Metacam dosage??!!

[Happy Hopping]

Here's a no. of dosage given by a no. of vets from a no. of different clinic/hospitals.

1) The 1st 1 at the top left is after Goofball's leg removal, around Dec. 2007, metacam dosage to deal w/ her post-surgery pain from the leg removal, and the pain from bone cancer. As you can see, the Veterinary Clinic prescribes 0.33 ml per 24 hr., at that time, Goof is 5.1KG.

2) The 2nd 1 at the top right is Apr. 2008, for Bernie, he has 3 bad teeth removal in 2 separate surgeries, and he is about 2.25KG, and as shown, the dosage given post dental surgeries is 0.15 ml. This one, the surgery was done at the vet hospital, you can see from the very top of the box that the label is from Veterinary Hospital.

3) The central photo is around Feb. 2008 for Goofball, they increase her dosage abit for the pain against bone cancer, and as you can see, they move it up to 0.46 ml, at that time, her wt. is anywhere from 5.1KG to 7KG. This dosage is given at the vet hospital, same as #2.

In particular, it even stated "DO NOT Exceed recommended dosage"

4) The 4th and final photo at the bottom is from Humane Society Vet Clinic, judging by the date, it's from the spay surgery of Minnie, again, you can see from the DIN 02237715 (the box at the left) is corresponding to metacam, and Minnie is about 2.2 KG or so, as such, for post-spay pain, the SPCA Vet Clinic prescribe 0.15 ml PER 24 hr. for 3 days.

Likewise, for my other 2 SPCA buns, Bernie and Monty, they prescribe the exact same amt. 0.15 ml per 24 hr. x 3 days for their post-neuter surgery.

All of the above dosage for all my rabbits goes by the formula

Dosage (in ml) = weight in KG x 0.1 / 1.5

So looking back at these bunnies, the only question that matters is, is the dosage adequate?

W/ the post spay/neuter surgery, all 3 of my SPCA buns ate a very good amt. of hay + pellets post surgery after I look after them in my house, w/ a large amt. of poos daily,
so clearly the 0.15 ml is working very nicely

Likewise, w/ Bernie's post dental pain, the 0.15ml is also working very nicely as his diet is excellent after those 2 dental surgery

And finally w/ Goofball, this photo is a sample of the amt. of poos every 24 hr. on her diet,

they are well into 400+ poos on an average day, so needless to say, she's enjoying her life and was eating very nicely.

In fact, w/ Goof, at that time frame, I PM a no. of other members to compare their Giants' wt. w/ bunny poos count, and Karen1980 got back to me, and her giant didn't even have the amt. of poos compares to Goof.

The prescriptions of my SPCA buns are given by 3 different vets at SPCA vet clinic, in which SPCA is owned by the CDN govt. They have a total of 4 vets over there.

The other 3 boxes, pertaining to Bernie and Goofball, along with other metacam boxes (for Goofball 1 yr. usage) were given by 5 different vets in 2 different clinic/hospital, ea. location doesn't relate to the other.

These 9 different vets, ea. holds a Doctor of Veterinary Medicine deg. and they are well qualified and educated professional in the field.

The dosage uses, is clearly consistent among 9 different vets, is based on top notch published rabbit medicine books in the USA, such as:

The 5 minute Veterinary Consult: Ferret and Rabbits by Barbara Oglesbee (2006 Edition)

along w/ other books that I mentioned

And ea. yr., hundreds of thousands of vets in North America, treated million(s) of rabbits across North America, among the good rabbit vets, the dosage formula based on amt. published from above is what they goes w/.

For heavy dosage, in which Goofball had use it for about 5 days, we use:

dosage (in ml) = wt. in KG x 0.2 / 1.5

Ea. yr., these North America vet has some sort of Conference in Aug., chat about appropriate amt. of dosage for drugs such as metacam, and the current recommend dosage, as you can see from the photo, has not changed. (The most current box above is dated Apr. 2008, and dosage is still sitting at 0.15 ml for a 2.25 KG bun)

On an unrelated matter, the thought had occurred to me that it could possible that the vets owned by CDN Govt. chat w/ the vets in the private sectors, thus, they use very same dosage. So when I ask my vet at the private sector this question, I was told there are a few things that private sector vets have in common w/ CDN Govt. vets:

1) They take the well-being of an animal very seriously, they don't endanger their lives

2) They don't overdose any animals w/ hype up dosage, and jack up the sales of metacam and Ranitidine

And for the publishing of the next edition of rabbit medicine books published in the US, such as

Ferrets, Rabbits and Rodents, Clinical Medicine and Surgery by Dr. Katherine E. Quesenberry, Dr. James W. Carpenter,

The 5 minute Veterinary Consult: Ferret and Rabbits by Barbara Oglesbee

If any fly-by-night is hoping for some astronomical dosage increase on metacam, I wouldn't count on it.

