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NSAIDs & CKD Treatment: Another Piece to the Puzzle?

Clinician's Brief (Capsule)

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Multiple forms of cyclooxygenase are constitutively expressed in the kidneys of many species, including dogs and cats. In some species, products of renal COX activity modulate glomerular filtration rate (GFR), thus feline GFR may be dependent on COX activity.

This study examined whether meloxicam or acetylsalicylic acid at commonly recommended dosages had any short-term effect on GFR and proteinuria in 6 euvolemic cats with renal azotemia. Renal function was assessed by serum creatinine concentration, urinary clearance of exogenously administered creatinine, and urine protein:creatinine (UP:C). Measurements from cats in a placebo group were compared with results from cats at the end of 7 days’ treatment with either meloxicam or acetylsalicylic acid. Neither drug had a measurable effect on urinary clearance of exogenously administered creatinine, serum creatinine concentration, or UP:C. No measurable effects on GFR were noted—consistent with the hypothesis that GFR of euvolemic cats with normal or reduced renal function is not dependent on cyclooxygenase function.

Commentary

Many practitioners are appropriately concerned about the NSAID effects on renal function in cats with chronic kidney disease (CKD). Information on this issue is limited, although judicious use of various agents was endorsed in the 2010 ISFM and AAFP consensus guidelines on NSAID use.1 In this study, meloxicam (given for 7 days at above-recommended doses) did not impact renal status and offers some reassurance regarding use of this NSAID in cats with CKD stages 2 and 3. However, the results should be interpreted cautiously; the study was short and these cats did not receive any other medications routinely used with feline CKD. Careful monitoring of cats on long-term NSAID therapy is still warranted, and these agents should be stopped if patients are not eating and drinking.—Audrey K. Cook, BVM&S, MRCVS, DACVIM, DECVIM, DABVP (Feline Practice)

Source

Evaluation of glomerular filtration rate in cats with reduced renal mass and administered meloxicam and acetylsalicylic acid. Surdyk KK, Brown CA, Brown SA. AM J VET RES 74:648-651, 2013.

References

For global readers, a calculator to convert laboratory values, dosages, and other measurements to SI units can be found here.

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