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Vetergesic

Piglington Ali

Piglington Ali

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Help! I'm scared my vet has over prescribed buprenorphine.

Hope is 600g. She's been prescribed

"8 x Vetergesic Multidose Injection
0.5ml orally every five hours".

The bottle doesn't give a strength but it looks like Vetergesic is 0.3mg/ml and from what I read her dose should be 0.06ml three times a day. I gave the first dose but I actually halved it while I researched the dose not thinking for a moment even that might be way too much.

Any advice or info or reassurance? She's so weak right now I'm scared if it was too much it'll be the end of her. I've stuffed her with food and water and will keep doing so to try to flush it through if it's an overdose.

I can't contact the vet now.

Thank you.
 

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0.06 is not a dose surely? That's far too tiny to measure. That said I've never been prescribed this medicine. I would call your vet to query and get them to double check the dose
 
I didn't know what it was, so I did what you have presumably done and searched for it on here, so you will have seen this thread...
Specialist - Buprecare
This is 5 years old and advice may have changed in that time like with metacam (we are now told by our vet that we can give higher dose and more often) but the fact that your dose is 10x out and the only difference is a zero in the number would make me very twitchy... I'd be phoning that vet.

I'm sorry to ask because I don't know your history - is it palliative care for your poor piggy or are they trying to turn her around.
 
Free Ranger said:
I didn't know what it was, so I did what you have presumably done and searched for it on here, so you will have seen this thread...
Specialist - Buprecare
This is 5 years old and advice may have changed in that time like with metacam (we are now told by our vet that we can give higher dose and more often) but the fact that your dose is 10x out and the only difference is a zero in the number would make me very twitchy... I'd be phoning that vet.

I'm sorry to ask because I don't know your history - is it palliative care for your poor piggy or are they trying to turn her around.
Click to expand...

Yes that's the thread I saw to find out the dose, thanks for sharing though. It's been about 45 minutes now and she's still seeming okay so far, not sure how long it takes to kick in.

I can't phone my vet at night so I'm a bit stuck for now.

She has a bladder stone which can't be removed yet due to a respiratory infection (poor girl) so needs dosing up on pain meds. Tramadol was swapped today to buprenorphine.
 
That does seem an awful lot..my Leonard was on about 0.15ml twice (I think? Possibly 3 times) a day and he was palliative, being given pretty high doses of multiple painkillers, he was on 3 different ones towards the end. As he was 1 kilo, 0.06ml does sound more plausible for a 600g pig but I dont know how to work out the dose, I would definitely contact your vet when you can to querie it, you may be able to speak to an out of hours vet over the phone just to double check the dose.
If that is infact the dose, you may want to have them drawn up in syringes for you already, I have to give 0.04ml doses of paracetamol to some of mine and its a bit of a faff getting it exact.
 
I don’t have much experience but just wanted to let you know that my 6 year old piggy was given buprecare last week by the vet. (thread link is: Little unwell the first two pages of the thread are where me and few members spoke about buprecare/buprenorphine)
It was absolutely awful, my piggy seemed like he was dead just about. He’d only eat if we put it in his mouth but would space out and sort of forget he was eating until we would snap him out of it and then he’d eat again. His eyes were wide too. I also didn’t dare syringe feed him because he was just out of it. It was horrible, I was already worried about him (it was an emergency app) but that medication honestly made me believe my piggy wouldn’t last the night.
I doubt you have overdosed, but rather you’re seeing the effects of the buprenorphine. But I’m not good with numbers and medication so I’m just going off my brief experience with this
 
Thanks all. It's hit her now. She's pretty out of it. Not too bad yet but effects could yet increase. It's just as well I only gave half the dose, but wish I'd researched properly first. I was just worried as she'd been at the vets ages and they'd not given any pain relief so she was way overdue. The vet was going to give her an injection just before discharge but I said just give me the med and I'll give at home, I'm so glad I did. This makes me very anxious about using this vet again.

I got some info from a friend who researched pain meds in piggies and she found cavy savvy vets now give 0.05-0.2mg per kg.

