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Metacam and Ranetidine advice needed please

Luciuslop

Luciuslop

Alpha Buck
Mr Bigwig - pictured below- is 6 years old :love::love: Really good age for a Frenchman.

Anyway, he started Metacam a week ago and I also asked for some Ranetidine. The Metacam has really helped him and he's even been climbing on the bales of hay again :D. He went back for a check-up today.Our vet, who is a small animal specialist ( ZooMed cert ), had made the point of looking up use of and side effects of Metacam and Ranetidine in rabbits. He said that Ranetidine can lower the PH balance in the rabbits gut and lead to GI disturbances and breeding of ' bad ' bacteria. He had spoken to several vets and researchers about this. It seems that some rabbits using Metacam without Ranetidine did NOT develop any GI ulcers. However,while some rabbits using Metacam and Ranetidine did NOT develop any PH gut balance problems some DID. It was unclear as to whether Ranetidine is really useful.

Vet said it was up to me whether I want to continue to use Ranetidine with the Metacam. Anyone got any advice about this, please ?


003.jpg
 
What a beautiful bunny :love:

I don't have any advice as such but this is what I have used in the past.

I do not routinely use ranetidine when my bunnies are on Metacam , and some of them have been on high doses for a long time. However a couple of bunnies do have sensitive tummys with the Metacam so when they need it I give ranetidine at the same time and they tolerate it well.

I always use ranetidine in cases of stasis with excellent results and have also used it successfully on bunnies with bleeding stomach ulcers :)
 
Hugo's There said:
What a beautiful bunny :love:

I don't have any advice as such but this is what I have used in the past.

I do not routinely use ranetidine when my bunnies are on Metacam , and some of them have been on high doses for a long time. However a couple of bunnies do have sensitive tummys with the Metacam so when they need it I give ranetidine at the same time and they tolerate it well.

I always use ranetidine in cases of stasis with excellent results and have also used it successfully on bunnies with bleeding stomach ulcers :)
Click to expand...

He is indeed a beautiful bunny :love::love: He has such a lovely nature, too - not a bad bone in his body.

My vet suggested that it would be the Ranetidine that would cause a problem rather than the Metacam. It makes sense though that Ranetidine would be used for upset tums. He said if Wigs should get a bad bum it would be down to the Ranetidine and to discontinue it. He was on 0.3mls twice a day, but vet said to cut it back to 6-7 drops once a day in morning, which is when Wigs is most active.
 
I have never had any problems with gut dysbiosis when using Ranitidine.
The only time I have questioned its use is for a Bun on Depocillin Injections.
In this case me and my Vet decided not to use Ranitidine as Depocillin is a high risk abx anyway and we both agreed that adding Ranitidine may be a risk too far.

I have a Bun with a chronic gut problem and I can honestly say that Ranitidine has saved his life on more than one occassion :)
 
This is a good question as there are potential issues with ranitidine and disruption of normal digestion in rabbits. Firstly there is little written about gastric ulceration in rabbits. Post mortem samples identifying surface ulcers have been found to have little or no inflammation surrounding them which indicates that thay may have developed as the animal died (agonal) and not have been there before. The pH of a rabits stomach secretions is around 2 and this is to sterilise stomach contents of bacteria as they enter the intestines. Is this evolutionary significant? I think a rabbits digestive system is so specialised that it must be. Rabbits depend on a fine balance of the correct type of bacteria to digest their diet and the stomach seems to act as a "gatekeeper" to make sure that only the right ones (caecotrophs) get through. Because of the high acidity of the stomach I would be surprised if there were no intrinsic mechanism to protect the stomach lining.

In contrast to other species, acid secretion is not stimulated by feeding in rabbits. Feeding does stimulate digestive enzyme secretion (pepsin and lipase). Ranitidine decreases acid secretion by 73% and pepsin secretion by 37% so there is an argument that the decreased pepsin secretion will lead to alterations in digestion; and the lowering of acidity of the stomach may lead to a loss of the protective effects of a strong acid on colonisation of the intestinal tract by inappropriate bacteria. Both these effects may potentially cause problems.

I think the answer is to use any drug as it is required and based on clinical response. It must be born in mind that any drug has potential issues and if we judge each case on its own merits we are less likeley to fall into any pitfalls
Hope this helps
 
rodneyvet said:
This is a good question as there are potential issues with ranitidine and disruption of normal digestion in rabbits. Firstly there is little written about gastric ulceration in rabbits. Post mortem samples identifying surface ulcers have been found to have little or no inflammation surrounding them which indicates that thay may have developed as the animal died (agonal) and not have been there before. The pH of a rabits stomach secretions is around 2 and this is to sterilise stomach contents of bacteria as they enter the intestines. Is this evolutionary significant? I think a rabbits digestive system is so specialised that it must be. Rabbits depend on a fine balance of the correct type of bacteria to digest their diet and the stomach seems to act as a "gatekeeper" to make sure that only the right ones (caecotrophs) get through. Because of the high acidity of the stomach I would be surprised if there were no intrinsic mechanism to protect the stomach lining.

