Max Metacam dose for short-term use?

User avatar
Mum
I GAVE, dammit!

Post   » Fri Dec 01, 2006 10:36 pm


a rep from Boehringer. When I initially told this person that my vet had prescribed Metacam at 1-2mg/kg, the rep (I probably still have her name at work, if anybody wants to contact her directly) stated that this was "unusually high." She went on to say that their 'unofficial' recommendation for off-label use (since Metacam for guinea pigs is considered off-label) is roughly 1 drop per pound
Hmmm, I would think the company that makes it would know?

Talishan
You can quote me

Post   » Fri Dec 01, 2006 11:00 pm


"...would direct you to a guide for lagomorphs, and not for rodents. I wonder why?"

Because a guinea pig is not a rodent. They're not lagomorphs, either, they are caviomorphs, but they are much closer (at least in digestive, and I would speculate metabolic, function) to a rabbit than a rat.

"Hmmm, I would think the company that makes it would know?"

They have a good idea, and, like Sef, I would tend to trust them, although the one drop per pound sounds ineffectively low. They can't legally say. It is time-consuming and very expensive for drug makers to do the testing that gets drugs approved for veterinary use in species x for condition y. The dog-cat market is big enough to justify the time, expense and effort. The small mammal market isn't, yet, anyway, hence 'off-label' use. But they know that vets know that this stuff works, so while manufacturers can't legally commit to a product or dose for a condition, they can make unofficial recommendations as to what they know, from their own research and/or from what veterinarians using their product have reported back to them.

TwoWhitePiggies

Post   » Sat Dec 02, 2006 3:07 am


They have a good idea, and, like Sef, I would tend to trust them, although the one drop per pound sounds ineffectively low. They can't legally say. It is time-consuming and very expensive for drug makers to do the testing that gets drugs approved for veterinary use in species x for condition y.

Everything that I could find on the metacam site showed that the drug was originally approved for dogs, and has just now officially been approved for cats in the U.S., and I'm thinking a few other animals in a few other countries. But nothing official for guinea pigs.

TwoWhitePiggies

Post   » Sat Dec 02, 2006 3:11 am


Just as a note, when I looked up caviomorphs:

Kingdom: Animalia
Phylum: Chordata
Class: Mammalia
Order: Rodentia
Suborder: Hystricomorpha
Infraorder: Hystricognathi
Parvorder: Caviomorpha

And when I looked up lagomorphs, it showed this:

Kingdom: Animalia
Phylum: Chordata
Class: Mammalia
Order: Lagomorpha

Doesn't this mean that their common ancestry is the mammal? I once made a comment about guinea pigs being in the same family as rabbits to a biology professor, and he told me that humans had as much in common with whales as cavies had with rabbits.

User avatar
sef1268

Post   » Sat Dec 02, 2006 10:21 am


I would have thought that a guinea pig's metabolism is closer to rabbits than rats or mice, but I haven't really been able to find anything useful on the web.

I'll probably be going in to work sometime this weekend (joy)...I'll see if I kept the emails that were being passed around about this between Dr. Carpenter and Elsevier Saunders back in January. I'm having trouble remembering exactly what Carpenter's UK source said about guinea pigs.

Nurgle
...what, what, what?

Post   » Sat Dec 02, 2006 10:55 am


Erm. Wonder if I can remember this order?

Kingdom, Phylum, Class, Order, Family, Genus, Species

If I recall correctly, even trying to draw parallels between members of the same family (but different Genus and Species) is pretty chancy on the medicine front.

kleenmama
I GAVE, dammit!

Post   » Sat Dec 02, 2006 11:20 am


To add more mud to the mix, my vet just told me with Bailey to give .05mgs/kg daily, but that I could go up to .10 if needed for a 1 kg pig.
She basically said what TWP said, that GP's metabolize the stuff quickly.
I've always preferred giving 2 half doses every 12 hours rather than 1 dose per 24 hours.

I have absolutely nothing to base this on except my own personal experience with pain and pain meds.

I know I'm not a guinea pig, but with my meds, I get much better pain relief with dosing smaller and more frequently than dosing once per day.

User avatar
sef1268

Post   » Sat Dec 02, 2006 1:36 pm


When I looked at the Formulary to double-check whether his suggestion is q12h or 24h, he doesn't mention this at all in the Rodent section (whereas it's noted in every other analgesic, except for Piroxicam). In the Rabbit section, he indicates q24h.

When I was giving Zachary Metacam for his bladder inflammation, I gave 2 doses of .1 every 12 hours and it seemed to be very effective in giving him some relief.

This is an interesting discussion!

TwoWhitePiggies

Post   » Sat Dec 02, 2006 8:32 pm


I think what it all boils down to is that guinea pig medicine is still a bit of a wild frontier. For so long, everyone considered them either lab animals or disposable pets, and vets and owners alike are just starting to feel their way through how to keep them healthy. Our pigs are trailblazers!

User avatar
sef1268

Post   » Thu Dec 07, 2006 1:57 pm


Okay, I went back through my Metacam notes from earlier this year. The only potentially useful thing I could find was this email from Dr. Carpenter, in which he asks his source about the recommended dose for rats. This was in response to my email, in which I stated that my vet had used the rodent dosing information when prescribing it for my guinea pig, rather than the rabbit dose, and it had raised some questions as to why there was such a discrepancy between the two amounts:
...I contacted the manufacturer of Metacam, Boehringer Ingelheim, and spoke to one of their representatives about off-label use of the drug. While they are unable to make specific dosing recommendations for guinea pigs, they referred me to the rabbit dosing information in your book -- stating "hypothetically" that .1-.2mg/kg would be an appropriate dosage for guinea pigs as well.

