Would you give a test dose of metacam to siblings of one who reacted?

:wave:

Between us, Lou and I have 6 bunny siblings from 2 litters (same parents). The biggest one has been spayed, but she had a horrendous reaction we think to the metacam. She came down with profuse diarrhoea, which started with wet sloppy poops half an hour after the second dose and got progressively worse until it was pouring out of her. It slowly got back to sloppy splats over the course of the day (constant syringe feeding/fluids at my vets) and was back to normal the following night.

Typically, this happened to the first one of the six. Was it just a very unlucky one-off, or could it be something genetic that means one or more of the others will react the same?

Having discussed this (including with trusted vets) we have come up with two options. We can either avoid metacam altogether for all of them and instead use opiates for the boys and cartrophen (so it also has some anti inflammatory effect) for the girls. But we know that metacam would ideally be the drug of choice due to its ease of dispensing and use and non-sedating effects.

The other option is to give one of the bunnies a test dose of metacam alongside ranitidine to protect the stomach - so try it in a controlled manner when they are healthy and there isn't a wound to risk infecting.

I really don't know what to do! I don't really want any of them to be a guinea pig for something that might make them poorly (although I suspect it was a one off that won't be repeated) but on the other hand it would be better for them in the long run and for any future needs if we know they are ok with metacam. Might it also make them harder to rehome if we don't know if they can have metacam?

What would you do? I genuinely don't know what to do, so I'd be interested in your thoughts.

i would do a controlled test. i think that in the long run it would benefit them the most as it would make decisions at critical times easier and quicker.

I have said test dose too providing you have a healthy one to test on. Its possible it was just a reaction to the op, to the GA to something else so at least this way you can confirm if it is the metacam and make a decision. Good luck

^... What she said!!!

Good luck x

I would test a small dose (eg 1 drop) on a healthy sibling - maybe from the other litter. If OK, repeat a few days later with a normal dose. If OK, test another sibling until they are all tested. Hopefully you will either see the effects at a minimal dose and avoid metacam forever for these buns, or test each of them in turn to see if any react and stop if there is any doubt. If the reaction is that severe, it should be an easy decision, but one that I think is worth knowing the answer to if done in a controlled manner.

There are a lot of variables that could have caused the reaction, especially as the first one was a female and therefore a more invasive op. Finding out if it was metacam could be very useful for their future wellbeing - although if metacam is proved to be OK, it still leaves a query as to what caused the original reaction and there's the chance that you may never find out.

I would definitely try a controlled test too. Really hoping it isn't an issue for all of them.

Yes it may be that we'll never know what caused it. The metacam seems the prime suspect because she had the op in the morning, had a dose of metacam in the evening, wasn't really eating or producing any output overnight, but within half an hour of the morning dose, it started appearing in wet blobs and then shortly after that pouring forth. Initially my vet was considering a latent cocci infection which had been triggered by the op, but because of the pattern of it starting so suddenly and being hideous for several hours before clearing back up to normal, it seems more likely that it was the metacam. She was pretty cheerful and bouncy throughout - not acting like a poorly bun at all. She did also have metaclopromide but my vet in discussion with an exotics specialist concluded that the metacam was the much more likely suspect - and two of the siblings have already had metaclopromide for other reasons and have been fine with that.

I like the idea of starting with a very low dose as an initial tester and then trying a full dose later on if that seems ok. The affected bun was a black and white butterfly marked bunny and they do seem to be genetically funny about some things, so maybe I'll try it on one of the non-black-and-white ones first.

Something else to consider with the reaction to metacam, is that it may not be the active ingredient meloxicam that caused the reaction, but it possibly could have been the suspension syrup that the meloxicam is mixed with, which I believe contains artificial sweeteners including xylitol(presuming it was the metacam suspension that you used and it has the same ingredients as in the US). An alternative that could be tried is using the injectable form given orally, so it wouldn't have these added sweeteners.

