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Mordecai had been getting fouler tempered over the years. It had become a family joke to quip that no one should approach him barehanded while he’s sleeping. And absolutely no one is to scratch him anywhere except behind his ears and under his chin—which he still loves. 

This big black behemoth of a cat had never been so ornery. Before the age of ten he’d been the sweetest-natured of beasts, rubbing himself between legs trippingly and bouncing off walls playfully well into his middle age.

Despite his size he’d never been a fat cat—just a big one. Panther-esque even now in his early teens, he lumbers lazily to the food bowl or litterbox and back to one of half-dozen favorite spots he protects with a stare that says, “go ahead….make my day.”

In the office for his yearly visit it was hard to believe this cat could be so ill-tempered. Mordecai’s two healthy canines protrude comically from his upper lip, lending him a not-so badass façade for all his owners’ anxiety over his personal flaws.

Then again, I guess you have to know him in his natural habitat to question that vampire grin. According to his owner, it promises a couple of unpleasant punctures should he be inadvertently touched anywhere except around his head.

Because of his behavior, Mordecai hadn’t seen a vet since before his inner Sybil materialized. But a punctured pad, the result of some seriously curled front toenails (no way to trim those bad boys with that nasty temper) finally occasioned a multi-family member pillowcase chase and his eventual capture.

Here at the hospital, however, Mordecai was the very picture of pleasant catdom. Sometimes the stress of a new environment has a way of changing behavior patterns…but not always for the better. Luckily Mordecai is one of those who chills in resignation at the sight of a scrub top.

Nonetheless, a full exam revealed his grouchy side whenever his back was manipulated. His muscle mass and coat quality had also suffered, the former due to lack of exercise from stiffness and discomfort, the latter likely the result of poor self-grooming habits (often the result of pain on the required twisting maneuvers).

X-rays confirmed the diagnosis: moderate to severe osteoarthritis of the spine, hips and elbows. Who wouldn’t be ticked off by attention to all these stay-away zones?

A course of anti-inflammatory medications (Metacam every three days) combined with some occasional non-sedating opiates (Tramadol) and the obligatory nutraceuticals (glucosamine, chondroitin, green lipped mussel extract and the occasional course of Adequan, for good measure) has turned him back into the pussycat of years past.

This guy is my most obvious example of success in the relief of chronic pain in cats. He’s done so well his owners are actually considering a hip replacement for him. With his fine labwork and extreme good health in other respects, Mordecai’s a model candidate, despite his thirteen years.

Given their success rate with procedure in small dogs, we expect our local surgeons (experts in teensy-weensy hip replacements) to consent to his candidacy.  If so, stay tuned…I’ll have a lot more to talk about on the subject of Mordecai the monster kitty. 
 

Comments
I'm so glad Mordecai is feeling better!!! I know whenever my cats have been grouchy, it's because they don't feel good and off to the vet they go. (Unless we've just come *back* from the vet, and then I know they'll be grouchy for a couple hours regardless.)

I also just love happy endings for big black cats. :)
# Posted By Cindy | 4/27/08 8:11 PM
I think its a case of getting to know your pets, and knowing what is normal and what is not. If it changes, there is usually a reason. I had an old black cat who was confined indoors because of multiple medical problems. He got grumpy and I wondered if it was due to being confined. But two days later an abscess appeared on the top of his head - he had had an altercation with his brother and no one had noticed. Abscesses take a while to show up, but meanwhile can cause pain. I felt guilty about it, but it was off to the vet the day I found it, and he was happy again after treatment.
# Posted By Robin | 4/27/08 10:04 PM
See:

www.veterinarypartner.com/Content.plx?P=A&A=1752


The above link is a link to a veterinay website with information on Metacam.

It says:

"Meloxicam can be used in cats but with caution. The original oral solution of meloxicam was commonly dosed in drops from the bottle. Since the wrong dose of meloxicam can be very dangerous for cats, it is important not to drop the drops directly into the cat's mouth from the bottle as squeezing too strongly could easily deliver an overdose. There is currently a newer formulation at one third the strength of the original, which can be dosed more accurately with the included syringe. In cats. this product is given either as a single one time injection in association with surgery (its FDA approved use) or long term 2 to 3 times per week.

"Cats are even more sensitive to NSAID side effects as a general rule and the quest for a feline NSAID is still on-going; still, meloxicam has been approved by the FDA for use in cats for surgical pain so long as only one dose is given. Longer term feline protocols have been developed (though not approved by the FDA at this time) and are in wide though cautious use in needful cats.

Patients being considered for long term meloxicam use should be evaluated with a complete physical examination and initial screening blood test to identify any factors, such as liver or kidney disease, that might preclude the use of this or any other NSAID.
"If a patient has borderline kidney function, NSAIDs should not be used as they reduce blood flow through the kidneys. It is also important that NSAIDS not be given to dehydrated patients because of this potential side effect. This is particularly true in cats."

