ISFM and AAFP consensus guidelines: long-term use of NSAIDs in cats

Abstract

NSAIDS AND CATS: Non-steroidal anti-inflammatory drugs (NSAIDs) are an important class of drug in feline medicine, having analgesic, anti-inflammatory and antipyretic activity. While most published data on their use in this species relate to short-term (often perioperative) therapy, there is increasing evidence of the value of these drugs in treating chronic pain in cats (for example, that associated with degenerative joint disease), and some NSAIDs have now become licensed for long-term use in cats in some geographies. Most of our knowledge of therapeutic mechanisms or adverse drug reactions associated with NSAIDs is extrapolated from work in other species, and there is a paucity of published data relating to cats.

Guidelines: These guidelines have been drawn together by an expert panel, which have reviewed the current literature on long-term NSAID use in cats and other species, and developed guidance on their use based on this information. The aim is to provide practical information for veterinarians to encourage appropriate NSAID therapy whenever cats will benefit from the use of these drugs.

FIG 1

(a,b) Degenerative joint disease of the elbow in a feline patient

FIG 2

Anteroposterior (a) and lateral (b) radiographs of the hock of a Scottish fold cat with severe osteochondrodysplasia, showing destruction of joint spaces and extensive plantar exostosis. Courtesy of Kim Kendall

FIG 3

Watson, a DJD sufferer, enjoying the benefits of daily NSAID treatment

FIG 4

Transitional carcinoma of the bladder (a) and multifocal osteomyelitic bone lesions (b) in two feline patients. The tumour in the first cat was debulked surgically and the cat then received piroxicam; the second cat was given meloxicam in addition to antibiotics. Courtesy of Randolph Baral (a) and Emma Hughes (b)

FIG 5

(a-c) Severe and painful ulcerative and proliferative gingivostomatitis in three cats. (c) Courtesy of Alberto Barneto

FIG 6

Uveitis in a cat with toxoplasmosis. Courtesy of Carolyn O'Brien

FIG 7

Overview of the role of COX and LOX in prostanoid production

FIG 8

Use of a dedicated dosing syringe is advisable

FIG 9

Blood pressure measurement should ideally be performed as a screening measure before NSAID therapy in cats

FIG 10

Client leaflet advising on safe use of NSAIDs. The leaflet may be downloaded from www.isfm.net/toolbox and www.catvets.com/professionals/guidelines/publications