Clinical evaluation of the effectiveness of meloxicam in acute spinal cord trauma in cats and dogs

Acute spinal cord injury is a nervous system pathology that follows a progressive pathophysiological process with secondary damage occurring after trauma, which is encountered frequently. Various medical treatment options are being investigated in order to inhibit neurodegenerative events that cause clinical findings and reduce secondary neuronal damage. As a result of the National Acute Spinal Cord Injury Studies (NASCIS), it was stated that methylprednisolone has beneficial effects if used within the first three hours after the trauma occurs; however it has been also reported that methylprednisolone application 8 hours after trauma can cause serious complications such as pneumonia, immunosuppression, secondary infection, and sepsis and does not provide sufficient improvement in motor functions and its use is not recommended after that period. As a result of several different experimental studies, it has been reported that non-steroidal anti-inflammatory drugs also can (NSAIDs) provide functional recovery in acute spinal cord injury. Our study aimed to evaluate the clinical effectiveness of meloxicam, an NSAID, in cases with acute spinal cord trauma. The material of the thesis study consisted of 50 cases, 25 cats and 25 dogs with complaints of weakness, wobbly gait (ataxia), difficulty in walking, paralysis, cervical or lumbal pain and diagnosed with acute spinal cord trauma. Examinations and follow-ups were performed with neurological examination, Texas Spinal Cord Injury Score and Modified Frankel Scoring System scales, and 1.5 Tesla MRI devices were preferred for Magnetic Resonance Imaging (MRI) of the cases. Cases that did not require decompression, reduction and mechanical stabilization, did not accept the operative treatment option, and were not suitable for operative intervention due to systemic disease, multiple trauma or secondary complications were included in the experimental group. The cases which no treatment other than analgesia and supportive treatment were applied were included in control group. The first examination data of the cases were evaluated as day 0, and score evaluation and neurological examination were performed on the cases in both groups on days 3, 7, 14 and 30. Meloxicam injection was administered to cats in the experimental group at a dose of 0.1 mg/kg and to dogs at a dose of 0.2 mg/kg, and it was repeated every 24 hours during the treatment. It was determined that 10 of 15 cases in the cat experimental group showed improvement but could not gain full motor function, 5 cases showed full recovery, while the average initial TSCIS score of the group was 2.2/10, the average score at the end of the experiment reached 8.80/10 (p<0.001). In dogs, while partial recovery was observed in 7 of 15 cases evaluated in the experimental group, motor functions were completely recovered in 8 cases, while the average initial TSCIS score of the group was 4.20/10, it reached 9.20/10 at the end of the experiment (p<0.05). As a result of this study, there was a positive increase in the scores of the cases, improvement of motor functions was detected, pain control was achieved, and no mortality or morbidity was encountered due to the treatment; meloxicam was found to be clinically effective in acute spinal cord injury in cats and dogs.