Extremely high metacam dosage

[Geomore]

Sorry, i know this topic has come up several times. Our 5 year old pig has (for the first time) Just been prescribed Metacam cat at 2ml twice daily, which translates to 1mg per dose or 2mg per day (equivalent 0.75ml dog per dose) , as part of suspected UTI or bladder stones. I have read several other posts on here about large doses but this seems to be a record. We're one dose in and pig is still alive after 6 hours, despite being significantly over the overdose rate of 0.6mg/kg for guinea pigs (spoiler: she doesn't weigh 10kg). I've read on here that doses up to about half this are used in extreme paliative circumstances, but this is not the case. I might be wrong, but the 3 week supply we have been given will only last 4 days, and an extra large syringe had to be given because the standard one is too small, which both ring alarm bells.

Vet is adamant dose is correct. Friend who is a large animals vet says I should report then to the royal college, but admits she had no guinea pig experience. Anyone have experience with huge doses like this?

 

[Veggies Galore]

Don't worry .....that's not an overdose .

 

[Piggies&buns]

To clarify (I’ve had a long day, numbers are whirring around my head at the moment and I’m not focusing) - 2ml twice per day (so 4ml per day total) , or 2ml per day (so two 1ml doses per day)?

 

[Betsy]

That's not a high dose. My Christian has arthritis in his spine and is on 0.5ml twice a day of dog Metacam. Initially was prescribed 0.7 ml twice a day and I have slowly managed to reduce this to 0.5ml twice a day. His sister Meg also has arthritis of the spine and she was prescribed 0.3ml dog Metacam twice daily by one of the best piggy vets in the country (Kim Maddock)

 

[PigglePuggle]

A usual regular high dose of dog metacam is 0.4mls twice a day... so as that is 3x stronger than would be 1.2mls cat metacam twice a day... and that is usually considered safe long term for piggies with ongoing pain/inflammatory issues.

Not being unpleasant here but it seems a bit like you are trying to find fault/get someone in trouble here by stating this is an overdose according to your knowledge and asking another vet about it, but still giving it anyway?

There is a big gap between the 1 published study on metacam in piggies and routine off label use by experienced guinea pig vets. The toxicity data I believe refers to an extrapolated maximum dose from what might be toxic but wasnt really after giving it twice daily for 3 months.

If you arent comfortable with the dosage, please seek a second opinion from an experienced piggy vet. Or, give 1.2mls cat metacam twice daily which is very safe and quite standard practice. Or, ask a vet for some tramadol or buprenorphine or similar if your piggy is in a lot of pain and the metacam isnt working.

Have you had an xray to confirm bladder stones, and if so are they operable? That might well make a difference- or not, really- as if operative this will be short term pain relief until the op, if inoperable this would unfortunately be palliative and so overdose is less of a concern than piggy not being in pain...

 

[Geomore]

To clarify (I’ve had a long day, numbers are whirring around my head at the moment and I’m not focusing) - 2ml twice per day (so 4ml per day total) , or 2ml per day (so two 1ml doses per day)?

2ml twice per day

 

[Geomore]

being unpleasant here but it seems a bit like you are trying to find fault/get someone in trouble here by stating this is an overdose according to your knowledge and asking another vet about it, but still giving it anyway

No that's fair, i should have clarified, my wife gave one dose before I raised concerns. I am going on the manufacturers documentation, which clearly gives the rate considered overdose in guinea pigs. I was hoping I was just very mistaken, and no I'm not rushing to report anyone, I like to get my facts before acting, but the next dose is due and I'd like to try and work out whether to continue our reduce it based on the manufacturers rates.

Thank you for your detailed post, it seems I might be over reacting, I wondered if it was down to simply lack of more extensive testing by the manufacturer, it sounds like it actually is.

We are monitoring for 2 days and if no improvement they want to x ray for stones. Which brings on to next question... is £200 for an xray reasonable? I'm told this is because sedation is required, desire despite her being very dosile. If it is then it is, maybe I'm just looking for issues, I'm not a fan of this practice but there's not many options at the moment.

 

[PigglePuggle]

£200 for an xray with sedation sounds reasonable, we had an xray yesterday without sedation on a very docile piggy that cost £140. You might suggest they try the xray without sedation, our vet warned that they usually only get a "top view" of piggy standing then which may not show the bladder, but yesterday our piggy let them tip her on her side for a full set of lung xrays- but in her case the sedation was an issue as she has a respiratory infection, if your piggy has no breathing issues and the vet needs a clear tummy shot to fully examine the bladder then the sedation may be worth it for a clear and prompt diagnosis, as if a stone becomes stuck in the urethra before it is removed then it can become inoperable, so a quick diagnosis and operation is preferable there. Hope your piggy is ok x

 

[Geomore]

Many thanks for all your help and information, very appreciated. Clearly I'll have to trust vets more! Fingers crossed it's not stones, this guinea pig is more important than me in our household.

 

[VickiA]

No it’s not an overdose. Metacam is given on a sliding scale according to weight and severity of pain/inflammation.

 

[Swissgreys]

How much does your guinea pig actually weigh? Sorry if I missed this info somewhere.
My exotic vet and the vet hospital both agree that the latest studies show that 1mg per kg twice a day is a perfectly safe dose for guinea pigs in times of acute pain, so it sounds like the dose you have been given is fine. Over the years I have had several guina pigs on this does of Metacam for short term issues.
And that price for sedated x-rays also sounds pretty standard.
Guinea pigs often end up costing more than cats and dogs when it comes to veterinary bills!