Pain relief query

[Emx93]

Princess is currently on 1.2ml cat metacam twice daily for her arthritis/ tumour, she seems very well with her arthritis but I'm concerned her tumour pain isn't as well managed as it could be... I'm going to try and speak with the vets Friday while there for nuggets spay about getting her switched back to dog metacam, I know they've previously said liscencing/ red tape but I feel we've tried cat metacam for long enough now and they are generally reasonable. I'm also going to ask for a prescription since we can get a big 100ml bottle of dog metacam online for half what it costs for a 15ml bottle of cat metacam from the vets, feel mean considering they've been so great but that's a huge saving that could go towards other vet bills!
I'm also going to ask for tramadol, but I'm going to try and get this from the vets directly as we don't need a huge bottle initially, can anyone suggest the doses we should be looking at? She was previously on 0.4ml dog metacam x2 when we adopted her is this the maximum safe dose?

Also any experience with tramadol and piggies much appreciated, we've used it previously for a cat and it worked well but not for a piggy! P seems well today but had an off morning yesterday, she nearly had me phoning for an urgent appointment when she miraculously perked up, I swear they know when you mention the word vets

 

[pig in the city]

The advantages of dog metacam over cat metacam are, firstly, that you need to use less volume of medication and secondly you can get larger bottles which are more cost effective.
There will be no increase in effectiveness of pain relief.
My vet (the guinea pig vet, Ellie Whitehead) uses dog metacam 0.4ml /kg twice a day but does increase the dose up to as high as 1ml/kg twice a day for short term pain relief, or in palliative care.

I have no experience of Tramadol. But find Gabapentin very useful as extra pain relief. You can start on a low dose, say 0.1ml two or three times a day and gradually increase as needed. I have safely used 0.4ml three times a day in piggies with bladder issues.
Downside is it is very expensive and it goes off after 28 days ( l have used for up to 6 weeks but notice that little crystals form in it so usually chuck it at that point)

 

[Emx93]

The advantages of dog metacam over cat metacam are, firstly, that you need to use less volume of medication and secondly you can get larger bottles which are more cost effective.
There will be no increase in effectiveness of pain relief.
My vet (the guinea pig vet, Ellie Whitehead) uses dog metacam 0.4ml /kg twice a day but does increase the dose up to as high as 1ml/kg twice a day for short term pain relief, or in palliative care.

I have no experience of Tramadol. But find Gabapentin very useful as extra pain relief. You can start on a low dose, say 0.1ml two or three times a day and gradually increase as needed. I have safely used 0.4ml three times a day in piggies with bladder issues.
Downside is it is very expensive and it goes off after 28 days ( l have used for up to 6 weeks but notice that little crystals form in it so usually chuck it at that point)

Thankyou I will show this to the vet, it's good to know that metacam can be slightly upped as well if needed and there's options for additional pain relief, I've never heard of gabapentin (other than from you) but I think tramadol is slightly cheaper and lasts longer, if it works as well for her as it did onslow its highly affective too, if they're reluctant to prescribe stronger stuff I can always see if we can have her under two vets and use Ellie for pain relief related stuff and usual vets for everything else I just don't want to deregister her from our vets as finding a brilliant vet on your doorstep doesn't happen often I will enquire about gabapentin as well to see if the vet can give us an idea on whether gabapentin/ tramadol is more effective. The only downside we found of tramadol was it seems to taste gross, onslow used to foam at the mouth, vomit or gag whenever we tried to get it in him but he was very near end of life when it was prescribed and struggling with anything orally at the time I think onslow only had 0.1ml twice a day and he weighed 4kg he died around 2 weeks after starting it though so I'm not sure on long term stuff but he went from hunched over to able to lay comfortably xx

 

[PigglePuggle]

I think @Eriathwen has a piggy who takes tramadol for long term pain relief from osteodystrophy? Maybe she has has some advice on high strength pain relief?

