Robenacoxib versus meloxicam following ovariohysterectomy in cats: A randomised, prospective clinical trial involving owner‐based assessment of pain

Abstract

BackgroundInjectable non‐steroidal anti‐inflammatory drugs (NSAIDs) are commonly prescribed to queens undergoing ovariohysterectomy (OVH), but the requirement for postoperative administration is unclear and practices vary. Existing studies assessing efficacy rely on pain scoring by experienced clinicians. However, following OVH, most cats are discharged within hours of recovery.MethodsCats undergoing OVH were randomly assigned to two treatment groups: MEL and ROB. Cats in the MEL group (n = 76) received meloxicam (0.2 mg/kg) and those in the ROB group (n = 65) received robenacoxib (2 mg/kg). Owners were contacted by a blinded assessor 3 days postoperatively and asked to identify physical or behavioural changes and to assign pain scores using a numerical rating scale.ResultsMore cats in the ROB group displayed abnormal behaviours than cats in the MEL group (p = 0.03). Most owners assigned a pain score of 0 (72%) (n = 101), but pain scores were significantly higher in the ROB group than in the MEL group (p = 0.005).LimitationMethods of owner assessment of pain in cats have not been validated.ConclusionsBoth meloxicam and robenacoxib are effective in controlling postoperative pain. Meloxicam may have improved efficacy in certain patient populations. Applying a blanket approach to prescribing NSAIDs to cats undergoing OVH postoperatively may not be necessary. This has safety, environmental and cost implications.

Optimising postoperative pain management in cats undergoing ovariohysterectomy

“…A blinded assessor then contacted the owners three days after discharge and asked them to identify any physical or behavioural changes they had observed in their cat and assign them a pain score using an 11-point numerical rating scale. 9 Although overall pain scores were very low in these cats, the pain scores of cats in the robenacoxib group were significantly higher than those of cats in the meloxicam group. This finding led the authors to conclude that both meloxicam and robenacoxib are effective in controlling postoperative pain, but meloxicam may have improved efficacy in certain patient populations.…”

“…This finding led the authors to conclude that both meloxicam and robenacoxib are effective in controlling postoperative pain, but meloxicam may have improved efficacy in certain patient populations. 9 Therefore, applying a blanket approach to prescribing postoperative NSAIDs to cats undergoing ovariohysterectomy may not be necessary. This is important, as NSAIDs have a narrow safety margin in cats, meaning that indiscriminate use can pose a risk to patients.…”

“…15 This study also showed that FGS scores had good reliability when used by cat caregivers, regardless of demographic variables, demonstrating the potential applicability of the instrument to improve feline pain management and welfare worldwide. 15 Providing a clear explanation of how to identify signs of pain is given before hospital discharge, cat owners can reliably assess behavioural changes associated with acute pain during the postoperative period Following on from these studies, Hillen and colleagues' study 9 not only rigorously adheres to scientific methodology but also recognises the practical importance of involving cat owners in assessing their pets' pain experience. This approach acknowledges the subjective nature of pain perception in animals and harnesses the power of pet owners as key observers in the postoperative period.…”

“…To help address this knowledge gap, Hillen and colleagues conducted a randomised, prospective clinical trial, summarised on p 323 of this issue of Vet Record, evaluating the effectiveness of robenacoxib and meloxicam in controlling postoperative pain in cats, as assessed by their owners in the home environment. 9 This study compares robenacoxib and meloxicam in terms of pain relief, side effects and overall postsurgical recovery.…”

Evaluation of the analgesic efficacy of grapiprant compared with robenacoxib in cats undergoing elective ovariohysterectomy in a prospective, randomized, masked, non-inferiority clinical trial

“…Robenacoxib was selected as the positive control because it is efficacious in attenuating musculoskeletal 3 , 8 , 32 , 48 and soft tissue 1 , 8 , 9 pain, and it has comparable analgesic efficacy to tolfenamic acid 2 and superior efficacy to meloxicam 9 , 49 in cats undergoing OVH. In addition, safety and pharmacokinetic 50 , 51 profiles for robenacoxib in cats have been established, 51 including use in cats with stable, low grade, chronic kidney disease.…”