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Metacam dose

C

cara

Alpha Buck
I am going to try my elderly rabbit on Metacam.

She is a tiny thing, around a kilo - I want or make sure the vet prescribes enough to make a difference to her quality of life (I believe they can under prescribe). Rosie is quite poor on her back legs. It sometimes takes a bit of an effort for her to get going and grooming if awkward. This may of course be muscle weakness but at 13 years or so, I do think it is worth giving pain relief a go.

Anyone advise on the usual dose?
 
It was probably me who said a lot of vets under prescribe as that's what my specialist said in his talk.

I think there is a link somewhere to the amount to give but obviously you need to consult with your vet first. By way of example and I am not saying this is what you should be giving, my rabbit weights 1.2kg and when she was really ill my specialist prescribed the highest dose 0.5ml 3 times a day. I have seen another specialist who wouldn't prescribe more than 0.5ml to her twice a day, but I trust my specialist. This is the dog metacam.
 
it's not easy to give an actual dose as standard but inflammation takes a while to settle, so our vets start with higher doses to bring it under control, and then gradually taper off the dose. then if they need extra help at certain times, you start higher again and reduce. some vets seem to give a lower dose to start to 'see how they go' and then increase if they feel the pet needs more. but this way you don't ever seem to get the initial inflammation under control so ours start higher and reduce. obviously this means any inflammation based pain is then under control aswell.

it's hard to advise a dose specifically really but for example, bisc has spondylosis and he has 1.5ml 2x a day as his high dose. he's around 2.23kg at the moment. initially the plan was to start at 1.5ml 2x day, reduce to 1ml 2x day and hopefully get him on a maintenance dose of 0.5ml 2x day. however this hasn't worked and he can't seem to stay comfortable under 1.3ml 2x day at the moment.

obviously you want the lowest maintenance dose you can achieve, but really you want to bring any inflammation down first, if the pain your bunny has is because of inflammation. it sounds that way with the stiffness.

sorry if that is no help! but i'd get the vet to test your bunny's movements and see if they think arthritis is probable and see what dose they seem to think would be best. i'd see an exotics vet aswell to make sure the doses are appropriate :wave:
 
My specialist went in for the higher dose and then reduced it. That's his approach make sure they are painfree and eating then reduce so you have that extra scope to put it up when necessary.
 
cpayne said:
It was probably me who said a lot of vets under prescribe as that's what my specialist said in his talk.

I think there is a link somewhere to the amount to give but obviously you need to consult with your vet first. By way of example and I am not saying this is what you should be giving, my rabbit weights 1.2kg and when she was really ill my specialist prescribed the highest dose 0.5ml 3 times a day. I have seen another specialist who wouldn't prescribe more than 0.5ml to her twice a day, but I trust my specialist. This is the dog metacam.
Click to expand...

.... and then there are vets who would prescribe 0.5 ml to be given only once daily.

Your vet should be the starting point for a discussion - there are so many differing opinions
 
Also remember that the dose will vary depending on whether you are prescribed the cat or dog version of metacam (or equivalent). The dog one has 3x the drug concentration of the cat version, so will require a correspondingly lower volume dose.
 
MightyMax said:
.... and then there are vets who would prescribe 0.5 ml to be given only once daily.

Your vet should be the starting point for a discussion - there are so many differing opinions
Click to expand...
I think the word is getting round as he gives talks to vets and a lot of vets call him for help

I understood it that rabbits metabolic rates are very quick so by the time the next dosage is due if given every 24 hours it is out of their system so they will be in pain again. Giving more regularly gives constant relief.

I am referring to the dog one.
 
Last edited:
Smokie is on 0.5ml once daily - it has done wonders for her in terms of confidence to go out running round the garden. She had a go at jumping in a plant pot the other week which she hadn't done for ages. Not bad for a 10 yr old bunny
 
Thanks everyone for your replies - all very interesting and Jacks-Jane, for your link :)

Taken from Jacks-Jane's link:

•0.3 - 0.6 mg/kg subcutaneously or orally every 24 hours. "studies have shown that rabbits may require a dose exceeding 0.3 mg/kg every 24 hours to achieve optimal plasma levels of meloxicam over a 24-hour interval and doses of 1.5 mg/kg subcutaneously or orally are well tolerated for 5 days." (B546)

Rosie is 2.2 kilo (I was way out! Not very good with metric even now), and has been prescribed .9 mg once a day (dog version). Does that relate well to the above? I think it is about middling?

There does seem to be a lot of differing views on the subject.
 
Yep, if I've done the maths right :oops: it sounds like they've gone for a dose somewhere in the middle of the recommended range from the link.

