Im confused with the syringe the vets given me???

Twinkles been on meloxidyl for a week, ive used the syringe provided that has marks of 1 - 7 along the length then KG at the end, obviously doseage is per kg of animal, Twinkle weighs 2.5kg but as this medication is generally for dogs and cats shes only been having up to the number 1kg mark.

The difference in her mobility has been amazing so today weve been back to discuss long term use of it. The vets given me a different syringe and said to do 0.6ml for 2 weeks then drop to 0.4ml.

Ive come home and filled both syringes to the points that they are supposed to be, so ones at 1kg and the others at 0.6ml. The idea being that the 0.6ml is less than what shes on currently.

But its not. The 0.6 is loads more than the 1kg so Im really worried. Twinkle hasnt had any yet so its ok that way but Im now waiting for the vet to ring back and discuss it.

So I have a kg syringe and a ml syringe at the moment.

The vets rung. The kg syringe shouldnt have been used at all, she should have had the ml syringe. So the amount shes been getting has been minimal probably about 0.2ml which the vet says will have only maybe taken the edge off the symptoms.

I have been told to now just give her 0.4ml with the new syringe for a month so shes actually increasing her dose then the longterm thing is to reduce slowly and see how she does. this seems a bit wrong way round to me??

She says that with 0.4ml she will be getting full benefit of the drug. Shes already like a different bunny but I suppose being a prey animal she could be putting on a brave front, feeling better than she was but still not 100%.

I have a Meloxidyl syringe for Cassie. It's nothing like the same as a 1 ml syringe, so you've either got to measure in ml or use the kg marks that the vet prescribes.

1 kg is a teeny tiny dose! I'm confused as to why the vet would have prescribed that in the first place.

SarahP said:

I have a Meloxidyl syringe for Cassie. It's nothing like the same as a 1 ml syringe, so you've either got to measure in ml or use the kg marks that the vet prescribes.

1 kg is a teeny tiny dose! I'm confused as to why the vet would have prescribed that in the first place.

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Its because its not licienced for rabbits so I think its a case of less is more really.

madcatwoman said:

Its because its not licienced for rabbits so I think its a case of less is more really.

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:wave: I don't think it's that, it's well known that rabbits have a much higher (typically 5 times) dose of meloxicam than dogs. I think they just messed up. We've been told to dose at 5 times the weight using the dog syringe so we dose a 2kg rabbit as if it were a 10 kg dog.

Yes, my vet is incredibly cautious with it (too cautious in my view - another vet used to prescribe me over twice the amount), and Cassie the guinea pig is on 2 and a third a day of that syringe. She weighs about 1200 g.

If the 0.6 ml is supposed to be less, then surely they meant to prescribe 1 ml.

SarahP said:

Yes, my vet is incredibly cautious with it (too cautious in my view - another vet used to prescribe me over twice the amount), and Cassie the guinea pig is on 2 and a third a day of that syringe. She weight about 1200 g.

If the 0.6 ml is supposed to be less, then surely they meant to prescribe 1 ml.

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I think now being logical that she thought the original kg syringe was a ml one. so yes human error. Im going to give her 0.4ml tonight using the latest ml syringe, ive thrown the kg one away. Im sorry I presumed Cassie was a dog or cat.

I think maybe its me being a bit blonde too but Im glad I checked with them

SarahP said:

If the 0.6 ml is supposed to be less, then surely they meant to prescribe 1 ml.

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That's what I understood from madcatwoman's 2nd post. :thumb:

The original dose should have been 1ml, with the aim of decreasing that slowly to a level that's enough to deal with Twinkle's pain - and I think it's pretty normal to do it that way round (start with a high dose and then lower). But, as she'd only been actually receiving a 1kg dose (around 0.2ml) they've actually now increased the dose to 0.4ml (so double what she's been on up until now).

Is it the dog or cat metacam you were given, as they're different strengths? The recommended dosage is 0.3 to 0.6 mg/kg, which (for the dog metacam) is 0.2 to 0.4ml/kg. That equates to a 0.5ml to 1ml dosage for a 2.5kg bunny. http://wildpro.twycrosszoo.org/S/00Chem/ChComplex/Meloxicam.htm So (if you were given dog strength metacam) it looks as though (not taking into account the mix up with syringes) the vet had prescribing the max. dose to begin with, which is what I would expect. I believe some vets have also been using even higher dosages than those in the link too. I hope that all makes sense. :lol:

I think it can be hard to assess whether the dosage is enough but, when Bubbles was on metacam long-term, I could only really judge by her behaviour and I could tell that the full dose was enough to keep her comfortable but, when we tried reducing it, she was a little quieter and so I felt that it wasn't doing the job and the vet agreed it would be more beneficial to keep her on the maximum.

KarenM said:

That's what I understood from madcatwoman's 2nd post. :thumb:

The original dose should have been 1ml, with the aim of decreasing that slowly to a level that's enough to deal with Twinkle's pain - and I think it's pretty normal to do it that way round (start with a high dose and then lower). But, as she'd only been actually receiving a 1kg dose (around 0.2ml) they've actually now increased the dose to 0.4ml (so double what she's been on up until now).

