Chronic pain in cats is under-recognised, under-diagnosed, and too often under-treated. But with increasing evidence and better tools for detection and monitoring, veterinary medicine is catching up. A major leap forward came in 2024 with the release of the ISFM and AAFP Consensus Guidelines on the Long-Term Use of NSAIDs in Cats, a globally significant document aimed at helping veterinary professionals safely and effectively manage chronic pain using non-steroidal anti-inflammatory drugs (NSAIDs).
Why Do These Guidelines Matter?
NSAIDs are the most widely used class of analgesics in veterinary medicine, but their long-term use in cats has historically been approached with caution. This is for good reason: the feline metabolism is uniquely sensitive, particularly due to reduced glucuronidation capacity, increasing the risk of adverse effects.
However, the 2024 guidelines provide clear, evidence-based protocols that shift the conversation from avoidance to appropriate, monitored, long-term use – especially in the management of chronic conditions like degenerative joint disease (DJD), dental/oral pain, and some types of cancer.
Key highlights from the guidelines include:
- Careful patient selection: Emphasis on identifying stable chronic conditions (e.g., stable CKD) before initiating NSAIDs.
- Behavioural pain assessment: Chronic pain in cats presents subtly, often through changes in mobility, grooming, social behaviour or appetite. Tools like caregiver-completed questionnaires (e.g. FMPI, CSOMf) are essential for diagnosis and monitoring.
- Preferred NSAIDs: Meloxicam and robenacoxib remain the most studied and supported drugs for long-term use in cats, with demonstrated safety and efficacy, including in stable CKD patients.
- Multimodal therapy approach: NSAIDs are rarely used in isolation – environmental modification, nutrition, and caregiver education are all integral.
- Monitoring and dose titration: Recommendations for regular re-assessment, aiming for the lowest effective dose while still achieving analgesia.
- Managing comorbidities: Guidance on concurrent disease (especially renal disease, hypertension, or neoplasia), and how to mitigate risk with proper screening and patient selection.
Led by a Global Expert – Dr Sam Taylor
The panel chair for these guidelines was Dr Samantha Taylor, a world-renowned feline internal medicine specialist. Dr Taylor is also a lead tutor and program developer for our upcoming Feline Medicine Program. Her clinical expertise, leadership, and ability to translate evidence into practice make this a truly unique opportunity for veterinarians wanting to advance their skills in feline health care.
This immersive learning experience will guide veterinarians through real-world clinical reasoning, evidence-based treatment protocols, and the nuanced decision-making needed to manage complex feline cases. Whether you’re aiming to improve your confidence in chronic disease management or elevate your skills in feline internal medicine more broadly, this program is designed for you.
What next?
If you’d like to read the full NSAIDs guidelines, you can access them here.
Alternatively, if you want to delve deeper into feline practice, then our upcoming Feline Practice online learning program is for you. With 16 diverse modules delivered through a world-leading interactive platform, you’ll gain new knowledge and skills while engaging with an online community that shares your passion for advancing feline care in practice.
Because our feline patients deserve tailored, compassionate care, and you deserve the education to deliver it.
Learn more about the program or enrol today: Explore program
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Written by Dr Carmel Griffin BVSc CSAM GCEd MANZCVS