hope something shows up in the urine culture, I really do hope it is just struvite crystals or something similar that can be managed through diet and careful monitoring. I really don't want it to be her kidneys as she's only 6 years old.

She's been on the c/d diet since friday evening now, soft smelly poo in her tray today. Think I changed her over a bit too quick, didn't phase old food out new food in slow enough but she's never had a sensitive tummy with food before. Hope it agrees with her. She was doing so well on her other food too, lovely poos with no smell, soft shiny coat. Looking at the ingredients this stuff is pretty bad (first 3 ingredients: Brewers Rice, Corn Gluten Meal, Chicken By-Product Meal ). Will try it anyhow until the end of the bag or until I get to the bottom of everything.

Well, technically true but the question is why she's drinking more! This is what I'd like to know. I can understand your concern re kidney probs but it's way more likely to be due to infection, if this ever turned out to be the case though kidney stones may be another possiblitly in a very young cat!

Yes, I know the ingredients list of some of those Hills diets including the digestion ones is very offputting! All those grains etc.

Still wonder why vet is forwarding the urine sample to the UK? Strange, I'd certainly be interested to know her reasons. It might also throw some light on what she believes it might be!!

When I'm dropping the sample off in the morning I'l ask.

...Arrgh, I know how you feel with the worrying! ..I tend to do my own head in looking her symptoms up on the internet and fearing the worst! I also tend to second guess my vets a lot now after they failed to diagnose her original infection and worry they're not investigating her present symptoms properly, which drives me crazy because I don't know if I'm being unreasonable or not! ...very frustrating!

Anyway, I keep telling myself that they're vets for a reason and do probably know what they're talking about, so if they're not concerned about kidneys, it's probably unlikely that there's a problem....

We go in tomorrow for another checkup, so I'll let you know what they say...in the meantime, hope your kitty's doing ok...