 

[Lady Kelly]

I believe that cat metacam is only licensed in guinea pigs for soft tissue surgery so isn't licensed for arthritis use anyway. Might be worth looking that up and showing your vet if they need more persuading to go for dog metacam

 

[Emx93]

I believe that cat metacam is only licensed in guinea pigs for soft tissue surgery so isn't licensed for arthritis use anyway. Might be worth looking that up and showing your vet if they need more persuading to go for dog metacam

Thankyou, this is going to be part of my argument I'll book her in for an appointment if needed to go through it all, I just don't want to book an appointment for them to say no to dog metacam to then have to book an appointment with ellie...

 

[Eriathwen]

I think @Eriathwen has a piggy who takes tramadol for long term pain relief from osteodystrophy? Maybe she has has some advice on high strength pain relief?

I'm afraid I can't help unfortunately, it's something we've looked at but we're still on metacam and paracetamol at the moment, my vet seems a bit leery of giving anything stronger yet. I believe Adelle uses tramadol for Crunchie however

 

[Emx93]

I'm afraid I can't help unfortunately, it's something we've looked at but we're still on metacam and paracetamol at the moment, my vet seems a bit leery of giving anything stronger yet. I believe Adelle uses tramadol for Crunchie however

Thankyou, I didn't know paracetamol was an option... Are you on dog or cat metacam?

 

[Merab]

Can’t advise but wanted to assure you of my support

 

[Eriathwen]

Thankyou, I didn't know paracetamol was an option... Are you on dog or cat metacam?

We're on dog, luckily. He hated the taste to start with so I have no idea how I would have managed to get the larger amount of cat metacam into him! Worth asking your vet about the paracetamol, I was advised to get infant calpol so it's great I can just go out and buy more anytime I need it, but the dose is dependant on how much of other painkillers you're giving so your vet will have to work that out if they think it's a good option

 

[Emx93]

We're on dog, luckily. He hated the taste to start with so I have no idea how I would have managed to get the larger amount of cat metacam into him! Worth asking your vet about the paracetamol, I was advised to get infant calpol so it's great I can just go out and buy more anytime I need it, but the dose is dependant on how much of other painkillers you're giving so your vet will have to work that out if they think it's a good option

Thankyou, I have loads of infant calpol in the house so it's definitely something to ask about I also want her on dog metacam, so much more cost effective and it will last longer

 

[Emx93]

Princess LOVES metacam

 

[VickiA]

Just to add into the mix that we’ve only had tramadol in the very short term after surgery. Not sure it can be used longer term for piggies?

 

[Eriathwen]

Thankyou, I have loads of infant calpol in the house so it's definitely something to ask about I also want her on dog metacam, so much more cost effective and it will last longer

It's definitely sooo much more cost effective, I think I only paid £5 more for the 100ml bottle than I used to pay for the 32ml one.

 

[VickiA]

Q&As - Metacam

Metacam’s website q & a makes it clear cat metacam is for post surgical pain.

 

[Emx93]

Just to add into the mix that we’ve only had tramadol in the very short term after surgery. Not sure it can be used longer term for piggies?

Thankyou, I didn't realise this definitely a conversation with the vets then! Paracetamol sounds like a good starting point!

 

[piggieminder]

Braken had Tramadol 3 times daily post op 0.11ml it did make him a bit sleepy, he was also on 0.46ml dog Metacam 2 x daily (glad I kept notes!) . He also had Gabapentin 0.1ml 2 x daily for a few days later on while we had a last few days to say goodbye which seemed to work well for him. Hope you can find a solution with your vet soon.
Sending you hugs, you are having a hard time with your furries at the moment. Xx

 

[VickiA]

https://www.boehringer-ingelheim.com/press-release/european-metacam-indication-expanded-guinea-pigs

 

[Emx93]

It's definitely sooo much more cost effective, I think I only paid £5 more for the 100ml bottle than I used to pay for the 32ml one.

