Is arthritis treatment safe for cats with kidney disease?

Q: Emmy, my 12-year-old cat, has arthritis and chronic kidney disease. Her veterinarian recommended Onsior for her arthritic pain but warned that it could further damage her kidneys. I'm torn, because I want Emmy to be free of pain, but I don't want her therapy to cause additional problems. What's your advice?

A: Osteoarthritis, or degenerative joint disease, is apparent on radiographs (X-rays) in an astounding 90% of cats. The condition coexists with chronic kidney disease in 70%, so Emmy's situation is not unusual.

Most of the developed world's drug regulatory agencies have approved Onsior (generic name robenacoxib) and a related nonsteroidal anti-inflammatory pain reliever, Metacam (meloxicam), for long-term use in cats with musculoskeletal disorders.

One study combined use of an activity monitoring collar, veterinary exams, lab work and family assessments to compare Onsior with an inactive placebo. Over the six-week study, cats that received Onsior were 11.9% more active than cats receiving the placebo. Increased activity is a good sign of improved comfort.

In this study, the incidence, types and severity of side effects were the same in the Onsior and placebo groups—including in cats with preexisting chronic kidney disease. Since additional studies have corroborated the safety of Onsior and Metacam, you can feel comfortable following your veterinarian's recommendation.

Though only you and your veterinarian can make a decision about Emmy's care, I can at least put your mind at ease that Onsior should help relieve her arthritis pain without further damage to her kidneys.

Editor’s Note: Treatment of chronic kidney disease, a disease that most often strikes aging pets, is based on the severity of the disease. Dr. Lee discusses the stages and treatment here.

Lee Pickett, V.M.D. practices companion animal medicine in North Carolina. Contact her at vet@askthevet.pet.