Based on this and Hope's weight her dose range would be 0.03 to 0.12mg. The dose I gave was 0.075 so within that range. If I'd given the vet's dosing it would have been 0.15mg so over the highest dose. 😱

I'll keep you updated on her.
 
Little Ones said:
I don’t have much experience but just wanted to let you know that my 6 year old piggy was given buprecare last week by the vet. (thread link is: Little unwell the first two pages of the thread are where me and few members spoke about buprecare/buprenorphine)
It was absolutely awful, my piggy seemed like he was dead just about. He’d only eat if we put it in his mouth but would space out and sort of forget he was eating until we would snap him out of it and then he’d eat again. His eyes were wide too. I also didn’t dare syringe feed him because he was just out of it. It was horrible, I was already worried about him (it was an emergency app) but that medication honestly made me believe my piggy wouldn’t last the night.
I doubt you have overdosed, but rather you’re seeing the effects of the buprenorphine. But I’m not good with numbers and medication so I’m just going off my brief experience with this
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That sounds so scary. I've had a pig a bit like that after surgery once which was really scary. From what I've read on here on older threads others have said they've had that reaction with higher doses and it was very scary. I hope your piggy was okay in the end.
 
@Piglington Ali It also looks quite a big bottle in the photo - am I right that they want you to do 8 x 0.5 ml doses so they have put in about 4ml? Or 0.4ml?
@Little Ones I had a look at the pic or your receipt - do you know if that was 0.1ml of the stuff he had? I don't know how to interpret those numbers because it's done for pricing but I was thinking the '10' next to fluids might be a 10ml injection... would that be about right?
@Wiebke ? Sorry to disturb if you are on-line?

For some things I can understand that an oral dose of something that is usually injected might be a bit higher but this is all just guesswork.

The other reason I'm twitchy - and again I might just be being stupid here - is that I was prescribed 0.24ml doses of something by the vet last year and he spoke about including a special weeny syringe to get it accurate (I have problems with memory loss but I wouldn't have imagined that much detail!) and when the bottle came it said 0.2ml. Because it was according to bodyweight I thought that if there was a mistake it would be important - my 1 kilo pig wouldn't get enough - so I queried and waited outside while the dispenser double-checked. The answer came... it was 0.24ml but "it's just because our machine only prints one decimal place" I just came home thinking that it was designed for dog/cat doses and that now we use 'their' meds in GPs etc and I wrote it on with a biro! If your vet's machine is the same and the dispenser saw 0.0ml as the dose they might have 'corrected' as they saw fit - maybe adjusting to the amount usually given for a dog or cat?

@Piglington Ali I would be very tempted to do as you have done and reduce the dose - maybe even less - as long as you keep a close record of how much is given and when in case you are 'challenged' by the vet. I am not a vet and I don't know how much of this my piggy had - I don't even know if it was the same stuff I can just remember them going for 'an opioid painkiller - but my poor girl was totally wasted and didn't eat anything properly until she came out of it. This might be OK for cats or dogs but as you know it's important that pigs keep eating. They thought she might be trying to pass a bladder stone which is why they brought out the big guns along with a fluid injection. Ivy, like Little mentioned above, only had the one dose - not multiple doses to top her up - so the risk is that if Hope is out of it and can't eat there's not much point in pain relief. It sounds like it's going to be a long night for you and little Hope and I'm so sorry x
 
Free Ranger said:
@Piglington Ali It also looks quite a big bottle in the photo - am I right that they want you to do 8 x 0.5 ml doses so they have put in about 4ml? Or 0.4ml?
@Little Ones I had a look at the pic or your receipt - do you know if that was 0.1ml of the stuff he had? I don't know how to interpret those numbers because it's done for pricing but I was thinking the '10' next to fluids might be a 10ml injection... would that be about right?
@Wiebke ? Sorry to disturb if you are on-line?

For some things I can understand that an oral dose of something that is usually injected might be a bit higher but this is all just guesswork.

