Veterinary 2025 Guide: Piroxicam for Canine Cancer & Pain Management 🐾🩺

Hello, I’m Dr Duncan Houston BVSc. Today’s 2025 guide covers piroxicam (Feldene®)—a non-selective NSAID used off-label in dogs (and occasionally cats) for transitional cell carcinoma, other cancers, and osteoarthritis pain. We’ll discuss how it works, dosing tips, side effects, contraindications, monitoring strategies, and client support integrated with Ask A Vet 😊.

🔍 1. What Is Piroxicam?

Piroxicam is a non-selective cyclooxygenase (COX‑1 & COX‑2) inhibitor in the oxicam class, offering anti-inflammatory, analgesic, antipyretic, and anti-tumor actions :contentReference[oaicite:3]{index=3}. Although FDA-approved for humans, it’s used extra‑label in canine oncology and pain management :contentReference[oaicite:4]{index=4}.

🎯 2. Indications in 2025

• Dogs: Particularly effective for transitional cell carcinoma (bladder cancer), squamous cell carcinoma, mammary adenocarcinoma, and osteoarthritis pain :contentReference[oaicite:5]{index=5}.
• Cats: Occasionally used adjunctively for TCC and rhinitis—but with caution due to limited safety data :contentReference[oaicite:6]{index=6}.

💊 3. Dosing & Administration

• Typical dose: ~0.3 mg/kg PO once daily (≈0.15 mg/lb daily) for both pain and cancer therapy :contentReference[oaicite:7]{index=7}.
• Administer with food to reduce gastric irritation :contentReference[oaicite:8]{index=8}.
• If a dose is missed, give it as soon as possible unless it’s near the next dose; do *not* double-dose.

⚠️ 4. Side Effects & Risks

• Risk of significant gastrointestinal ulceration, bleeding, and perforation—even life-threateningly without warning :contentReference[oaicite:9]{index=9}.
• Kidney damage and renal papillary necrosis possible—especially in hypotensive or dehydrated pets :contentReference[oaicite:10]{index=10}.
• Elevated liver enzymes or liver damage may occur :contentReference[oaicite:11]{index=11}.
• Blood clotting abnormalities—bleeding risk may increase :contentReference[oaicite:12]{index=12}.
• Other signs: lethargy, loss of appetite, vomiting, black tarry stools, edema, central nervous system signs (e.g., dizziness, tinnitus) :contentReference[oaicite:13]{index=13}.

🚫 5. Contraindications & Precautions

• Do not use in pets allergic to NSAIDs, or those taking other NSAIDs or corticosteroids :contentReference[oaicite:14]{index=14}.
• Use with extreme caution—or avoid entirely—in pets with GI ulcers, bleeding disorders, heart disease, hypertension, renal impairment, or dehydration :contentReference[oaicite:15]{index=15}.
• Avoid in pregnant, nursing, or senior pets unless deemed necessary and monitored :contentReference[oaicite:16]{index=16}.
• Cats are particularly vulnerable—use only with vet oversight and baseline testing :contentReference[oaicite:17]{index=17}.

📋 6. Drug Interactions & Monitoring

• Concurrent NSAIDs/corticosteroids dramatically increase GI ulcer risk—avoid combinations :contentReference[oaicite:18]{index=18}.
• Other interacting drugs: cyclosporine, furosemide, SSRIs, tricyclics, ACE inhibitors, diuretics—may exacerbate renal or bleeding issues :contentReference[oaicite:19]{index=19}.
• Baseline bloodwork (CBC, chemistry, urinalysis) is essential; repeat every 4–8 weeks with prolonged use :contentReference[oaicite:20]{index=20}.
• Monitor clinical signs—vomiting, appetite, stool character, edema, behavior—continuously.

📝 7. Client Education & Support

• Explain off-label use, dosing schedule, and necessity of food administration.
• Educate about recognizing side effects—black/tarry stool, vomiting, anorexia, lethargy—and when to call vet.
• Advise not to combine with other NSAIDs/corticosteroids.
• Recommend Ask A Vet app for dosing reminders, side-effect logs, lab alerts, and 24/7 vet messaging 😊.

📌 8. 2025 Vet Takeaways

• Piroxicam is a potent, non-selective NSAID used off-label for canine cancer pain management and osteoarthritis.
• Use at ~0.3 mg/kg once daily with food—ensure baseline labs and owner awareness of risks.
• Side effects can be serious; close monitoring and avoiding other NSAIDs is key.
• Cats: use cautiously and only under strict veterinary oversight.
• Owner education and app-based support via Ask A Vet improve safety and treatment success 😊.

At Ask A Vet, we offer dosing calculators, lab-tracking tools, symptom alerts, and 24/7 vet messaging to support safe, effective piroxicam therapy. Encourage your clients to download our app for confident, informed care ❤️