Based on this information, I suspect that the 1-2mg/kg reference [in the rodent section] is a typographical error made by Elsevier Saunders, but I wanted to contact you directly and ask for clarification. Ms. Rudolph indicated that plans are already underway to change the rodent reference in the 4th edition, but she has been unable to confirm to my satisfaction that this was indeed an error and not a recommendation that you may have made.

Any help you can give me into this matter would be greatly appreciated.

Very sincerely,
Sandra F
--------------------------------------------------
Dear Ms. F:

(I'm resending this email with the attachment.)

The meloxicam dose we cited in the Formulary is higher than we generally use, but according to the researcher in England, it is correct. Please see the attached citation.

Best wishes. Dr. Carpenter
---------------------------------------------------
>Dr. Flecknell:
>
>Greetings from Kansas. As author/editor of the "Exotic Animal
>Formulary", I've had a number of inquiries regarding the
>meloxicam dose our book. We based the rodent dose of 1-2
>mg/kg on the Vet Clinic of North America: Exotic Practice (your
>citation). The VCNA has a number of your references pertaining
>to analgesics; can you let me know which one(s) contain the
>research (or the recommendation) for the 1-2 mg/kg of
>meloxicam in mice and rats (recommendations for rabbits and
>most other small mammals are 0.1-0.3 mg/kg)? Also, do you still
>feel comfortable with this dose, and is it the one you are still
>recommending (and have seen no adverse effects?)?
>
> Thanks.
>
> James W,. Carpenter, MS, DVM, Dipl. ACZM
> Professor, Zoological Medicine
> Kansas State University
>


Dr. Carpenter:

Following is our reference for the meloxicam dose in rodents.

ROUGHAN, J.V. and FLECKNELL, P.A. (2003) Evaluation of a short-
duration behaviour-based post-operative pain scoring system in rats.

European Journal of Pain, 7, 397-406 has the rat data; the mouse recommendation is based on clinical impression (and cited in Pain Management in Animals), but we should be publishing much more detailed dose rates later this year once Sian completes her PhD. Both species dose rates are what we still use, and we've seen no adverse effects.

Best wishes

Paul

Prof. Paul Flecknell
Comparative Biology Centre
Medical School, Framlington Place
Newcastle, NE2 4HH
0191-222-6715 (Voice) 0191-222-8688 (Fax)
view our educational resources at: www.digires.co.uk and www.ahwla.org.uk

----------------------------------------------------

Flecknell doesn't say that this dose should also be applied to guinea pigs; he says it's correct for "both species" (rats and mice). Maybe my interpretation is off, but I really don't see anything in either his or Dr. Carpenter's comments that make me think 1-2mg/kg also applies to guinea pigs -- especially since Carpenter made the comment, "...recommendations for rabbits and most other small mammals are 0.1-0.3 mg/kg."

Thoughts?

User avatar
Mum
I GAVE, dammit!

Post   » Thu Dec 07, 2006 2:07 pm


It sounds to me as if there research was done on rats. I don't see anywhere that it applies to guinea pigs.

TwoWhitePiggies

Post   » Thu Dec 07, 2006 2:08 pm


I'm glad you found the exchange. It's helpful to read.

My gut instinct is that guinea pigs are rodents, so in general, I would be inclined to think the rodent dose is correct. But I'm not a vet, so I'm only guessing.

User avatar
Lynx
RESIST

Post   » Thu Dec 07, 2006 5:24 pm


sef1268 is if anything thorough. I always wanted a last word on this. As it is, I pulled the higher recommendation from the page Josephine put up as it made more sense to me that the lower dose was safer.

User avatar
TWP_2

Post   » Thu Dec 07, 2006 6:55 pm


I will post here if any abnormalities appear on Gilbert's necropsy that are attributable to the high dose of Metacam.

While you can't go tragically wrong with lower doses, I don't read in that exchange any last word that would remove GPs from the rodent dose category. I can vouch for the effectiveness of high dose Metacam in making Gilbert more comfortable in his last few months.

Jim

chii
I Love Lucy

Post   » Thu Dec 07, 2006 7:15 pm


This is a very interesting discussion. I'm sticking to the low dosage (and it's seemed very effective in that cases where I've needed to use it), but am curious to know what the final word on this will be. I agree that GP's are simply just a new frontier in animal medicine, and therefore there are no finalized guidelines on a lot of things. That's why we're all here... to share our experiences and our vets' treatment protocols.

User avatar
luvmypigs2

Post   » Thu Dec 07, 2006 9:19 pm


I had to go to the vet tonight and asked her about this. She was not surprised about the higher doses being used in cases that might warrant it, such as Gilberts. She said that she's either heard or used (?) up to 2.0 in guinea pig chemo/cancer patients. She said that they're learning more and more about this particular drug and its effects through time.

User avatar
TWP_2

Post   » Sat Dec 30, 2006 4:28 am


I looked up this thread for someone earlier, and remembered that I was going to update here.

Gilbert's necropsy report showed no changes that were attributable to the high dose Metacam. They did find some mild liver abnormalities, but they attributed this to effects from the stone problems and not to Metacam.

Jim

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