 

[marie_kubiak]

I have seen rabbits that have been spayed and not given any post-op analgesia that still produce normal poos and eat so this is not proof. Continuing to survive is a protective response, it does not mean that the rabbit is not still painful. Rabbits are a prey species and mask the signs of pain so observation alone is not a complete indication of pain status.
The latest information is that higher doses of metacam are far more effective and therefore beneficial to the rabbit. Perhaps contact your rabbit specialists in the US - I am on various international rabbit and exotic pet veterinary forums and those vets in Europe and the US that work routinely with these animals prescribe far higher doses of metacam than cat/dog vets. I suspect this is because they attend rabbit conferences, read the relevant journals and communicate frequently with other exotic species vets are so are familiar with the recent increase in information and transfer that into their daily practice.
I have cases referred to me for investigation that are already on metacam, but at low doses (previously considered adequate). The difference increasing the dose, to newly accepted doses, makes in a painful bunny can be unbelievable.

I really don't understand why you are so against the improvements being made in our understanding of rabbit analgesia. Surely now that we know it is safe and beneficial to use higher doses, and rabbits are much more comforable on these doses, this has to be a good thing? Perhaps channel your energy into reading up on this rather than shooting down those giving information.

 

[Mudgy]

Not wishing to get into a disagreement, re metacam dosage, but that is one of the most bizarre pile of dark, dry, misshapen poos I have ever seen. Only seen similar before, and after, a bout of GI stasis.

 

[Carrie1983]

Happy Hopping,

I don't think Jane was saying that your vet/s are wrong; she was just saying that vets here use a different formula.

My bun was on a relatively low dose of Metacam and then a rabbit expert vet at Langford Vet School saw my bunny and DID put the dose up high, explaining that bunny metabolisms work in a different way to dogs and bunnies can take 6x the dog dose.

As I am not a qualified vet, I wouldn't wish to make assumptions about whose vet is right and whose vet is wrong; but I, like others here, trust my vets. You posted a link the other day about Metacam killing people's pets, but it related to cats, who take an even smaller dose than dogs.

I am happy to continue on qualified vet advice. I would suggest to people that if they are concerned about their pets' prescribed meds, they should consult either the prescribing vet or an alternative vet for a second opinion. The internet can give lots of conflicting information and while anecdotes can be useful, supportive and encouraging, I don't feel they are a substitute.

My rabbit specialist vet (of over 20 years I might add), has upped Zeb's dosage to 35kg dose, by the way (he weighs just over 6.5kg). This expert also stated that there is only ANECDOTAL evidence of Metacam having a positive effect on rabbits at this time, not scientific. Maybe that is why they only do dog and cat ones?

 

[Carrie1983]

Also, my bunny has always done good healthy droppings, and has only recently been taking Metacam.

 

[rodneyvet]

Hey, happy hopping , youre from Canada. You are using 0.2mg/kg . Im sure you would respect some good old canadian research. Check this out. The last sentance says it I think

Pharmacokinetics of meloxicam in rabbits after single and repeat oral dosing
Comp Med. February 2006;56(1):63-7.
Patricia V Turner1, H Cheng Chen, W Michael Taylor
1 Department of Pathobiology, University of Guelph, Guelph, Canada. pvturner@uoguelph.ca[/email[/B]]

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.

lots of love, "that thing"

 

[Jack's-Jane]

lots of love, "that thing"

.........................

Sorry......................................

 

[Happy Hopping]

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.

Did you skip the day they teach medicine? Didn't they teach you at University Statistical studies the importance of "Samples" and "Population"?

What's the no. of Samples that Ms. Turner, Mr. Chen, and Mr. Taylor finding based on?

What's the Population and how is it chosen? You expect people to buy a 1 paragraph "study"? Shouldn't the Population and No. of samples be clearly defined in this 1 paragraph study? What's the number?

You're buying the above w/o knowing the no. of samples taken? You're kidding.

