Metacam is a wonderful reliever of pain and inflammation and is used a great deal in the treatment of arthritic dogs. The new advice sheet however suggests it needs monitoring carefully where there is a risk of liver failure or certain other conditions. Some suggestions include giving Zantac to prevent duodenal ulcers in some cases and perhaps glucosamides, if treating for arthritis to support the cartilage.

It appears that the risks were measured at around 1:10,000 which doesn't sound too bad. Presumably the risks are very much less if the owners and vets know how to modify the dangers around these powerful pain killers or to change to something else if problems arise.