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Looking at the syringe, I'd say the 1 kg dose is less than 0.1 ml (I haven't measured it though). It's amazing that your bunny has improved on so little.

SarahP said:

Looking at the syringe, I'd say the 1 kg dose is less than 0.1 ml (I haven't measured it though). It's amazing that your bunny has improved on so little.

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Going by the dog strength and dosage rates, I think you're right actually - 1kg is probably around 0.1ml. :thumb:

KarenM said:

Going by the dog strength and dosage rates, I think you're right actually - 1kg is probably around 0.1ml. :thumb:

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It was a very tiny amount when it was the 1kg syringe. Its meloxidyl which I presume is similar to metacam. I was definately given the wrong syringe initially.

She was supposed to start it last Friday but on that morning she was fine and to be honest I forgot, when I remembered she was still ok so I decided to wait. Saturday afternoon she was back to being poorly, not eating not moving. Within half an hour of giving her the tiny dose she was up and hopping, within the hour she was eating. This makes me think that its definately a pain/joint issue. I have then given her this tiny dose daily till our revisit to the vet this morning.

So she is now going to have 0.4ml a day after long discussion on the phone to the vets, she will either be totally out of it in a drug induced slumber or bouncing to the moon and back, Im hoping for the latter!

My only other experience is from years ago with a 4.5kg frenchie that was on a syringe full twice daily but I cant remember how big the syringe was its so long ago so I just accepted that as Twinkle is half that size and its a slightly different drug that the amount was correct. I feel awful thinking that she might still have been uncomfortable all week. Shes been manipulated alot at the vets this morning and the conclusion was that without xrays/blood test and big bills the assumption is that its old age arthritic pain. It doesnt help that before we got her she was kicked about alot so its to be expected that she has these issues, poor little girl.

So the chat on the phone concluded that she has 0.4ml daily till 18th June when she goes back, then they will review dropping it to 0.2ml daily as the weather will hopefully be warmer and her mobility better as a result. Its then a case of monitoring it and adjusting accordingly. At least I know now that theres plenty of room for increasing dosage when she gets older and stiffer. My frenchie was only on it a few months before her legs completely went and we had to pts. My daughter is hoping that Twinkle is with us for a couple more years at least.

KarenM said:

That's what I understood from madcatwoman's 2nd post. :thumb:

The original dose should have been 1ml, with the aim of decreasing that slowly to a level that's enough to deal with Twinkle's pain - and I think it's pretty normal to do it that way round (start with a high dose and then lower). But, as she'd only been actually receiving a 1kg dose (around 0.2ml) they've actually now increased the dose to 0.4ml (so double what she's been on up until now).

Is it the dog or cat metacam you were given, as they're different strengths? The recommended dosage is 0.3 to 0.6 mg/kg, which (for the dog metacam) is 0.2 to 0.4ml/kg. That equates to a 0.5ml to 1ml dosage for a 2.5kg bunny. http://wildpro.twycrosszoo.org/S/00Chem/ChComplex/Meloxicam.htm So (if you were given dog strength metacam) it looks as though (not taking into account the mix up with syringes) the vet had prescribing the max. dose to begin with, which is what I would expect. I believe some vets have also been using even higher dosages than those in the link too. I hope that all makes sense. :lol:

I think it can be hard to assess whether the dosage is enough but, when Bubbles was on metacam long-term, I could only really judge by her behaviour and I could tell that the full dose was enough to keep her comfortable but, when we tried reducing it, she was a little quieter and so I felt that it wasn't doing the job and the vet agreed it would be more beneficial to keep her on the maximum.

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My goodness this has got my head spinning. Its Meloxidyl 1.5mg/ml contains 1.5mg of melixicam and 2mg of sodium benzoate. Theres a picture of a dog on the front.

I thought I might confuse you. :lol:

Metacam and Meloxidyl are the just different brand names for the same drug - meloxicam. It's the dog strength that you've been given so the maximum dose (according to the link) Twinkle could have daily is 1ml.

If you were noticing a difference with even the tiny dose she was having then I think it sounds reasonable to go with the vet's advice and try the 0.4ml, then reduce to 0.2ml. Like you say, there is then the option to increase the dose at a later date or during the winter months if you notice that the low dose is no longer helping.

Rabbits have a faster metabolism than dogs too (meaning the drug leaves their system a lot faster) so you could also have a chat with your vet about splitting the dose and giving twice daily if you begin to notice that the pain relief effects seems to tail off by late afternoon, say.

KarenM said:

I thought I might confuse you. :lol:

Metacam and Meloxidyl are the just different brand names for the same drug - meloxicam. It's the dog strength that you've been given so the maximum dose (according to the link) Twinkle could have daily is 1ml.

If you were noticing a difference with even the tiny dose she was having then I think it sounds reasonable to go with the vet's advice and try the 0.4ml, then reduce to 0.2ml. Like you say, there is then the option to increase the dose at a later date or during the winter months if you notice that the low dose is no longer helping.

Rabbits have a faster metabolism than dogs too (meaning the drug leaves their system a lot faster) so you could also have a chat with your vet about splitting the dose and giving twice daily if you begin to notice that the pain relief effects seems to tail off by late afternoon, say.

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Thank you for you advice and your patience with me.