 

[Happy Hopping]

I have seen rabbits that have been spayed and not given any post-op analgesia that still produce normal poos and eat so this is not proof.

You didn't read above, did you? The above prescriptions are not just for spay/neuter surgery. Some are for post-dental pain of teeth removal, and the other case is prescribed to combat bone cancer pain.

I really don't understand why you are so against the improvements being made in our understanding of rabbit analgesia. Surely now that we know it is safe and beneficial to use higher doses, and rabbits are much more comforable on these doses, this has to be a good thing? .

Who's "WE"? For 1 thing, "WE" doesn't include the above 9 vet's opinions. You mean YOU think it's safe? Clearly, the above vets, in which I know personally some of them also attend the US conf. held in Aug. vs. your country's conf. held in Nov., does not agree w/ you.

They don't see it as safe or improvement. They never prescribe those higher doses. And the pt. is, set aside the dosage for spay and neuter post-surgery, the prescription dosage for post-dental teeth extraction pain and bone cancer pain works. So the buns I looked after didn't need those higher doses. In fact, Goofball, I have been using the above dosage for about 1 yr., once daily.

But according to you, it shouldn't have work.

You claim it's safe and you think it's improvement. Tell that to Diane, and the other pet owners who lost their rabbits in the link that she provided to me:

http://metacamkills.com/

She lost her bun due to overdose.

Hello,
one of the other members thought maybe you could help me, i recently lost my rabbit to a very high dose of Metacam, i also live in Canada, Quebec actually, do you know about this medication,
Diane

thanks for your reply, my four year old rabbit Caramel two weeks ago had one day that she did not eat, i noticed lets say the size of the tip of my pinky finger a little what i now know was sand, sludge with a tiny drop of bllod, i rushed to a vet I DID NOT KNOW, they said she took rabbits, she first gave me atibiotics with metacam at .06ml every 12 hours and then, my rabbit ate a whole bowl of romaine, i was also feeding her, she had normal urine and small poop, i was happy next day she did not eat, i believe the .06ml of metacam made her feel sick , so i called the vet, she said give her 1ml every 12 hours, the next night Caramel had a seizure, caramel took another seizure became paralyzed and died 90 minutes later, www.metacamkills.com, under Dianne`s story you can see my Caramel, so what do you think, thanks, sorry so long just wanted to explain what happened.
Diane

By the way, I am watching Jerry Seinfeld in this HBO Special: "I'm telling you for the last time", it's very good. In 1 of the segment, he talks about Tylenol:

"Everybody wants maximum nowadays. Tylenol regular strength, no, not good enough. Tylenol Extra Strength, no, not good enough. Tylenol Maximum, that's right, give me the max. that can kill me and tap it down just a bit and sell it to me."

 

[Jack's-Jane]

You didn't read above, did you? The above prescriptions are not just for spay/neuter surgery. Some are for post-dental pain of teeth removal, and the other case is prescribed to combat bone cancer pain.



Who's "WE"? For 1 thing, "WE" doesn't include the above 9 vet's opinions. You mean YOU think it's safe? Clearly, the above vets, in which I know personally some of them also attend the US conf. held in Aug. vs. your country's conf. held in Nov., does not agree w/ you.

They don't see it as safe or improvement. They never prescribe those higher doses. And the pt. is, set aside the dosage for spay and neuter post-surgery, the prescription dosage for post-dental teeth extraction pain and bone cancer pain works. So the buns I looked after didn't need those higher doses. In fact, Goofball, I have been using the above dosage for about 1 yr., once daily.

But according to you, it shouldn't have work.

You claim it's safe and you think it's improvement. Tell that to Diane, and the other pet owners who lost their rabbits in the link that she provided to me:

http://metacamkills.com/

She lost her bun due to overdose.







By the way, I am watching Jerry Seinfeld in this HBO Special: "I'm telling you for the last time", it's very good. In 1 of the segment, he talks about Tylenol:

"Everybody wants maximum nowadays. Tylenol regular strength, no, not good enough. Tylenol Extra Strength, no, not good enough. Tylenol Maximum, that's right, give me the max. that can kill me and tap it down just a bit and sell it to me."

So what do you think should be done then? Should all our Rabbit Vets ignore the clear evidence of the safety of higher Metacam doses because 9 Canadian Vets and one Rabbit Forum member disagree with them :?

