title: Dose reduction of meloxicam in dogs with osteoarthritis-associated pain and impaired mobility.
abstract: BACKGROUND
  Progressive nonsteroidal anti-inflammatory drug (NSAID) dose reduction appears logical; however, there is no evidence-based medicine indicating that efficacy is maintained as dose is reduced.
  
  
  OBJECTIVE
  To determine if NSAID dose can be reduced and pain relief and mobility can be maintained in dogs with osteoarthritis (OA).
  
  
  METHODS
  Client-owned dogs (n = 59) with OA-associated impaired mobility and pain.
  
  
  METHODS
  Prospective, randomized, blinded study. After 14 days wash-out, dogs were randomized to reducing dose (RDG) (n = 30) or maintenance dose (MDG) (n = 29). MDG received standard dose meloxicam. RDG received a reducing dose from D28 onward, reducing to 0% of maintenance for the final 2 weeks. Assessments were at D14, 28, 42, 56, 70, 84, 98 and 112 using subjective owner assessments, accelerometry (AM), and standing percent body weight distribution (%BW). A Kaplan-Meier survival curve described how dogs dropped out because of insufficient pain control. A Log-rank test compared the groups.
  
  
  RESULTS
  More dogs in RDG (13) dropped out because of owner-evaluated insufficient pain control compared with MDG (5) (P = .029; odds ratio: 3.67; median dropout time: 84 days in each group). For the dogs that did not drop out (n = 41), there were no significant differences between groups in owner assessments (P > .2 for each), %BW placed on the index limb (P = .750), or accelerometer-measured activity (P = .14).
  
  
  CONCLUSIONS
  Dose reduction is a less effective means of pain control compared with maintained dosing. However, NSAID dose reduction with maintained efficacy is possible, but success appears to be individual dog dependent.
authors.affiliation: Comparative Pain Research Laboratory and the Center for Comparative Medicine and Translational Research, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607, USA.
authors.forename: B G J
authors.initials: BG
authors.lastname: Wernham
authors.forename: B
authors.initials: B
authors.lastname: Trumpatori
authors.forename: J
authors.initials: J
authors.lastname: Hash
authors.forename: J
authors.initials: J
authors.lastname: Lipsett
authors.forename: G
authors.initials: G
authors.lastname: Davidson
authors.forename: P
authors.initials: P
authors.lastname: Wackerow
authors.forename: A
authors.initials: A
authors.lastname: Thomson
authors.forename: B D X
authors.initials: BD
authors.lastname: Lascelles
mesh_terms: D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use; D004283:Dog Diseases / Q000188:drug therapy*; D004285:Dogs; D004305:Dose-Response Relationship, Drug; D005260:Female; D008297:Male; D000077239:Meloxicam; D010003:Osteoarthritis / Q000150:complications / Q000188:drug therapy / Q000662:veterinary*; D010146:Pain / Q000188:drug therapy / Q000209:etiology / Q000662:veterinary*; D013843:Thiazines / Q000008:administration & dosage / Q000627:therapeutic use*; D013844:Thiazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D013843:Thiazines; D013844:Thiazoles; D000077239:Meloxicam