I’ve participated in a Yahoo Group for feline renal failure for many years, and believe me the Metacam issue is not “hysteria”. There are a huge number of cats who have been driven into severe and permanent renal failure by this drug, usually after receiving more than the single dose that the current prescribing information gives as the limit, but in a few cases just from a single dose. If the kidneys are damaged enough that you start seeing blood in the urine, with cats at least, it’s already too late. The problem seems to be much more serious in cats than dogs, and I think part of the problem is that many vets try to transfer their experience with using it in dogs, to cats. In the vast majority of cases, there was no good reason for the cat to have received even a single dose. The better vet hospitals are now using Fentanyl patches pretty routinely for post-surgical pain.
Fentanyl is very effective for pain, but to my knowledge has no potential “off label” benefit for cancer treatment, palliative or otherwise, unlike Metacam. I do know that cats and dogs react quite differently to certain medications, and some that are quite good and very safe for dogs, are problematic for cats.
I honestly can only speak for my own dog, Woody, who passed away in October of 2007. Metacam was a godsend for him, and it, in part, enabled us to have a year together that we otherwise would not have had. He was happy as a clam, and had better mobility and higher spirits during the time of his treatment, right up to his death, than he had had for at least a year prior to that point. I loved him dearly, and still do. I did everything I could for him, short of making him feel any more discomfort than he already did. A “cure” for him was out of the question, as the cancer had metastasized when discovered, so we/I chose the palliative route. I don’t regret it at all.