I dont see why you are so intent or using scare tactics to try to win your argument. IMO, albeit it totally unqualified, the lower dose of Metacam does not work. The picture of the faeces you posted does not indicate normal gut motility. They are the faecal pellets of a Rabbit whose gut motility is compromised. Pain compromises gut motility.

 

[marie_kubiak]

You didn't read above, did you? The above prescriptions are not just for spay/neuter surgery. Some are for post-dental pain of teeth removal, and the other case is prescribed to combat bone cancer pain.

I did indeed read your post. I am sorry I did not give examples of multiple types of surgery where analgesia was inadequate yet the bunny did not develop stasis. For your personal satisfaction, I can inform you that I have also seen rabbits post dental/castrate/wound repair that have not been given analgesia and although in pain they still behaved relatively normally, ate and passed faeces. This doesn't mean they were comfortable, it means they were surviving.

Who's "WE"? For 1 thing, "WE" doesn't include the above 9 vet's opinions. You mean YOU think it's safe? Clearly, the above vets, in which I know personally some of them also attend the US conf. held in Aug. vs. your country's conf. held in Nov., does not agree w/ you.

Peer-reviewed scientific studies published in international journals and accepted by specialists is enough for me. 9 cat/dog vets and one man in Canada do not hold prescedence over these I'm afraid.
For your information we have more than one conference in this country! even if attending a conference they may not have had access to the information. It requires interest in the subject matter to read the relevant journals.

You claim it's safe and you think it's improvement. Tell that to Diane, and the other pet owners who lost their rabbits in the link that she provided to me:
http://metacamkills.com/
She lost her bun due to overdose.

There is one of these websites for every drug available. Standard situation is that a sick pet is taken to the vets, is prescribed x medication. Pet dies. Immediately the medication is blamed by the owner (without considering that the original illness may be responsible) and with no evidence they start a witchhunt. These cases were not reviewed in any way so there is not evidence to claim what these people do.
I use metacam at the described levels on a daily basis for many patients and have not had any 'suspicious' deaths. However, I recognise that simply using anecdotes does not count as evidence so rely on the safety trials done on the medications.

If you do not wish to keep abreast of new developments that is fine, but to villify people simply for trying to pass on scientifically proven information just because you, (in your unprofessional opinion) don't like it, is not the behaviour of a reasonable adult.

 

[rodneyvet]

Well I know you love to quote FHB`s book. It may interest you to know she is recommending 0.3mg/kg (Spoke to her yesterday). how many have to be in a study for you. This article was peer reviewed. How long do they need to keep going. All of the animals failed to show saturation at 1.5mg/kg (over seven times your dose). You can be pretty sure if even one had shown something abnormal, higher doses would be avoided. did you know in rats the dose is 2mg/kg. But more than this, we tend to judge cases on their clinical merits and how they respond to therapy whilst monitoring for any potential side effects. and most cases referred to me immediately improve on a decent level of analgesia. this includes bone cancer patients where on the advice of well respected US vets I have given upto 1mg/kg and improved their quality of life dramatically. Perhaps you should try a higher dose and see what happens. However I know you wont. Just remember that Francis` book was written a while ago and since she has changed her protocol. Perhaps when the next edition of 5 minute consult comes out your position will change

 

[Hugo's There]

Jason for God sake please stop all this ridiculous arguing.

Marie and Rodney are well respected and professional people who have willingly given up there precious time and experience to help others on the forum. They have access to more information and research than anyone else here and I and many others on the forum really value their opinions.

I am not asking you to agree with everything they say, but if you don't agree just say so politely and move on. I cannot believe you have lowered yourself to childish name calling. If you went to your vet and you didn't agree with everything you say would you call them names to their face? No you wouldn't. Marie and Rodney deserve more respect.

If they decide to leave the forum because of the way they are being treated by you, I for one would be very upset as I am extremely interested in their point of view even if I don't necessarily agree with it every time. I think the forum would be a much poorer place without their input and I think we should just be grateful that we have such experienced members

 

[Jack's-Jane]

Jason for God sake please stop all this ridiculous arguing.

Marie and Rodney are well respected and professional people who have willingly given up there precious time and experience to help others on the forum. They have access to more information and research than anyone else here and I and many others on the forum really value their opinions.

I am not asking you to agree with everything they say, but if you don't agree just say so politely and move on. I cannot believe you have lowered yourself to childish name calling. If you went to your vet and you didn't agree with everything you say would you call them names to their face? No you wouldn't. Marie and Rodney deserve more respect.

