Postoperative pain in cats: does robenacoxib give better analgesia than meloxicam after ovariohysterectomy or other surgery? — POSSIBLE

In cats after ovariohysterectomy or dental surgery, does robenacoxib vs meloxicam give better analgesia?

Shelf #744 · gate-verified and displayed under the developer's blinded-trial rule

POSSIBLE: The randomised head-to-head trials do not agree on a winner, so neither drug can be claimed better overall. In the trial closest to the question — Hillen 2023, 141 cats after ovariohysterectomy assessed by owners at home at day 3 with a blinded assessor — pain scores were significantly higher and abnormal behaviours more common on robenacoxib 2 mg/kg than on meloxicam 0.2 mg/kg (pain p = 0.005; abnormal behaviours p = 0.03), although 72% of all owners scored pain 0. In Kamata 2012 (96 cats, mostly ovariectomy, multicentre in Japan), a single pre-operative subcutaneous robenacoxib 2 mg/kg injection was superior to meloxicam 0.3 mg/kg on the primary total clinician score (relative efficacy ratio 1.47, 95% confidence interval 1.19-1.78, P = 0.0003; relative measure, no absolute scores in the record). In Speranza 2015 (147 cats undergoing orthopaedic surgery), robenacoxib was statistically non-inferior to meloxicam over 3-22 hours (relative efficacy 1.029, 95% confidence interval 0.847-1.231; relative measure). Design class (a): randomisation and blinding are both established by carded records — Kamata 2012 is a 'randomised, blinded' trial in its own wording, Speranza 2015 is a randomised masked trial, and Hillen 2023 used a blinded assessor; the blinding established is assessor/masked blinding, not necessarily double-blinding of owners in every trial. Scope caveat on the face of this shelf: NO carded trial studied dental surgery — the evidence is ovariohysterectomy/ovariectomy, mixed soft-tissue and orthopaedic surgery, and the dental part of the mined question is unanswered by eligible evidence. The honest limits: doses, routes, timing and assessors (owners at home vs clinicians in hospital) differ across trials, the owner pain instrument in Hillen 2023 is explicitly unvalidated in the record, and two of the three trials are from the robenacoxib manufacturer's programme. Drafted Nov 10, 2026 (VetMed build, topic #744); all figures from the abstract fetched and verified at drafting.

Hillen 2023: after ovariohysterectomy, owner-assessed pain scores at day 3 were significantly higher on robenacoxib than meloxicam (p = 0.005), and more robenacoxib cats showed abnormal behaviours (p = 0.03)

Randomised, prospective clinical trial with blinded assessor (record's own title wording: 'A randomised, prospective clinical trial'; publication type: Randomized Controlled Trial, Veterinary)

Who: Cats: 141 queens undergoing ovariohysterectomy in a clinical setting, randomly assigned to meloxicam 0.2 mg/kg (MEL, n = 76) or robenacoxib 2 mg/kg (ROB, n = 65) by injection. Owners were contacted by a blinded assessor 3 days postoperatively and asked to identify physical or behavioural changes and assign pain scores using a numerical rating scale — reflecting that most cats are discharged within hours of recovery.

Result: More 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). The record concludes both meloxicam and robenacoxib are effective in controlling postoperative pain, that meloxicam may have improved efficacy in certain patient populations, and that a blanket approach to prescribing NSAIDs postoperatively after ovariohysterectomy may not be necessary. The record gives no group mean pain scores.

Watch out: The outcome is owner assessment at home on day 3, and the record itself states methods of owner assessment of pain in cats have not been validated; 72% of owners scored 0, so the significant difference sits on a small minority of non-zero scores. Single injectable doses as tested (meloxicam 0.2 mg/kg vs robenacoxib 2 mg/kg) — not a comparison of multi-day oral courses. One-home note: this record is not carded on Shelf #743 (robenacoxib vs placebo in feline osteoarthritis; PMIDs 33833276, 26058587, 34196973 desk-checked this session) — different comparison and indication, no re-carding.