Jbun said:

Something else to consider with the reaction to metacam, is that it may not be the active ingredient meloxicam that caused the reaction, but it possibly could have been the suspension syrup that the meloxicam is mixed with, which I believe contains artificial sweeteners including xylitol(presuming it was the metacam suspension that you used and it has the same ingredients as in the US). An alternative that could be tried is using the injectable form given orally, so it wouldn't have these added sweeteners.

Click to expand...

That's a good point. There is something about it that animals seem to like...

Yes that's a really good point - it may well have been exactly that which caused the vets to conclude that it was the metacam (as in the product as a whole) which caused it. Something like xylitol would be a prime suspect, wouldn't it. I'll have a rummage and see if I can find the leaflet. I suppose the worry with that is that there may well be a whole heap of other meds which might contain similar artificial sweeteners!

Santa said:

Yes that's a really good point - it may well have been exactly that which caused the vets to conclude that it was the metacam (as in the product as a whole) which caused it. Something like xylitol would be a prime suspect, wouldn't it. I'll have a rummage and see if I can find the leaflet. I suppose the worry with that is that there may well be a whole heap of other meds which might contain similar artificial sweeteners!

Click to expand...

Is it Metacam or Meloxidyl that she had? I have an old box of Meloxidyl here (will check for a leaflet).

edit: only seem to have the bottle - no box and leaflet.

I've just thought: it surely can't be xylitol, as dogs can't eat that.

Santa said:

Yes that's a really good point - it may well have been exactly that which caused the vets to conclude that it was the metacam (as in the product as a whole) which caused it. Something like xylitol would be a prime suspect, wouldn't it. I'll have a rummage and see if I can find the leaflet. I suppose the worry with that is that there may well be a whole heap of other meds which might contain similar artificial sweeteners!

Click to expand...

Like infacol. Though it doesn't contains xylitol. With xylitol being so bad for animals to be given, I don't know why the metacam manufacturer feels it necessary to include it, but supposedly it is supposed to be a very small amount.

Not sure if you'll have much luck finding the inactive ingredients listed. They seem to feel they have to keep it secret or something(here in the US anyways). It seems that if you want to find out the inactive ingredients, you have to contact the FDA here to get them.

SarahP said:

Is it Metacam or Meloxidyl that she had? I have an old box of Meloxidyl here (will check for a leaflet).

Click to expand...

Another good point - it was probably meloxidyl. I have a metacam cat leaflet here, it doesn't give the full ingredients list, so maybe they are all very secretive and only tell you what they have to.

Santa said:

Another good point - it was probably meloxidyl. I have a metacam cat leaflet here, it doesn't give the full ingredients list, so maybe they are all very secretive and only tell you what they have to.

Click to expand...

Says here that it is 'sweet tasting'. http://www.ceva.co.uk/Products/Products-list/Meloxidyl-Oral-Suspension-for-Dogs

Cassie used to go crazy for it.

All the 'itols' can cause diarrhoea in humans, so I'd strongly suspect artificial sweeteners.

I wonder if you can get the full ingredients list by going back and finding its EU authorisation. There's a task for later on unless anyone fancies looking in the meantime Sarah

Santa said:

I wonder if you can get the full ingredients list by going back and finding its EU authorisation. There's a task for later on unless anyone fancies looking in the meantime Sarah

Click to expand...

Got it! http://www.ema.europa.eu/docs/en_GB...Information/veterinary/000115/WC500065296.pdf

Bloomin' 'eck.. it has sorbitol and xylitol in it!! :shock:

Oh well done you! One or both of the -itols seems incredibly likely, doesn't it.

Definitely. I can't find the details for the Metacam at the moment. I have a sneaky suspicion that the Meloxidyl might be a bit sweeter, but that's only because of Cassie's craziness for it (and she had Metacam previously at various times when I was at the Wickford vets).

I can check exactly what was used when I next speak to Sam but she normally dispenses meloxidyl - don't know if she uses something different if it's dispensed from a larger container rather than giving a whole bottle, though.