"The side effects of concern are the same with all NSAIDs: stomach ulceration, loss of kidney function, and inappropriate bleeding . . . "

I find it scary
# Posted By Stefani | 4/27/08 11:35 PM
Here is the Handout "Metacam risks in cats," which discusses the narrow safety profile of metcam use for cats.

http://www.persiancats.org/nss-folder/filefolder/M...

specifically:

"Metacam has a narrow margin of safety . . . meaning that there is very little difference between a safe, effective dose and a toxic dose. Repeated doses of Metacam Oral in cast have been known to result in death, as documented in the clinical tests submitted to the FDA. The narrow safety margin in cats is reflected in the FDA's Adverse Drug Experience (ADE) reports for Metacam Oral . . . in 320 cats, 105 cases of kidney failure, 48 deaths and 35 cases resulting in euthanasia have been reported."
# Posted By Stefani | 4/27/08 11:42 PM
While metacam may work for some the risks are far too great in my book..

I created www.metacamkills.com to educate about the dangers of this drug..

check out the site before giving this drug and make your own decision....

good health to you and yours...

Dave & PB
# Posted By Dave | 4/28/08 7:42 AM
My philosophy on the use of Metacam and other drugs like it can be summarized in a couple of words: Risk. Reward. What are you giving up for all that relief? Sometimes it's worth it. Sometimes it's not.

I dislike the concept of limiting our power to relieve suffering pharmaceutically on the basis of side effects alone. ALL drugs have them. It's up to us to determine where the balance lies for each individual patient.

My philosophy can be pretty much summed up in this post:
http://www.dolittler.com/index.cfm/2006/10/5/pet.v...
# Posted By Dr. Patty Khuly | 4/28/08 8:54 AM
IMO, it's gotta come down to quality of life. Obviously this kitty's has increased significantly with the use of Metacam.

I wish the drug companies would come out with NSAIDs specifically for cats. There are so many for dogs, but cats get arthritis, too. Are they just supposed to suffer?
# Posted By katie | 4/28/08 1:04 PM
I think what is more important than the vet's attitude is that of the owners. Hopefully they have been provided with all the risk information (client info sheet, awareness that this is a non-FDA approved use, etc) in order to make that choice in an informed way for their pet.
# Posted By Stefani | 4/28/08 2:00 PM
My vet prescribed metacam for my cat with arthritis. I almost decided not to use it because of the risk information, but I did choose to use it and I'm glad I did. She was 12 yrs old and acting like a kitten again. It was great to see her so active again except for her 4:00 am morning races that always included running over my husband and me in bed!
# Posted By CLynch | 4/28/08 2:47 PM
I've long suspected that my 13-year old has arthritis - he responds the same way as Mordecai did, and has been that way for quite some time (several years). He was also de-clawed when he was 3 or so (I think - I was in middle school when my parents had it performed) and shifts weight between his front paws when sitting. I accidentally stepped on his front leg about a year ago - the vet I was working for at the time didn't palpate any fractures or joint instability and he was weight-bearing, so he mixed up some butorphanol in V.A.L. syrup...my kitty's personality totally changed. He was friskier and better-tempered until the torb wore off. I figured the torb was alleviating more than just that sprain pain. It's frustrating, though, b/c I've asked different vets and they all tell me the same thing - long-term NSAID use just isn't possible for cats as it is dogs.
It never occurred to me to do full body radiographs, though - I think I'll ask for them. He gets blood screening at least annually if not every six months - everything has always looked great (CBC and chem12). Thanks for the post - I'd be more than willing to try what you prescribed to Mordecai w/mine if it's appropriate - judiciously, of course, and w/lots of follow-up bloodwork to monitor kidney/liver function. I think it'd be worth it. :)
# Posted By anna | 4/28/08 3:05 PM
I agree wholeheartedly with Dr K. Prescribing any medication is a matter of balancing the potential risks versus the potential benefits. Thats how I approach medication for myself and my cats.
For example, my cat Katie has hypertrophic cardiomyopothy (sp?) and is on a med regimine that includes 12.5 mgs of Atenol twice a day and 20 mgs of ASA every three days. Many have told me that the aspirin shouldn't be given to cats but after a discussion with a veternanian cardiologist and my vet, I decided to use it. Katie is a different cat (more so a result of the atenol than the aspirin).
# Posted By Shannon | 4/28/08 5:42 PM
My experience was similar to that of CLynch -- my arthritic manx cat (Bob) was prescribed metacam and cosequin -- I was very hesitant to give Bob metacam due to published risks. However, my vet felt it was the most effective approach for reducing Bob's arthritis pain, and Bob actually did quite well for several years on metacam with cosequin.
# Posted By karen | 4/28/08 10:02 PM
My dog has been on Metacam now every day for three years and it's been a lifesaver for him. Plus it's being available as a liquid, which he will lap up voluntarily, is a big plus over hiding a pill.
# Posted By Natalie | 4/29/08 3:56 PM
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