Anti-inflammatory Therapy in Cats

Inflammation is part of the body's response mechanism to injury or infection. Whilst inflammation plays a useful role in carrying white cells to the seat of an injury and helping to remove toxins, in the long term it can be damaging and painful. 

The unique physiology of cats means many common drugs are not metabolized and therefore cats are particularly vulnerable to toxic accumulation. Thus, extreme care needs to be taken over the dosage, frequency of administration, drug type, and how the medication is given in order to reduce the likelihood of possible complications. 

Corticosteroids are potent anti-inflammatories, but newer drugs belonging to the non-steroidal anti-inflammatory (NSAID) group are preferable in most cases. There are several licensed for use in cats, which are a powerful addition to our ability to relieve pain in cats. 

NSAIDs are prescription medications, so the cat needs to be seen by a vet. Most NSAIDs are cleared from the body through the kidney, therefore before starting therapy the vet may need to take a blood draw to screen the patient for renal disease. 

Treatment may be short term, such as reducing fever in a patient with an infection whilst antibiotics get to work. Or they may be long term, such as the arthritic cat with painful joints. 

NSAIDs are not compatible with many other common medications, such as steroids, because of a heightened risk of gastric ulceration, so extreme care must be taken when mixing meds.

To reduce the risk of side effects such as gastric ulcers, NSAIDs must be given either with food or on a full stomach. Oral formulations include liquid suspensions, which make fine dose adjustments possible. Depending on the particular NSAID prescribed, the dosage is usually given once or twice daily. 

Anti-inflammatory drugs from the NSAID family are good at managing mild to moderate pain. Severe pain requires the use of more potent analgesics (pain relievers) such as those from the morphine family. 

Some anti-inflammatories, such as steroids, are potent at reducing inflammation but have no pain relieving properties.

Your vet will make a call as to which anti-inflammatory is best, based on the nature of the underlying problem. For example, mild arthritis or minor surgery is best served with NSAIDs. Severe debilitating arthritis may require steroids (for the strong anti-inflammatory effect) with the addition of a painkiller from another drug group. Whilst severe pain, such as a fractured leg, may require potent painkillers from the morphine family. 

The big advantage of NSAIDs is they provide an option for at-home pain relief of cats with mild to moderate discomfort. 

Some patients need short courses of pain relief, such as during the perioperative period. Other have long-term conditions, such as arthritis, and need ongoing medication. 

NSAIDs are non-addictive and can be curtailed without problems once the inflammation has subsided. Corticosteroids, however, can induce a state of dependency in the body by suppressing the natural production of steroid. Therefore a slow, staged reduction of dose is necessary, especially for those on steroids for several weeks or months. 

The anti-inflammatory medications licensed for use in the cat are prescription only. The most economic way to acquire NSAID medications is for your vet to write a script (cost $10 to $14) and then fill the script at a pharmacy. There are also economies of scale, whereby a 30 ml ($24) bottle of meloxicam is more economical to buy than ten x 3ml (10 x $6 = $60) bottles. 

Blood tests to check kidney function are around $45 to $60 or more. 

Anti-inflammatory medications can considerably reduce a cat's discomfort or pain and therefore greatly enhance that cat's welfare. It is no longer a case that elderly cats with arthritis have to put up with sore joints, as there are good pain-relieving medications which are safe in the long term. 

However, NSAIDs need to be treated with respect and care taken to ensure they are given safely. This includes screening for renal disease before the start of therapy, sticking within the recommended dosage, and giving food before or with medication. 

Unfortunately, for severe pain the vet may need to look at stronger medications that are more tightly controlled by law, and therefore administered mainly within the confines of a veterinary hospital. 

Cat owners should act responsibly to ensure their pet is safe from harm. This may mean keeping a cat as an indoor pet in order to reduce the risk of traffic collisions. 

Cats may suffer pain for a number of reasons. Of these, the most preventable is dental disease. With regular toothbrushing or the use of dental hygiene products such as washes or food additives, the risk of gum disease or loose teeth can be greatly reduced. 

With regards to arthritis, keeping your cat slim and supplementing their diet with nutraceuticals such as glucosamine and chondroitin, helps to protect their joints. That said, a cat that develops arthritis should not suffer pain unnecessarily, and rather than avoiding NSAID use, it should be encouraged in order to relieve discomfort.