Hillen F, Polson S, Yates D, Watkinson R, White K. Robenacoxib versus meloxicam following ovariohysterectomy in cats: A randomised, prospective clinical trial involving owner-based assessment of pain. Vet Rec. 2023;193(8):e3264. PMID: 37494365. Registry ID: none in the record. MeSH: Female · Cats · Animals · Meloxicam/therapeutic use · Pain Measurement/veterinary · Prospective Studies · Ovariectomy/veterinary · Hysterectomy*/veterinary · Anti-Inflammatory Agents, Non-Steroidal/therapeutic use · Postoperative Pain/drug therapy, prevention & control, veterinary · Cat Diseases*/drug therapy · Diphenylamine/analogs & derivatives · Phenylacetates

Kamata 2012: a single pre-operative robenacoxib injection was superior to meloxicam on the primary clinician score in 96 surgical cats, mostly ovariectomy (relative efficacy 1.47, 95% CI 1.19-1.78, P = 0.0003)

Prospective, multi-centre, randomised, blinded, non-inferiority clinical trial (record's own wording; publication types include Randomized Controlled Trial, Multicenter Study)

Who: Cats: 96 cats undergoing surgery at eight centres in Japan, allocated randomly to a single subcutaneous injection of robenacoxib 2 mg/kg (n = 67) or meloxicam 0.3 mg/kg (n = 29) shortly before induction of anaesthesia. Most cats underwent soft tissue surgery (n = 87), mainly ovariectomy (n = 68). Postoperative pain and inflammation were assessed at 3, 8 and 22 hours after recovery using numerical rating scales.

Result: For the primary efficacy endpoint (total clinician score), robenacoxib had significantly better efficacy than meloxicam, the relative efficacy ratio being 1.47 (95% confidence interval 1.19-1.78, P = 0.0003; relative measure — the record gives no absolute clinician scores). Robenacoxib was superior on posture, behaviour, pain on palpation and overall pain control, while meloxicam was superior with respect to wound heat. No cat in either group required rescue analgesia. Pain during injection and pain and inflammation at the injection site at 22 hours were rated significantly less with robenacoxib; both treatments were well tolerated with no significant differences in clinical observations or blood tests.

Watch out: A mixed surgical population (only 68 of 96 were ovariectomy) in one country, with unequal group sizes (67 vs 29), a single pre-operative injection, and follow-up to 22 hours only. The superiority claim rests on a relative ratio without absolute scores in the record, and authors include the robenacoxib manufacturer's programme (King JN, Seewald W). Its direction conflicts with Hillen 2023's owner-assessed ovariohysterectomy result — the shelf does not resolve that conflict.

Kamata M, King JN, Seewald W, Sakakibara N, Yamashita K, Nishimura R. Comparison of injectable robenacoxib versus meloxicam for peri-operative use in cats: results of a randomised clinical trial. Vet J. 2012;193(1):114-8. PMID: 22227226. Registry ID: none in the record. MeSH: Animal Welfare · Animals · Cats/surgery* · Cyclooxygenase 2 Inhibitors/therapeutic use* · Diphenylamine/analogs & derivatives*, therapeutic use · Female · Inflammation/drug therapy, etiology, veterinary* · Injections, Subcutaneous/veterinary · Japan · Male · Meloxicam · Ovariectomy/adverse effects, veterinary · Postoperative Pain/drug therapy, etiology, veterinary* · Phenylacetates/therapeutic use* · Preoperative Care/veterinary · Prospective Studies · Thiazines/therapeutic use* · Thiazoles/therapeutic use*

Speranza 2015: robenacoxib was non-inferior to meloxicam for peri-operative pain in 147 cats undergoing orthopaedic surgery (relative efficacy 1.029, 95% CI 0.847-1.231)

Prospective, randomised, active- and placebo-controlled masked clinical trial (record's own wording; publication type: Randomized Controlled Trial)

Who: Cats: 147 cats undergoing orthopaedic surgery in a prospective, randomised, active- and placebo-controlled masked clinical trial. Group 1 (n = 101): robenacoxib 2 mg/kg subcutaneously before surgery, followed by robenacoxib tablets 1-2.4 mg/kg postoperatively for approximately 9 days. Group 2 (n = 46): meloxicam 0.3 mg/kg subcutaneously before surgery, followed by placebo tablets for approximately 9 days. Clinician numerical rating scales before surgery and at 3, 8, 22 and 28 hours and at the final visit (approximately Day 10), plus daily owner assessments; primary endpoint was the global investigator score (sum of clinician scores for posture, behaviour and pain on palpation/manipulation).

