Meloxicam (Metacam) and your older dog
September 20, 2019 4:59 AM   Subscribe

Have you used Metacam for joint / arthritis pain in your older dog? I have questions about the length of treatment. (Only interested in answers for dogs, and do already know it can be dangerous for cats.)

My main question is whether it is typical to have breaks between treatment periods, or if ongoing daily dosing is ever common.

We've been using Metacam at the suggestion of our Vet, and the results have been pretty great. We've gone from our dog having nearly no appetite, barely able to walk, and seemingly in drastic decline, to eating regularly, able to walk (not like a spring lamb, but she actually runs around during walks, and can now stay mostly upright when perambulating about the house), and, if not like her younger self, at least having a decent quality of life. She's between 13 and 16 years old, healthy weight (now that she's not losing weight due to not eating), and her blood tests before this Rx came back fine. She also has a dose of Neurontin (Gabapentin) daily, but when she was only on Neurontin she was not doing well, and we were wondering how long we had left with her.

We've finished the first bottle of Metacam (oral suspension), and our Vet had suggested breaking for 10 days before starting again. We'll be keeping a sharp eye on her, but I don't want to "power through" a break if she begins to decline again, if it's not necessary. I'm not objecting to our Vet's recommendation (she's been "let's see what works / helps," not "you must follow this exact dosage pattern") — I just want to know if daily Metacam at the lowest effective dosage without breaks is ever normal. Don't worry, we won't go rogue with treating our dog; we'll work out the approach with our Vet.

(Our dog has not shown any adverse reactions to the Metacam such as vomiting, diarrhea, etc., and her appetite has improved, not declined.)
posted by taz to Pets & Animals (10 answers total)
My good friend who is also a vet doesn't like metacam over long periods as it can impact the liver. She uses it for short term pain only and doesn't like to prescribe for extended use.

My vet is like yours, use the metacam daily, with some breaks - she wants to see if the inflammation has gone way (thereby removing the pain).

Based on those two bits of advice, I've chosen to use as needed- but I use it 5 days at a time (so if I think he needs it, I'll do 5 days, and then stop to see how he's doing). Both vets seem to think its a reasonable.

Dog had knee surgery, and has arthritis in his back legs
posted by Ftsqg at 6:00 AM on September 20, 2019 [1 favorite]

We used it long term for our 8-year old greyhound with arthritis. We used it without breaks for I think two years before he had a neural problem and we had to put him down.

I don't remember our vet recommending breaks since the arthritis was not going to go away.
posted by Naib at 6:04 AM on September 20, 2019 [1 favorite]

My 9 yr old large breed dog has arthritis in his hips. He has been on 7.5 Meloxicam tablets + Gabapentin capsules for 2 years now. They keep him mobile and he still runs into the yard after squirrels, plays with our emergency backup dog and goes for daily walks.

He has not had any “breaks” from his medication. He has bloodwork done annually at this point to check liver function and that’s it. If I recall correctly, when he first started taking it they had me bring him in for bloodwork more frequently- but once they saw it wasn’t affecting his liver, we went to once a year.

The vet also told me that the Meloxicam dosage can be upped if we start to see more mobility issues.
posted by hilaryjade at 6:15 AM on September 20, 2019 [1 favorite]

My God-dog was on it continuously for years, on top of weekly physio. It allowed him to have a great quality of life.

I honestly would not worry about liver damage in a senior dog.
posted by DarlingBri at 6:55 AM on September 20, 2019 [1 favorite]

We were never given it for more than very short runs, infrequently.

We got a lot more time than we expected with Galliprant/gapiprant, if you want to ask your vet about it.
posted by Lyn Never at 7:00 AM on September 20, 2019 [1 favorite]

It is a miracle for my baby but we also worry about her liver. We will do one bottle (about 3 weeks) then take a break until I feel that she needs it again, usually about another 10 days/2 weeks, the first sign of stiffness. She is 15 and we have had the discussion that keeping her comfy is more important than worrying about liver toxicity at this point, but all her organs are extremely healthy so our vet doesn't want to mess with a good thing.
posted by pearlybob at 7:18 AM on September 20, 2019 [1 favorite]

Metacam worked really well for my ancient greyhound except for the nausea. We switched her to gabapentin which is better for long term use and worked just as well for her rickety legs. If you see that the breaks from metacam are causing periods of discomfort, maybe ask about gabapentin?
posted by some chick at 8:22 AM on September 20, 2019

I have a dog on long term metacam use, but he also had regular bloodwork tests to check his liver function while on it because of older dogs tend to have problems with kidneys & livers & may not metabolise the drug as efficiently as a healthy dog so you get a build up of it in the system leading to poisoning or other problems. We had to cut back to half a doses on all his meds now as he has liver problems due to a fatty tumor in his liver (common in old dogs most older dogs have them but they don't always cause problems). I imagine having a break helps do the same thing gives it time to clear from the system so less chance of build up to dangerous levels. I am not a vet I am only guessing from what has happened to us with our dog. Talk to your vet.
posted by wwax at 9:00 AM on September 20, 2019 [1 favorite]

I have two 14 year old pugs who are both on meloxicam. One of them has been on meloxicam (+gabapentin and tramadol) for a little over three years for osteoarthritis, the other about a year and a half for spinal pain (+ gabapentin). They are both on it every day with no breaks. We did stop it once for a day during a health scare for Simon (osteoarthritis dog), but ended up restarting it.

Both are on 0.1 mg/kg once daily. My vet doesn't want us to go higher than that (one dog was overweight to start, and as he's gotten to his goal weight, his total daily dose has gone down- from 1.5mg/day to 1.05 mg/day). We check liver and kidney labs every 6 months, but truthfully: my dogs are old. They won't live forever, and I'd like them to be comfortable while they are still around. If the meloxicam ends up causing problems, they both had great runs.
posted by smangosbubbles at 10:47 AM on September 20, 2019 [1 favorite]

We had two senior dogs who both took meloxicam for arthritis pain, every day without breaks for years. Both dogs had regular bloodwork to check liver function. They both also took daily omeprazole to help protect their stomachs against common side effects from NSAIDs. One dog developed "lesions" in her liver toward the end of her life; these are not uncommon in older dogs, and I guess it's possible that there was a connection with the long-term meloxicam use. We gave her a liver support supplement, Denamarin, that helped significantly.

Our dogs' quality of life was so dramatically better with meloxicam, and that made it worth the risks of long-term use. I think it's great that you're maintaining a dialog with your vet to make the best decisions for your pup.
posted by Boogiechild at 11:01 AM on September 20, 2019 [1 favorite]

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