The other reason I'm twitchy - and again I might just be being stupid here - is that I was prescribed 0.24ml doses of something by the vet last year and he spoke about including a special weeny syringe to get it accurate (I have problems with memory loss but I wouldn't have imagined that much detail!) and when the bottle came it said 0.2ml. Because it was according to bodyweight I thought that if there was a mistake it would be important - my 1 kilo pig wouldn't get enough - so I queried and waited outside while the dispenser double-checked. The answer came... it was 0.24ml but "it's just because our machine only prints one decimal place" I just came home thinking that it was designed for dog/cat doses and that now we use 'their' meds in GPs etc and I wrote it on with a biro! If your vet's machine is the same and the dispenser saw 0.0ml as the dose they might have 'corrected' as they saw fit - maybe adjusting to the amount usually given for a dog or cat?

@Piglington Ali I would be very tempted to do as you have done and reduce the dose - maybe even less - as long as you keep a close record of how much is given and when in case you are 'challenged' by the vet. I am not a vet and I don't know how much of this my piggy had - I don't even know if it was the same stuff I can just remember them going for 'an opioid painkiller - but my poor girl was totally wasted and didn't eat anything properly until she came out of it. This might be OK for cats or dogs but as you know it's important that pigs keep eating. They thought she might be trying to pass a bladder stone which is why they brought out the big guns along with a fluid injection. Ivy, like Little mentioned above, only had the one dose - not multiple doses to top her up - so the risk is that if Hope is out of it and can't eat there's not much point in pain relief. It sounds like it's going to be a long night for you and little Hope and I'm so sorry x
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I'm not sure what the 8x means. The 'Multidose' bottles are 10ml, the single vials are 1ml. The amount I've got is about 8-10ml so I think she must mean 8x 1ml vials. The 'Multidose' are 10ml, it could be one of those, but then the '8x' doesn't make any sense. Both these are 0.3mg/ml so unless she's diluted it the prescribed dose is definitely very high.

Yes there could have been a system reason for writing the label as it is. She was looking in her book for dosing when on the phone with me so it'd be odd if she got it wrong.

Yes indeed like you say it may be fine for a dog to be conked out for the night but it's not okay for a pig who then doesn't eat. With piggies and bunnies you need to get just the right dose to reduce the pain enough to encourage them to eat, without knocking them out so much they don't eat. I'll be letting the vet know what I've done so hopefully she can use that info in future dosing.

I'm going to need to give her a syringe feed now, I hope she'll take it. She's still somewhat alert so not too bad but not moved at all for three hours.

No I won't be sleeping much! Thank you for your input.
 
So about 3 hours after her dose and she's not particularly out of it. She's a bit more comfy but obviously still some pain when she wee'd. She took the feed reluctantly but a bit less fighting than usual.

When the med first hit she went really dozy, her head kept falling off the hottie, but that level of 'dozy' was fairly short lived. So either the dosing of this is different to what we're thinking it is, or she just tolerates it fairly well.

The only issue I have is her breathing is quite heavy which is likely the med, and since she's already battling respiratory issues this is a bit concerning.
 

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I'm sorry, I went to bed really early last night, so didn't see that I had been tagged until this morning. I've never given Vetergesic orally, as I've always given it as an intramuscular injection, so really can't comment on the dosage. I did think that it needed to be injected intramuscularly as it could be destroyed by the digestive system, but I may be incorrect about that. Will need to check my pharmacology notes. How is she doing this morning?
 
furryfriends (TEAS) said:
I am a little concerned about the fact that buprenorphine can cause respiratory depression, which is worrying as you mention your piggy is already battling respiratory issues.
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Thanks for responding. She's doing okay, she seems to be tolerating the buprenorphine okay. I do wonder if the vet has diluted it or something as it's not as strong a response as I'd expect. I've given another dose but a little less this time. When I got her out to feed her she started eating hay so I let her sit and eat that which went on for half an hour on and off. So the pain relief seems to be enough to relieve pain but not so much as to stop her eating. But as you say I was concerned about her breathing given her respiratory issues, it's been quite heavy, hence giving a smaller dose the second time.

I noticed on previous threads here that others have given the injectable orally. The whole thing of giving injectables like that does my head in a bit, seems so wrong. But I've read quite a bit of others doing this so I have to assume it is okay and works.
 
