Piroxicam for Dogs – TCC + Oncology NSAID
Piroxicam is an oxicam NSAID with documented anti-neoplastic activity in canine TCC bladder cancer, SCC, and prostatic carcinoma.
Dose
0.3 mg/kg PO every 24-48 hours
Indications
- TCC bladder (~75% stable/partial response)
- SCC oral (~10-15% response)
- Prostatic carcinoma (palliative)
âš Higher Toxicity than Newer NSAIDs
- Higher GI ulcer risk than COX-2 selective (carprofen, meloxicam, Galliprant)
- GI protection ESSENTIAL
- Misoprostol 2-5 mcg/kg PO q8h
- Omeprazole 1 mg/kg PO q24h
Common Combinations
- + Mitoxantrone (TCC)
- + Vinblastine (TCC)
- + Carboplatin
Contraindications
- Concurrent steroids (severe GI ulcer)
- Other NSAIDs
- Existing GI ulceration
- Severe renal disease
- Coagulopathy
- Pregnancy
Monitoring
- Baseline CBC, chemistry, UA, BP
- Every 2-4 weeks initially
- Cystoscopy/ultrasound for TCC response
- Quality of life assessment
Frequently Asked Questions
How much piroxicam for my dog with bladder cancer?
STANDARD ONCOLOGY DOSE: 0.3 mg/kg PO every 24-48 hours. EXAMPLES: 1) 10 kg = 3 mg; 2) 20 kg = 6 mg; 3) 30 kg = 9 mg. Often combined with mitoxantrone or vinblastine chemotherapy. GI PROTECTION ESSENTIAL with misoprostol 2-5 mcg/kg q8h or omeprazole 1 mg/kg q24h. Monitor renal values every 2-4 weeks initially. Watch for melena, hematemesis, anorexia. Median survival TCC 6-12 months with treatment. Discuss with veterinary oncologist for personalized protocol.
Why use piroxicam instead of carprofen or meloxicam?
ANTI-NEOPLASTIC EFFECT specific to piroxicam. Inhibits COX-2 which is overexpressed in transitional cell carcinoma + squamous cell carcinoma + prostatic carcinoma. Induces apoptosis in tumor cells. Documented response in 75% of TCC cases. Newer NSAIDs (carprofen, meloxicam, Galliprant) DO NOT have established anti-neoplastic activity. For routine arthritis pain, NEWER NSAIDs are SAFER (less GI/renal toxicity). Piroxicam reserved for ONCOLOGY indications where benefit outweighs higher toxicity risk.
What are piroxicam side effects in dogs?
GI ULCERATION + PERFORATION significantly more common than newer NSAIDs. RENAL TOXICITY. SIGNS: 1) Vomiting; 2) Anorexia; 3) Melena (black tarry stool – upper GI bleed); 4) Hematemesis (vomiting blood); 5) Lethargy; 6) Increased BUN/Cr. MANAGEMENT: 1) GI PROTECTION mandatory (misoprostol, omeprazole, sucralfate); 2) NEVER combine with steroids; 3) Stop at first GI signs; 4) Monitor bloodwork every 2-4 weeks; 5) Discontinue if renal values rise significantly; 6) Lower dose if dose-related effects; 7) Hospitalize for severe complications. CONTRAINDICATIONS: existing GI ulcer, severe CKD, concurrent steroids, coagulopathy, pregnancy. Work with veterinary oncologist for safe protocol.
Related PuppaDogs Calculators
Continue building your dog’s personalised care plan with these related PuppaDogs calculators:
- Dog Pregnancy / Whelping Due-Date Calculator
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References & Further Reading
The dosing ranges and safety information on this page are drawn from the following veterinary references. Always defer to your own veterinarian and the manufacturer’s label for your specific product.
- Plumb DC. Piroxicam.
- Knapp DW et al. Piroxicam therapy in canine TCC. JAVMA.
- Henry CJ. Bladder cancer in dogs.
- Withrow & MacEwen’s Small Animal Clinical Oncology.
- PuppaDogs. TCC Calculator, Carprofen Calculator. puppadogs.com.
