Meloxicam Query: Dog vs Cat "units"

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Alright so be warned, it's Another Massive Post, but I'm working it through as I write so please be patient with me! The question I'm hoping to answer is has anyone had cat Loxicom (0.5mg/ml) prescribed for their pig in mls and/or in 'units' as the Norbrook version at least has it's own syringe with a picture of a cat on and markings going up in whole numbers (to 10 I think), because I'd like to know how many mls are in one of those units... and this is why:

So yesterday evening poor Zara had a squinty eye and it turns out she had a horrid grass seed (one of those big ones that look like a pointy dart with hairs on) stuck firmly in her eye under the top lid 😭 I tried to gently remove it, bathed the eye, gave her a dose of dog Metacam and laid awake worrying, but she was much happier this morning and her eye actually looked pretty good, but I took her up to see the vet anyway. I couldn't get my usual at short notice but the one I got was kind and young - I told him she bit, but only out of fear, and he said it was actually on her file from when she had her original check up and bit everyone there! She came out with green dye showing she has a wound on the eye but he said these usually heal pretty well in piggies - much better than for cats and dogs. He prescribed Isathal drops and Viscotears - no problem. Poor Louise had gone along as a companion and she was totally freaked out by the whole experience so I'm not sure what happened in there but Zara came out bristling! I had her in my lap in the car for 10 minutes until she'd calmed down enough to eat a bit of carrot (and make me a nice damp patch) then she went back in the cat box for hay and a nap.

Now, I had a bit of dog Metacam (Boehringer) left over from my Ivy last year but hardly any, so I asked for more painkiller and showed the bottle - also adding that in the past I'd sometimes gotten a vial with a portion dispensed from a big bottle in the surgery - presumably a generic version. I said specifically that I would rather have the dog one than the cat - we've never actually been given the cat version before (in 10 years). I also said about "twice a day..." and he said "once..." and I said "twice... " and waited to see what would happen.

I was given the 5ml Loxicom for cats (0.5mg/ml, Norbrook) with the special 'unit' syringe and instruction to give "1 unit once a day with food (2u for the first dose ONLY)". I asked to speak to the vet who stood his ground and said he'd spoken to another vet about it and that there was some sort of national shortage of dog Metacam so could I use this instead. Well I agreed - especially as Zara seems to be rapidly getting back to normal - but I asked whether the 'units' marked on the cat loxicom syringe (with the cat picture on) were the same as the 'units' on the dog metacam syringe (with the dog picture on) and he didn't know. I mean they look a similar sort of thing but the eye can't tell and if it's not like-for-like I couldn't up the dose so I asked for a 1ml syringe instead, which I got but he took the 'unit' one back. I was a bit flummoxed anyway, as I'd said that her weight had gone down a very little (50g) but that she was back eating again now the seed was out and so I wasn't too worried, and I got the distinct impression he'd not make any link between pig weight and dose calculation and frankly just offered a lowest measurable dose of "1 unit once per day". Hmmm... :hmm:

I'm going to follow this up just in case things have changed in the 6 months since I last went to the vet. Or possibly this will be a learning experience for one young chap instead of one middle-aged housewife. But does anyone have any idea of the 'unit' volumes for Metacam/Loxicom? We've been prescribed dM for a 1.2ish kilo pig at either 4 'units' or about 0.24ml per dose - twice a day (depending on the source of the painkiller) and the volume of the dM syringe works out about right for that as the full 10 'units' are only about 0.7ml. If the 'units' are even roughly equivalent that would mean 1 'unit' of cL would be about 1/12th what we were expecting - and only once per day makes it 1/24th. I'm glad I've got the 1ml syringe although Zara - true to form - seems to be the only pig in England to hate Metacam so unless Loxicom is more delicious I don't fancy my chances with a larger volume!

Phew! Anyway, we're otherwise feeling quite positive, if a little poorer, so just as a treat here's a picture of George enjoying himself in a bag of the damp hay and poops I'd spot cleaned from the girl's side before they went back in their cage. #guiltypleasures George!
Bag of George.webp
 
Cat "units" dont equate to mls, I measured the volume equivalent myself after being given a bottle with a weird top that only takes the cat syringe, then strictly instructed to measure the dose in mls not cat units!
3.4 cat syringe units equates to 0.5mls which is a very safe moderately high dose to give twice a day according to the published literature- though many vets do go higher based on experience. And many vets under-dose with the cat loxicom prescriptions too out of an abundance of caution.
Dog metacam is 3x more concentrated than the cat stuff if that helps at all...
 