If they decide to leave the forum because of the way they are being treated by you, I for one would be very upset as I am extremely interested in their point of view even if I don't necessarily agree with it every time. I think the forum would be a much poorer place without their input and I think we should just be grateful that we have such experienced members

Ditto to all of the above

 

[Santa]

Tritto (?) to all of the above

I think it's fantastic that we get to learn from Rodneyvet and Marie here and would hate to see them driven away by one person and their sometimes rather odd views.

 

[raine]

I hope you stay on Jason. I think its productive to air different views.

 

[Carrie1983]

You didn't read above, did you? The above prescriptions are not just for spay/neuter surgery. Some are for post-dental pain of teeth removal, and the other case is prescribed to combat bone cancer pain.



Who's "WE"? For 1 thing, "WE" doesn't include the above 9 vet's opinions. You mean YOU think it's safe? Clearly, the above vets, in which I know personally some of them also attend the US conf. held in Aug. vs. your country's conf. held in Nov., does not agree w/ you.

They don't see it as safe or improvement. They never prescribe those higher doses. And the pt. is, set aside the dosage for spay and neuter post-surgery, the prescription dosage for post-dental teeth extraction pain and bone cancer pain works. So the buns I looked after didn't need those higher doses. In fact, Goofball, I have been using the above dosage for about 1 yr., once daily.

But according to you, it shouldn't have work.

You claim it's safe and you think it's improvement. Tell that to Diane, and the other pet owners who lost their rabbits in the link that she provided to me:

http://metacamkills.com/

She lost her bun due to overdose.







By the way, I am watching Jerry Seinfeld in this HBO Special: "I'm telling you for the last time", it's very good. In 1 of the segment, he talks about Tylenol:

"Everybody wants maximum nowadays. Tylenol regular strength, no, not good enough. Tylenol Extra Strength, no, not good enough. Tylenol Maximum, that's right, give me the max. that can kill me and tap it down just a bit and sell it to me."

The thing that stuck out for me in the two anecdotes you provided, HH, especially the second one, was that the person 'THOUGHT' it was the metacam making her bun feel sick... the fact there was brown sludge and blood may have had something to do with the subsequent seizure and sickness (from reading that, the bun was prescribed Metacam after the sand/sludge incident). It isn't scientific proof that Metacam kills.

 

[Carrie1983]

Jason for God sake please stop all this ridiculous arguing.

Marie and Rodney are well respected and professional people who have willingly given up there precious time and experience to help others on the forum. They have access to more information and research than anyone else here and I and many others on the forum really value their opinions.

I am not asking you to agree with everything they say, but if you don't agree just say so politely and move on. I cannot believe you have lowered yourself to childish name calling. If you went to your vet and you didn't agree with everything you say would you call them names to their face? No you wouldn't. Marie and Rodney deserve more respect.

If they decide to leave the forum because of the way they are being treated by you, I for one would be very upset as I am extremely interested in their point of view even if I don't necessarily agree with it every time. I think the forum would be a much poorer place without their input and I think we should just be grateful that we have such experienced members

Hear, hear! I would rather take the opinion of a vet over someone who's got his knickers in a twist.
I saw a rabbit specialist at Langford who upped the metacam dosage considerably, stating that rabbits can take 6x the DOG dose!
Maybe it's YOUR vets that are wrong, rather than the hundreds of vets here who prescribe the higher dose? Or had you not thought of that? Of course not!

 

[Hugo's There]

I hope you stay on Jason. I think its productive to air different views.

I haven't asked Jason to leave or not to air his views :? I think it is good to have different opinions but there are ways and means of putting them across. I was just asking jason to be a bit more respectful towards other members of the forum including the OP's who are worried about their bunnies and don't want their threads turned into a string of name calling

 

[raine]

Liz, my post was not directed at you personally. I just feel that the thread is now turning into an attack on Jason and I would hate him to feel that he has to go.

Its good that we have a couple of vets who take the time to post on the forum, but the majority of us are not qualified vets and not all the information we post is in agreement with everyone else on a thread. In my opinion, advice should always be secondary to their bunny being examined and treated by a vet.

Even in the UK there is a great variation in metacam dosage and the good thing about this thread is that it highlights those differences. I have been giving Daisy quite high metacam doses recommended by Bristol and it has kept her comfortable.