Multiple dose pharmacokinetics and acute safety of piroxicam and cimetidine in the cat

Analgesia: What Makes Cats Different/Challenging and What Is Critical for Cats?

Cats have unique anatomic, physiologic, and behavioral considerations that may influence analgesia and pain management. They present specific challenges that require an individualized, feline-specific approach. This article presents an overview of recent advances in feline pain management and their differences in relation to other species and evolves on its future challenges. The main specific anatomy and physiology of the cat and how it may affect analgesia is discussed. Validated pain assessment tools including the UNESP-Botucatu Multidimensional Composite Pain Scale, Glasgow Feline Composite Measure Pain Scale, and the Feline Grimace Scale are summarized.

Piroxicam

A comprehensive profile of piroxicam including the nomenclatures, formulae, elemental composition, appearance, uses and applications. The methods which were utilized for the preparation of the drug substance and their respective schemes are outlined. The physical characteristics of the drug including the ionization constant, solubility, x-ray powder diffraction pattern, differential scanning calorimetry, thermal behavior and spectroscopic studies are described. The methods which were used for the analysis of the drug substance in bulk drug and/or in pharmaceutical formulations including the compendial, spectrophotometric, electrochemical and the chromatographic methods are reported. The stability, toxicity, pharmacokinetics, bioavailability, drug evaluation, comparison, in addition to compiled reviews on the drug substance are involved. Finally, more than four hundred and fifty references are listed at the end of this profile.

Evaluation of adverse events in cats receiving long-term piroxicam therapy for various neoplasms

The role of cyclo-oxygenase 2 (COX-2) and prostaglandins (PG) in carcinogenesis has been documented in many species. Piroxicam has shown efficacy against several neoplasms and is frequently prescribed for chronic use. There are no studies investigating chronic piroxicam administration in cats and the chronic use of non-steroidal anti-inflammatory agents in this species has long been cautioned against. This retrospective study aimed to evaluate adverse effects in cats receiving long-term daily piroxicam. Seventy-three cats received daily piroxicam at doses of 0.13-0.41mg/kg. Treatment duration ranged from 1 to 38 months. Treatment with piroxicam was found to significantly increase frequency of vomiting during the first month of therapy, though this was most significant for cats receiving concurrent chemotherapy. Piroxicam administration was not significantly associated with hematologic, renal or hepatic toxicities. Adverse events were not correlated with dosage. Adverse events were reported in 29% of cats, and were generally mild and transient. Eight percent discontinued piroxicam due to adverse reaction, and 4% due to difficult administration. This study indicates that long-term daily piroxicam is generally well tolerated in cats at conventional doses.

DJD-associated pain in cats: what can we do to promote patient comfort?

PRACTICAL RELEVANCE

Degenerative joint disease (DJD) has a high prevalence in domestic cats and can be associated with pain. This pain should be addressed wherever possible.

AUDIENCE

All practitioners are faced with cats that are mobility impaired due to DJD-associated pain.

PATIENT GROUP

Cats of all ages and breeds, and either sex, can experience DJD-associated discomfort.

CLINICAL CHALLENGES

Recognizing DJD and assessing DJD-associated pain in cats is a challenge. Owner observations of activity and behavior, careful observation and a logical and thorough orthopedic evaluation are key. Current understanding of the etiology of feline DJD and the mechanisms of DJD-associated pain is incomplete, making the rational choice of treatments a further challenge.

EVIDENCE BASE

Evidence is emerging on the prevalence of feline DJD, and on how to assess the associated pain and mobility impairment. There is a lack of information on the etiology of feline DJD and a relative lack of data on the efficacy of putative treatments.

Clinical signs, treatments, and outcome in cats with transitional cell carcinoma of the urinary bladder: 20 cases (1990–2004)

OBJECTIVE

To characterize demographics and clinical signs and evaluate outcomes of treatments in cats with transitional cell carcinoma (TCC) of the urinary bladder.

DESIGN

Retrospective case series.

ANIMALS

20 cats with TCC.

PROCEDURES

Medical records of 20 cats with a bladder mass identified as a TCC that were examined at 2 veterinary institutions between 1990 and 2004 were evaluated. Signalment, treatments, and outcome were assessed.

RESULTS

Breeds included domestic short hair (n=14), long hair (2), and medium hair (2) cats, Siamese (1), and Abyssinian (1). All cats had been neutered at an early age (< 1 year old; 13 neutered males and 7 spayed females). The median age at diagnosis of TCC was 15.2 years. The trigone region was affected in 9 cats. Treatments included piroxicam administration, chemotherapy, or surgery as single interventions or in combination; 6 cats were not treated. At the time of diagnosis, 3 cats had pulmonary metastasis and 1 cat had metastasis to local lymph nodes. Median survival time for all 20 cats was 261 days. Nearly all deaths were attributable to progressive disease in the urinary tract. Five cats were lost to follow-up.

CONCLUSIONS AND CLINICAL RELEVANCE

In cats, TCC of the urinary bladder appears to be a rare and aggressive disease that is more prevalent in male cats and frequently develops at sites distant from the trigone (unlike TCC in dogs). Nevertheless, initial clinical signs of TCC in cats in this study were similar to those reported for affected dogs.

Nonsteroidal anti-inflammatory drugs in cats: a review

OBJECTIVE

To review the evidence regarding the use of nonsteroidal anti-inflammatory drugs (NSAIDs) in cats.

DATABASES USED

PubMed, CAB abstracts.

CONCLUSIONS

Nonsteroidal anti-inflammatory drugs should be used with caution in cats because of their low capacity for hepatic glucuronidation, which is the major mechanism of metabolism and excretion for this category of drugs. However, the evidence presented supports the short-term use of carprofen, flunixin, ketoprofen, meloxicam and tolfenamic acid as analgesics in cats. There were no data to support the safe chronic use of NSAIDs in cats.

Study of feline oral squamous cell carcinoma: potential target for cyclooxygenase inhibitor treatment

Oral squamous cell carcinoma (OSCC) is associated with high morbidity and mortality. A potential target for OSCC treatment is cyclooxygenase-2 (cox-2). Pet cats with naturally occurring OSCC may offer the opportunity to study anticancer activity of cox inhibitors. Cox-2 expression in feline OSCC was determined by immunohistochemistry. High intensity cox-2 immunoreactivity was detected in 6 of 34 (18%) feline OSCC samples. Weak immunoreactivity was noted in 22 OSCCs and in epithelial cells from oral mucosa of clinically normal cats. Pharmacokinetics of a cox inhibitor (piroxicam, 0.3 mg/kg) were studied in carcinoma-bearing cats to confirm a dose for follow-up trials. The average peak serum piroxicam concentration (948 ng/ml, which inhibited cox-2 activity) and serum half-life (15.9 h) were similar to that in normal cats. These results provide information (cox-2 expression as an inclusion criteria, 0.3 mg/kg daily piroxicam) for the design of follow-up trials of cox inhibitor treatment in pet cats with OSCC.