Brilliant - thanks for that feedback. So the "1 unit once a day" that has been rec'd is very low indeed. Do you know I'm wondering if I've just been prescribed what you would give a 1 kilo cat. I was charged £48 instead of the expected £38 for the consult - I wonder if that's the cat price? I'm going to phone in and query now...

Zara is quite back on form. Getting eye drops in has so far been spectacularly difficult - in part because her beady little eyes are buried in fuzzy fur so when she closes one you can't even see where it should be. When I get into the enclosure with all her tubes she doesn't run - she goes straight into the tunnel and lies in wait. You never know which way she's facing so you have to put a hand in both ends. Whenever one gets the front end there's an immediate bite - but then at least the other hand can get a hold! There's a short battle to wrap her in the apron while the others assemble and wait, because after the eye drops she gets a veggie treat... that's when they all start jumping up and down for theirs. I feel like a gladiator in the Colosseum with a particularly vicious lion and a really keen crowd! We should have our routine honed within a day or so as she's a clever girl and will suss what's happening. She's just mad as heck about it!

Do you know, I love my fierce bitey girl so much 💕
 
Update:

A senior vet phoned (but not one of my piggy vets, I think of him as the 'doggy' one) and said 0.2ml of cat Loxicom once a day was as far as he could go and kept saying "Official Guidance" - so I pressed for twice a day but he stood his ground so on my own head be it if I go for twice a day. It sounded like he was reading the product sheet out. It's not just the amount of active ingredient in there but what else is in there too. As Zara isn't in obvious pain and is leaping around for veggies like normal I'm not too concerned on this occasion about a low dose but I AM going to follow this up as this guy has actually prescribed me the larger doses of dog Metacam himself in the past, so I want to find out if there is a policy change or if he's just backing up the young vet on this occasion - which I can respect, as long as piggies get the treatment they need.

I also got my £10 consult overcharge refunded. I'd called the non-emergency admin line to ask about this and got told 5 different reasons it 'might' be but it wasn't actually any of them it was just a mistake - although I had to contact the surgery direct to find this out. There used to be a price list on the website - some things are obviously variable but some are standard. Irritating, because when you get an itemised bill it's supposed to remove the guesswork (and give me an accurate written record of treatment) and frankly if you are employed as a person to answer admin questions for customers you should be able to pick up a price list and look, rather than just guess at why!

Enough grumbling!
 
Vets sound like need more piggy savvy training.the cat metacam is debatable since it was licensed for guinea pig use.more research needs to be done.whilst vets stick to it says....on metacam cat leaflet ...it could be argued the guinea pig is left in pain,due to not enough dosage to control pain.
 
You should actually be able to pop off that part of the bottle that takes the syringe and get a regular syringe in there to measure in mls, that's what I've always done. If you can't do this you can squirt the metacam into a spoon and syringe it from there. Even the datasheet says not to use the provided syringe when dosing guinea pigs.

My own veterinary references (including the datasheet) say 0.2-0.3mg/kg for the first dose and 0.1mg/kg once per day thereafter. The 0.1mg/ml dose of the cat metacam would be 0.2ml. Personally I would stick to once a day and see how Zara gets on.

Here is the data sheet if you want to have a look yourself: Dosage and administration
 
Just as a note - the datasheet I linked above is for Metacam but they both have the same concentration of the active ingredient (meloxicam) so the calculations still stand. Loxicom is not (yet?) liscensed for guinea pigs so their data sheet doesn't contain guinea pig dosage information, but it's essentially the same as Metacam which IS now liscensed
 
Sorry - I keep remembering things I wanted to add when it's too late to edit.

The reason this vet may have changed what he is recommending is what I said above - the "Cat" metacam is now - as of 2018 - also liscensed for guinea pigs, which means the data sheet gives recommended (and maximum known safe) doses for guinea pigs, where it didn't before. Previously, any treatment with metacam was "off license" so vets had to use knowledge and information from places other than the official datasheet to decide on dosing. Technically, using metacam for a corneal ulcer is still "off license" since metacam is only liscensed for treatment of post-opereative pain in guinea pigs, but it's basically more acceptable now (you can look up the veterinary cascade to find out more about veterinary liscensing and use of off liscense drugs - there is basically a step-by-step outline for which drugs you can use when you need something that there is no liscensed drug for).

TL;DR - the liscensing for Metacam has changed and this may be why this vet's recommended doses have changed!
 
Hope Zara recovers very quickly x
I have always been given Dog Metacam/Loxicom by Simon Maddock which I know lasts longer once opened and is quite a bit stronger. It’s not licensed for Guinea Pigs like the Cat one but if your vet is prepared to prescribe it you pay an extra £2.50 for unlicensed meds plus the cost of the medicine
 
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