Some vets believe that rabbits can tolerate higher doses than previously thought, and so prescribe much higher, but I'm not sure whether there have been any actual studies to confirm this so, equally, other vets prefer to stick to the recommendations. I don't think there's a right or wrong but hopefully any vet would be guided by whether or not the dose given appears to be adequate.

Rabbits have a faster metabolism than cats/dogs and so they eliminate the drug much quicker than other species, which is why it's often recommended to split the dose into two. I also recall somebody saying once though that a once-daily dose was better for the anti-inflammatory benefits while a twice daily dose was good for pain relief; perhaps others might have some input on this in case I've made it up. :oops::lol:
 
KarenM said:
Yep, if I've done the maths right :oops: it sounds like they've gone for a dose somewhere in the middle of the recommended range from the link.

Some vets believe that rabbits can tolerate higher doses than previously thought, and so prescribe much higher, but I'm not sure whether there have been any actual studies to confirm this so, equally, other vets prefer to stick to the recommendations. I don't think there's a right or wrong but hopefully any vet would be guided by whether or not the dose given appears to be adequate.

Rabbits have a faster metabolism than cats/dogs and so they eliminate the drug much quicker than other species, which is why it's often recommended to split the dose into two. I also recall somebody saying once though that a once-daily dose was better for the anti-inflammatory benefits while a twice daily dose was good for pain relief; perhaps others might have some input on this in case I've made it up. :oops::lol:
Click to expand...

http://www.ncbi.nlm.nih.gov/pubmed/16521861
 
The link isn't loading for me, Jane. :( Is it just me anybody know? I shall keep trying.....
 
KarenM said:
The link isn't loading for me, Jane. :( Is it just me anybody know? I shall keep trying.....
Click to expand...

It works for me, this is what it says :)

Pharmacokinetics of meloxicam in rabbits after single and repeat oral dosing.

Turner PV1, Chen HC, Taylor WM.



Author information



Abstract

We evaluated the pharmacokinetic profile of meloxicam (0.3 and 1.5 mg/kg) given as single and repeated (once daily for 5 d) oral doses to female rabbits (n = 5/group) to define the optimal dose and dosing interval for clinical use. Clinical signs, body weight, and serum chemistry parameters (sodium, potassium, chloride, total protein, urea, creatinine, glucose, alkaline phosphatase, gamma glutamyl transferase, and alanine aminotransferase) were evaluated before and 5 d after dosing to monitor safety at the 2 dose levels in both studies. Plasma samples were collected serially, and concentrations were determined by high performance liquid chromatography. After single oral dosing at 0.3 or 1.5 mg/kg, maximal plasma concentrations of meloxicam were achieved at 6 to 8 h and were 0.14 and 0.3 microg/ml, respectively. Plasma drug levels decreased rapidly to near-undetectable levels by 24 h. There was moderate interindividual variability in plasma meloxicam concentrations with less than proportional increases in peak plasma concentration and area under the concentration curve values at the higher dose after the single and repeat dosing. The elimination half-life was approximately 8 h at both dose levels, suggesting that metabolism was not saturated. Oral clearance of meloxicam is high in rabbits, indicating rapid metabolism and elimination. There was no accumulation of meloxicam when given at 0.3 or 1.5 mg/kg for 5 d, and meloxicam was rapidly eliminated after discontinuation of dosing. Rabbits may require a dose exceeding 0.3 mg/kg given once daily to achieve optimal plasma levels of meloxicam over a 24-h interval.
 
Aaah, thank you, still not working for me.

There were a lot of long words in that :oops: but I think it's saying that studies showed that there was no build up of metacam in the system either with the low dose or the much higher dose. And that both doses were completely eliminated from the body quickly after the drug was stopped. ?

Have there been any studies into longer term dosing though, anybody know - a higher dose for a short period of time is fine for short-term pain but what about long-term with a chronic condition like arthritis. Bubbles was on daily metacam for the last few months of her life (due to overgrown tooth roots) and it was at the higher end of the scale given in the link Jane posted but it was a case of managing her ongoing pain even if this eventually perhaps meant it caused damage to her organs so I guess this is something vets consider when dosing too?
 
KarenM said:
Aaah, thank you, still not working for me.

There were a lot of long words in that :oops: but I think it's saying that studies showed that there was no build up of metacam in the system either with the low dose or the much higher dose. And that both doses were completely eliminated from the body quickly after the drug was stopped. ?