Piglington Ali said:
Thanks for responding. She's doing okay, she seems to be tolerating the buprenorphine okay. I do wonder if the vet has diluted it or something as it's not as strong a response as I'd expect. I've given another dose but a little less this time. When I got her out to feed her she started eating hay so I let her sit and eat that which went on for half an hour on and off. So the pain relief seems to be enough to relieve pain but not so much as to stop her eating. But as you say I was concerned about her breathing given her respiratory issues, it's been quite heavy, hence giving a smaller dose the second time.

I noticed on previous threads here that others have given the injectable orally. The whole thing of giving injectables like that does my head in a bit, seems so wrong. But I've read quite a bit of others doing this so I have to assume it is okay and works.
Click to expand...

If we’ve needed stronger pain relief, we’ve used Tramadol.
I've found my notes which say it should never be given orally as stomach acids destroy the drug. Maybe guinea pig stomach acids are different, as this was relevant to a cat. Simon has always asked me to inject it, but maybe that's because he knows I'm confident with injecting guinea pigs.
 
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:agr:
We have also used tramadol for a stronger pain relief.
I think I’d be inclined to ask the vet for that and just not use the buprenorphine. As the bottle states that it’s an injection and with the information stated above, I wouldn’t risk it.
 
Hi, I'm not an expert but I had a piggy who had oral buprecare as part of her palliative care, she was 1.1kg when it was prescribed and the maximum we were told to give her was 0.2 three times a day, she never had any side effects 💖 hope your piggy is feeling better soon, buprecare worked great initially but eventually she didn't respond to it as well and we switched to tramadol. Sending healing wheeks to your piggy!
 
@Piglington Ali I'm so relieved your girl is tolerating this well enough to keep eating and it sounds like you are right on the ball monitoring her breathing. I'm keeping everything crossed for you. It would be useful for you to keep an eye on whether a higher/lower dose lasts for more/less hours if you know what I mean... for example, does a higher dose hit harder and the effects last longer than the lower dose, or did it hit harder but wear off after about the same amount of time allowing her to 'come to' and regain some appetite. It will give you an idea of how fast she is metabolising it and recovering from each dose - but also some indication of how long the pain relief is lasting. I am in awe of how you are balancing her needs so carefully - such a hard situation with a poorly little girl x
 
Thanks everyone for your input and care.

We swapped from tramadol to buprenorphine as the tramadol wasn't doing enough. Metacam is definitely helping as she dips when she's due a dose. I'm still giving the buprenorphine as I've seen others say they have been given the injectable to give orally by piggy savvy vets and I just need to get her through till tomorrow. It's definitely making her more comfortable even if she still isn't moving. The last dose I gave less and she didn't want grass on the next feed and was even more subdued so I've gone back up again. I certainly wouldn't give her the dose prescribed though.

For interest's sake, I gave her one dose without food (usually given with a syringe feed) and she was more out of it that time. So definitely worth giving with food.

She's not in a good way really. She's at the vets tomorrow morning for surgery or we may choose to let her go depending on what the vet says as she's been so ill lately with a URI, UTIs, ovarian cysts that have blown up, abdominal fluid retention for which she's on frusemide. I'd love for her to have surgery and pull through but I don't want her to get through surgery then deteriorate in the middle of the night and suffer badly. It's so hard to know what's right.

I will certainly let you know how things go.
 
Just wanted to let you know I had to have my sweet Hope pts last Sunday after I last wrote. She was in such a bad way. Not just out of it on meds but just so weak, breathing getting shallower, doing weird jerking movements when I tried to feed her. I don't think she'd even have made it through the night. Something was really not right with her. Thank you for your help everyone. It's all a constant learning curve with our piggies. 😔💗
 
So sorry that you had to make that difficult decision.
It’s one of the toughest we ever make, but one made out of love.
Be gentle with yourself as you grieve
 
I’m so sorry that you had to make that decision for her, it’s the hardest one we are called upon to make. Hugs to you x
 
I'm sorry it turned out that way. You both fought very hard but it sounds like she was coming to the end, and you did the kindest thing. Thanks so much for letting us know what happened. Take care of yourself and I'm so sorry for your loss. You and Hope will be in my prayers x 💕
 
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