Our latest webinar (available Weds 21st July) reviews the use of NSAIDs long term in cats, with a focus on those cats suffering with chronic kidney disease. This supplement to the webinar gives you our recommendations, collated from WSAVA and various papers referenced below.
General prescribing guidelines for NSAIDs in cats
Evidence demonstrates that benefits of treatment outweigh risks.
Pain should be monitored using a validated assessment tool for cats, such as Vetmetrica.
Owners should be encouraged to define behaviours that they associate with pain in their cat, in order to monitor treatment efficacy.
Compliance is a key factor in choosing between the licensed long-term options.
There is no evidence that lower doses result in reduced side effects.
NSAIDs should be administered at the prescribed dose and frequency.
NSAID switching should be considered if a cat does not respond to an NSAID.
Washout periods should be based on pharmacokinetics of the previously prescribed drug.
The risk of renal adverse effects might be increased if NSAIDs are used concurrently with other drugs that affect renal function (e.g. aminoglycosides, diuretics).
Renal function should be monitored in cats with pre-existing renal disease.
There is no indication to use NSAIDs and corticosteroids together.
Clinical signs that suggest ulceration include depression, anorexia, reduced appetite, vomiting, diarrhoea and haematochezia or melaena. But ulceration can occur without overt clinical signs and, conversely, symptoms such as vomiting, anorexia and diarrhoea can occur independently of gastrointestinal damage or ulceration.
Clients should be warned to stop the product if their pet is unwell and contact their veterinary surgeon.
References
Monteiro, B., Steagall, P.V.M., Lascelles, B.D.X et al (2019) Long-term use of non-steroidal anti-inflammatory drugs in cats with chronic kidney disease: from controversy to optimism. Journal of Small Animal Practice 1-4
https://wsava.org/wp-content/uploads/2020/01/Guidelines-for-the-Long-Term-Use-of-NSAIDS-in-Cats.pdf
This post was written by Matt Gurney.
Matt sees referrals in the pain clinic at Anderson Moores Veterinary Specialists. You can also receive telemedicine advice from us here if you have a pain case where you need a helping hand.
Matt & Carl established Zero Pain Philosophy to provide educational resources & telemedicine to veterinary professionals enabling optimal management of pain.
Matt Gurney is an RCVS & European Specialist in Veterinary Anaesthesia & Analgesia and works at Anderson Moores Veterinary Specialists. Matt is President of the European College of Veterinary Anaesthesia & Analgesia.
Carl Bradbrook is an RCVS & European Specialist in Veterinary Anaesthesia & Analgesia and is President of the Association of Veterinary Anaesthetists. Carl works at Anderson Moores Veterinary Specialists.
The intended audience for this pain update is veterinary professionals. This pain update is based on clinical experience and independent opinion.