It costs £20.50 for 15ml cat metacam at the vets.... Vet uk do 100ml dog metacam for under £15 that's quite the price difference!

 

[Emx93]

I feel like we're our vets most awkward client at the moment

 

[Emx93]

I'm more than OK with using cat metacam for post op pain, I just want dog metacam for princess as she's on it long term

 

[Lady Kelly]

Just to add into the mix that we’ve only had tramadol in the very short term after surgery. Not sure it can be used longer term for piggies?

I think tramadol is considered as palliative in longer term care. I was offered it for Bumble with her severe arthritis but it was clear that this would only be an option when, or rather if, the metacam stopped being effective. Sadly the week I rang to book a review to move on to tramadol is the week she went downhill and I had to have her PTS so other than being offered it I can't comment on its use

 

[Emx93]

I think tramadol is considered as palliative in longer term care. I was offered it for Bumble with her severe arthritis but it was clear that this would only be an option when, or rather if, the metacam stopped being effective. Sadly the week I rang to book a review to move on to tramadol is the week she went downhill and I had to have her PTS so other than being offered it I can't comment on its use

Thankyou p has an inoperable tumour, not all the time and she's certainly picked up the last 24 hours or we would be at a vet by now she will grind her teeth/teeth chatter when laid in certain positions (where her tumour is) I think given the diagnosis she is considered to be palliative but most of the time you couldn't tell she was sick, I'm not sure she needs extra every day or whether we'd be able to start on a 'as needed' basis if there are side affects with additional pain relief but if paracetamol is a valid option and has few side affects/indications then that may be a better place to start than the big guns like tramadol and gabapentin... As I said I'd need to speak with the vet

 

[Lady Kelly]

Thankyou p has an inoperable tumour, not all the time and she's certainly picked up the last 24 hours or we would be at a vet by now she will grind her teeth/teeth chatter when laid in certain positions (where her tumour is) I think given the diagnosis she is considered to be palliative but most of the time you couldn't tell she was sick, I'm not sure she needs extra every day or whether we'd be able to start on a 'as needed' basis if there are side affects with additional pain relief but if paracetamol is a valid option and has few side affects/indications then that may be a better place to start than the big guns like tramadol and gabapentin... As I said I'd need to speak with the vet

Yes at least you are armed with some options to ask about. Of course there could always be the sad situation that extra pain relief doesn't make a difference which you also need to be prepared for. I hope whichever option your vet sees as best, that she has a renewed quality of life to spend some more time with you

 

[Emx93]

Yes at least you are armed with some options to ask about. Of course there could always be the sad situation that extra pain relief doesn't make a difference which you also need to be prepared for. I hope whichever option your vet sees as best, that she has a renewed quality of life to spend some more time with you

Thankyou me too and I appreciate the different options to be armed with, at least I'm not going into the vets with one set idea to be hung up on but instead different ideas to be discussed! she definitely has a lot more good days than bad thankfully I'd just like to have something on hand to prevent the bad days

 

[Emx93]

Been to the vets, She has some buprecare for when pain is intense

 

[PigglePuggle]

That's great news, might make her a bit sleepy as its an opioid but good your vet has let you have that to keep her pain free on her worse days x

 

[Emx93]

Yes I'm very lucky to have a very good vet the vet said its quite strong so might make her a bit loopy lol

 

[VickiA]

I’m sure you will have her pain well under control.

 

[Emx93]

Well all I can say is this stuff is amazing, we've not had any side affects from it and her excessive drinking was clearly a pain sign because its calmed right down so she's drinking around 300-500ml a day now (I know this is still quite a lot) compared to the 1-1.5l she was drinking at times, I'm feeling so relieved she seems so much better, and my washing machine is also thankful! Crazy drinking = crazy peeing! The only thing is she really hates the taste, I've never had to fight to get medicine in her but with this I do metacam = yummy, buprecare = yucky!