Have there been any studies into longer term dosing though, anybody know - a higher dose for a short period of time is fine for short-term pain but what about long-term with a chronic condition like arthritis. Bubbles was on daily metacam for the last few months of her life (due to overgrown tooth roots) and it was at the higher end of the scale given in the link Jane posted but it was a case of managing her ongoing pain even if this eventually perhaps meant it caused damage to her organs so I guess this is something vets consider when dosing too?
Click to expand...

Yep, it's risks v benefits. A Rabbit with a chronic pain condition needs analgesic cover to enable him/her to have an acceptable quality of life. The Vet will aim to use the minimum dose rate possible to reduce any potential long term side effects. But if a relatively high dose is needed to give adequate pain control then in my (unqualified) opinion it is a risk well worth taking. I would rather the Rabbit had a good quality of life even if it meant that his/her quantity of life may be reduced should the medication eventually cause problems. Having said that I have had countless Rabbits on longterm high dose Metacam and not one has ever had any adverse effects. Morse was on almost Maximum dose daily for the last year of his life. He died due to an inoperable abdominal tumour, not due to organ failure caused by Metacam use.
 
I wonder how many rabbits on high doses for long term illnesses do actually die of organ failure due to metacam rather than something else. Maybe we should do an RU thread just to see how the balance lies. I know it's only a snapshot but would be interesting.
 
cpayne said:
I wonder how many rabbits on high doses for long term illnesses do actually die of organ failure due to metacam rather than something else. Maybe we should do an RU thread just to see how the balance lies. I know it's only a snapshot but would be interesting.
Click to expand...

But there would be no way of knowing for certain that organ failure was directly attributable to the longterm use of high dose Metacam. For example chronic renal failure is a common occurrence in elderly Rabbits. There would need to be blood testing, before starting the Metacam to obtain a baseline to work from and at regular intervals there-after to assess what impact the Metacam may be having on organ function. I think the only way an accurate assessment of the impact of longterm high dose Metacam could be achieved would be in the controlled setting of a Laboratory. And that idea does not sit well with me really :?
 
Jack's-Jane said:
Yep, it's risks v benefits. A Rabbit with a chronic pain condition needs analgesic cover to enable him/her to have an acceptable quality of life. The Vet will aim to use the minimum dose rate possible to reduce any potential long term side effects. But if a relatively high dose is needed to give adequate pain control then in my (unqualified) opinion it is a risk well worth taking. I would rather the Rabbit had a good quality of life even if it meant that his/her quantity of life may be reduced should the medication eventually cause problems. Having said that I have had countless Rabbits on longterm high dose Metacam and not one has ever had any adverse effects. Morse was on almost Maximum dose daily for the last year of his life. He died due to an inoperable abdominal tumour, not due to organ failure caused by Metacam use.
Click to expand...

I'm in total agreement with you there, Jane.
 
cpayne said:
It works for me, this is what it says :)

Pharmacokinetics of meloxicam in rabbits after single and repeat oral dosing.

Turner PV1, Chen HC, Taylor WM.



Author information



Abstract

We evaluated the pharmacokinetic profile of meloxicam (0.3 and 1.5 mg/kg) given as single and repeated (once daily for 5 d) oral doses to female rabbits (n = 5/group) to define the optimal dose and dosing interval for clinical use. Clinical signs, body weight, and serum chemistry parameters (sodium, potassium, chloride, total protein, urea, creatinine, glucose, alkaline phosphatase, gamma glutamyl transferase, and alanine aminotransferase) were evaluated before and 5 d after dosing to monitor safety at the 2 dose levels in both studies. Plasma samples were collected serially, and concentrations were determined by high performance liquid chromatography. After single oral dosing at 0.3 or 1.5 mg/kg, maximal plasma concentrations of meloxicam were achieved at 6 to 8 h and were 0.14 and 0.3 microg/ml, respectively. Plasma drug levels decreased rapidly to near-undetectable levels by 24 h. There was moderate interindividual variability in plasma meloxicam concentrations with less than proportional increases in peak plasma concentration and area under the concentration curve values at the higher dose after the single and repeat dosing. The elimination half-life was approximately 8 h at both dose levels, suggesting that metabolism was not saturated. Oral clearance of meloxicam is high in rabbits, indicating rapid metabolism and elimination. There was no accumulation of meloxicam when given at 0.3 or 1.5 mg/kg for 5 d, and meloxicam was rapidly eliminated after discontinuation of dosing. Rabbits may require a dose exceeding 0.3 mg/kg given once daily to achieve optimal plasma levels of meloxicam over a 24-h interval.
Click to expand...

Thanks so much cpayne - the link didn't work for me either :shock:
 
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