In contrast to other species, acid secretion is not stimulated by feeding in rabbits. Feeding does stimulate digestive enzyme secretion (pepsin and lipase). Ranitidine decreases acid secretion by 73% and pepsin secretion by 37% so there is an argument that the decreased pepsin secretion will lead to alterations in digestion; and the lowering of acidity of the stomach may lead to a loss of the protective effects of a strong acid on colonisation of the intestinal tract by inappropriate bacteria. Both these effects may potentially cause problems.

I think the answer is to use any drug as it is required and based on clinical response. It must be born in mind that any drug has potential issues and if we judge each case on its own merits we are less likeley to fall into any pitfalls
Hope this helps
Click to expand...

Thats very interesting.

So does that mean you wouldn't routinely prescribe Ranitidine with Metacam? I know most people on here say it is vital, but I have never given it to my buns on Metacam and many have been on high doses for months on end some even a year and have shown no ill effects :?
 
As I said. Its a case of judging each case on its own merits. Some patients are on high dose long term treatment and there is a case to say that H2 antagonists such as ranitidine may be helpful. I know Francis HB uses ranitidine and I prescribe it for some cases. For short courses of metacam I tend not to unless i have some clinical indication that it may be required. Dogs that are on metacam for several years for arthritis do not in the main require h2 antagonists but some do. Unless there is a concern to me I tend not to use it alongside metacam at a low to standard dose.
Hope this makes sense:D
 
rodneyvet said:
This is a good question as there are potential issues with ranitidine and disruption of normal digestion in rabbits. Firstly there is little written about gastric ulceration in rabbits. Post mortem samples identifying surface ulcers have been found to have little or no inflammation surrounding them which indicates that thay may have developed as the animal died (agonal) and not have been there before. The pH of a rabits stomach secretions is around 2 and this is to sterilise stomach contents of bacteria as they enter the intestines. Is this evolutionary significant? I think a rabbits digestive system is so specialised that it must be. Rabbits depend on a fine balance of the correct type of bacteria to digest their diet and the stomach seems to act as a "gatekeeper" to make sure that only the right ones (caecotrophs) get through. Because of the high acidity of the stomach I would be surprised if there were no intrinsic mechanism to protect the stomach lining.

In contrast to other species, acid secretion is not stimulated by feeding in rabbits. Feeding does stimulate digestive enzyme secretion (pepsin and lipase). Ranitidine decreases acid secretion by 73% and pepsin secretion by 37% so there is an argument that the decreased pepsin secretion will lead to alterations in digestion; and the lowering of acidity of the stomach may lead to a loss of the protective effects of a strong acid on colonisation of the intestinal tract by inappropriate bacteria. Both these effects may potentially cause problems.

I think the answer is to use any drug as it is required and based on clinical response. It must be born in mind that any drug has potential issues and if we judge each case on its own merits we are less likeley to fall into any pitfalls
Hope this helps
Click to expand...

This is very interesting reading.Thank you for posting it
 
rodneyvet said:
As I said. Its a case of judging each case on its own merits. Some patients are on high dose long term treatment and there is a case to say that H2 antagonists such as ranitidine may be helpful. I know Francis HB uses ranitidine and I prescribe it for some cases. For short courses of metacam I tend not to unless i have some clinical indication that it may be required. Dogs that are on metacam for several years for arthritis do not in the main require h2 antagonists but some do. Unless there is a concern to me I tend not to use it alongside metacam at a low to standard dose.
Hope this makes sense:D
Click to expand...

Thank you :D
 
My Vet agrees that its not a one-size-fits-all when prescribing any drug and each case needs to be assessed individually :)

I will continue to use Ranitidine (as prescribed by my Vet) for anyBun on longterm oral Metacam. I will also continue to use it (as prescribed by my Vet) for cases of GI stasis :)
 
I am particularly interested in this one because so many of my buns are on pain relief, but especially because of Flint.

Flint is a 2.75kg bun who up until this time last year was a repeated stasis bunny. Sometimes he would be in stasis upto 3 or 4 times a week, sometimes for a few hours other times a day and became very depressed
We tried him on courses of zantc, antepsin and low level metacam but nothing worked.

After my vet went to the RWA conference and found out about higher metacam doses we put Flint on to 0.6ml 2 x daily. After some adjusting this was the lowest dose he can survive on without bouts of stasis. It has been said to me by other bunny owners that this is too high, but he has been on this dose for nearly a year without any other medication and hasn't had a single bout of stasis :)

Should add he has an inoperable abdominal tumour that didn't initially show up on x-rays
 
My bridge bun Goofball (5 to 7.1 KG) who passed away due to dental complication was on metacam from May 2007 till May 2008. There is no GI ulcer or any problem of using metacam at the beginning. However, around May 2008, I have to use Ranitidine to offset the effect of Metacam

If your bun is using metacam for short run, there shouldn't be any need to use Ranitidine.
 
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