By Dayna Locitzer, DVM
It is a very exciting prospect that meloxicam might soon be allowed for use in organic dairy! This is an important pain medication that will expand the medical toolbox we have for treating organic cows. Meloxicam is a non-steroidal anti-inflammatory drug (NSAID) that is used in a variety of different ways on conventional dairies to improve animal welfare by helping to manage pain. Currently, the only other NSAID allowed for use in organic dairy is flunixin meglumine (more commonly known as Banamine), but because of slight differences in chemical composition they have different uses. Approving meloxicam will provide more options and, I think, better care for our dairy cows.
Currently, the only form of meloxicam that we can use in dairy cattle in the United States is an oral tablet obtained through a veterinary prescription. The medication typically comes in 15mg tablets. The dose for a cow is 1mg/kg, so that means a 1,200lb (545kg) Jersey would need 545mg, or 36 pills. While that might seem like a lot, I have easily administered this many pills to cows in a variety of different ways. I have sandwiched them between a bagel, I have cored out an apple and filled the center with pills, but most conveniently I have filled empty cow bolus gel capsules and used a balling gun to administer.
Meloxicam is used on conventional dairies for pain management after diagnosis of a known painful condition. It is most commonly used for pain associated with disbudding calves. When using cautery to remove horn buds on calves, 45mg of meloxicam can be administered to provide pain relief after the lidocaine nerve block has worn off. Additionally, it is becoming more common to use meloxicam in lactating animals since there has been a researched milk withhold established. Meloxicam has become the pain medication of choice for difficult calvings (for the cow and the calf) and for musculoskeletal injury.
There are important reasons why meloxicam is used over flunixin in the aforementioned situations. While they are both good at pain management, their different properties lend these two drugs to different uses. Meloxicam is what is known as a COX-2 inhibitor, meaning the inflammation that it inhibits is more specific and targeted. This means that meloxicam does not have the unwanted side effects of stomach upset, uterine malfunction, and kidney damage that flunixin has. For example, a difficult calving can be very painful for a cow, and it would be beneficial to treat her pain. Flunixin has proven to cause increased risk of retained placenta and delayed time to uterine involution. Meloxicam has none of those side effects, making it a useful drug in that situation. Meloxicam also has a longer duration of action, so one dose can last up to 4 days versus an injection of flunixin, which is effective for no more than 24 hours. Flunixin also must be administered intravenously. This is in contrast to the oral administration of meloxicam, a potentially more convenient route.
While there is exciting potential if meloxicam were to be approved, it is also important to understand the limitations of this medication. On conventional dairies, the milk withhold for meloxicam is 5 days and the meat withhold is 21 days. The current proposal for organic milk and meat withhold is 10 days and 42 days respectively. This is in contrast to flunixin, which has a milk withhold of 72 hours and meat withhold of 8 days on organic farms. Flunixin is also a better medication for conditions such as fever, colic and toxic mastitis. This is because flunixin is an effective fever reducer, can calm GI spasms, and has powerful anti-endotoxic properties. And it is important to note that meloxicam does not have a label for food animals and any use of it would be “extra-label”. This means that it is very important that the use of this drug needs to occur in close concert with veterinary direction.
Good animal welfare is a central tenet of organic dairy, as is the exclusion of harmful chemicals, hormones, pesticides and antibiotics. The inclusion of meloxicam among the products approved for organic dairy will enhance animal welfare without violating these important standards. Should meloxicam receive the green light for organic, this change would be welcomed by the veterinary community, so please let your practitioner know when it happens!