Result: The efficacy of the single robenacoxib injection over 3 to 22 hours was statistically non-inferior to meloxicam, with a relative efficacy of 1.029 (95% confidence interval, 0.847-1.231; relative measure). No significant differences were detected during follow-up treatment with robenacoxib tablets for approximately 9 days compared with placebo via clinician assessments at 28 hours and the final visit, or in owner assessments on Days 1 to the final visit. There were no significant differences in frequencies of reported adverse events, clinical observations, or haematology or clinical chemistry variables between groups.

Watch out: Orthopaedic, not ovariohysterectomy or dental, surgery — carded as the third randomised head-to-head in cats, not as evidence about the dental question. The design is asymmetric (robenacoxib injection plus tablets vs meloxicam injection plus placebo tablets), so the follow-up phase compares continued robenacoxib against no further NSAID, not against continued meloxicam. Manufacturer's programme authorship (King JN and colleagues).

Speranza C, Schmid V, Giraudel JM, Seewald W, King JN. Robenacoxib versus meloxicam for the control of peri-operative pain and inflammation associated with orthopaedic surgery in cats: a randomised clinical trial. BMC Vet Res. 2015;11:79. PMID: 25880535. Registry ID: none in the record. MeSH: Animals · Anti-Inflammatory Agents, Non-Steroidal/therapeutic use · Cat Diseases/prevention & control* · Cats · Diphenylamine/adverse effects, analogs & derivatives*, therapeutic use · Female · Hydrocortisone/blood · Inflammation/etiology, prevention & control, veterinary* · Male · Meloxicam · Orthopedic Procedures/adverse effects, veterinary* · Postoperative Pain/prevention & control, veterinary* · Perioperative Period · Phenylacetates/adverse effects, therapeutic use* · Thiazines/adverse effects, therapeutic use* · Thiazoles/adverse effects, therapeutic use*

Synthesis: robenacoxib and meloxicam are both effective in cats, with no consistent winner across randomised trials — POSSIBLE

Synthesis

Who: Synthesis of the cards above: Hillen 2023 (141 cats, ovariohysterectomy, owner assessment at day 3), Kamata 2012 (96 cats, mostly ovariectomy/soft tissue, clinician scores to 22 hours) and Speranza 2015 (147 cats, orthopaedic surgery, clinician and owner scores to ~Day 10) — all randomised head-to-head trials in cats in clinical settings.

Result: (1) Ovariohysterectomy, owner-assessed at home: meloxicam favoured (pain p = 0.005; abnormal behaviours p = 0.03; 72% of all owners scored pain 0). (2) Mostly-ovariectomy, clinician-assessed in hospital: robenacoxib superior on the primary score (relative efficacy 1.47, 95% CI 1.19-1.78). (3) Orthopaedic surgery: robenacoxib non-inferior to meloxicam (relative efficacy 1.029, 95% CI 0.847-1.231). (4) No trial required rescue analgesia differences to separate the drugs (Kamata: no cat in either group required rescue). Conflicting directions across assessor types and settings support POSSIBLE for 'no consistent superiority', not a claim for either drug.

Watch out: No carded evidence addresses dental surgery in cats, multi-day oral meloxicam vs oral robenacoxib courses after ovariohysterectomy, or pain beyond ~10 days. Results are not transported to dogs, to osteoarthritis (Shelf #743's home), or to robenacoxib vs placebo questions. A separate randomised blinded timing trial (PMID: 38235901, meloxicam or robenacoxib given at admission, induction or end of surgery in 60 ovariohysterectomy cats) was not carded: its question is administration timing and renal markers, not which drug gives better analgesia, though it found admission groups received earlier rescue analgesia (p = .033) and no drug/timing effect on renal markers.

Synthesis of Hillen F et al. PMID: 37494365; Kamata M et al. PMID: 22227226; Speranza C et al. PMID: 25880535. Registry IDs as on the individual cards.

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