Metacam (Lara RIP)

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BunnieRosanna

BunnieRosanna

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Coquitlam, British Columbia, Canada
I have posted about Lara before:

http://rabbitsonline.net/view_topic.php?id=57567&forum_id=16&highlight=lara

She has been given months to live due to growing chest tumours, 9 months at tops (this was 2 months ago) and she has been on Metacam for the last 2 months. I give about 0.9 once per day, she is 4lbs. The vet prescribed 0.15 but I don't want to go that high.

I don't like the idea of what the metacam can do to her - i.e. kidney, liver issues but also concerned if I stop the metacam, any pain from her growing tumours will increase. I do not know FOR SURE if she is in pain anyway, there is no way I know.

Ahh what to do....I want to do the best by her but don't want to increase health issues or ailments either!!:X

She is a rex so a BIG eater and drinker. She is not drinking anymore than usual (kidney) but HOW would I know that she is having liver issues??

She is breathing quite heavily, rocking back and forth....this might be the tumors on her chest. It has become more prominent. Aside from that, she is our normal bunny and eats and runs around......:pray:

Anyone out there had their bun on metacam long term and have seen side effects?






 
I have not had a bun on metacam long term so I don't actually have experience with it except for giving it for a few days.
If it were my bun I would keep her on the Metacam to make sure that she is not in pain ; I believe that you meant 0.09??

Because of her condition and prognosis I would not worry about long term effects as long as she seems comfortable now,
I am sorry that Lara is so ill :(

You are certainly a conscientious caretaker. :hug:
 
I would be more concerned about stomach bleeding with metacam. I think it is important that she's on a long-term pain medication, and if you start to see problems with any of her input or output systems, you may want to change. The problem is that most other rabbit pain meds have psychotropic effects and the bunny may be a bit "spaced out" on them. Another one commonly used for long-term care is tramadol, which is not harmful to the kidneys, and doesn't make them space out too much. The stronger ones, like buprenorphine, often come with psychotropic effects at therapeutic doses but if you are willing to tweak the dosing, pain relief can usually be achieved without altered mental state. Metacam is just the easiest and least mind-altering drug available for bunnies in her condition.
 
How would I know the tummy is bleeding? would there be blood in the faeces? do you know how quickly bleeding can begin after starting metcam?

Comparing tramadol and metacam, you perceive tramadol has more psychotropic effects than metacam?

I have a check-up for Lara scheduled for the 6th Nov so I'd like to discuss the options with my rabbit-savvy vet.

I might lower the dose some more with metacam which could reduce the possibility of bleeding.

Thanks so much :innocent
 
I don't know about the bleeding. I know one of our members had a bunny on metacam long-term and he had stomach bleeding. I think it was Flashy. Do you remember, Maureen? I would expect to see pain and blood in the feces, but I'm not sure. I think as long as she's not acting like she's in pain, she's not having stomach bleeding.

Tramadol would have more psychotropic effects than metacam, yes.
 
Thanks - don't see her acting in pain (shivering, teeth grinding, standing still & not moving)....BUT have noticed this in the last week:

1. a sigh of air, slight squeek noise like passing a bit of gas, as she is lifting her bum up for a pee? rabbits do not fart?? cannot tell if coming from front or back end! she does not stop eating or widens eyes as if in pain so not sure what this is. Never happened before.

2. Her back two legs acting SOMETIMES like they have gone a bit 'dead'. Either one of them, not both, drags a little like it's been left behind a bit, and her bottom bum and back drops down a little.

What is this??
 
Bunnies can fart ...so that doesn't sound lke any thing significant

the leg behavior might be the effect of the chest tumors pressing on nerves.

the dose of metacam that you are giving is small;I wouldn't worry about bleeding now; bleeding could occur with any NSAID but the good that it does here far out ways the problems that could occur . if she did not have a limited prognosis then you could explore other options. If she is doing well now I would continue as you are without worrying

the other drugs couldmake her more "drugged"whichI don't think that you would want for her

if you want to discuss tramodol with your vetand possibly try it.......... that is an option , however, it were me and my rabbit I would leave it alone if it is working now.
 
I agree. I mean, I would talk with the vet next time I'm there about other pain med options, but it sounds like she's doing fine at the moment.
 
Disabled Karla has been on metacam for four+ years. Her weight is 4.45 lbs on the average. Dosing is .25 to .30 ml. Once a day. Should her eyes indicate more discomfort from her disabled condition or moving herself across the carpeted floor..., then I'll add Tramadol before bedtime. The slightly higher dose of Metacam offers more comfort management from her disabled posture. She's also taken Tramadol, and does on occasion now and then, alternating with metacam dosing per the advice of her DVM. I noticed more bleeding and visible facial discomfort with other pain meds suggested; Tramadol has a bitter taste which she isn't fond of.

Metacam is honey-flavored, per a vet who tasted it. :)
... I am more cautious on Tramadol dosing. At one point, I took her off a combo of pain meds and kept her solely on metacam. Withdrawing Tramadol at that point, too.

CBC panel is done every 12-18 mo. to check her organ levels and how she is handling the metacam.

Buprenex (buprenorphine) injections in Karla's back leg muscles are given if I need to be away for a longer duration of time (6-10 hours) and am unable to reposition her with her hind limb impairment. Dosing is 0.1 - 0.12. Highest received was .15 ml. She gets loopy (think space cadet), and stays calm instead of moving about when Buprenex is administered. Buprenex will suppress her GI function, so her poo size decreases.
Not moving about on the carpeted floor or her housing bath rug, and administering Buprenex now and then assists her overall happiness and physical limitation.

All meds are approved and discussed with our knowledgeable, rabbit savvy vet.

In Lara's situation, hospice care :hearts with loving guardians helps them stay comfortable. {{Bunny hugs to your Lara}}

I hope Lara will eat and run around for many more months, she's lucky you are carefully looking after her ~



 
Is Lara's spine okay? Did the vet test her reflexes in her toes or gently pinch her leg areas?

Just had an xray taken for disabled Tamm who's got an abdominal mass (diagnosed in '09) that we are opting not to surgically remove). The vet pinched her toes when starting the physical exam to make sure her spine was alright.

:: my two cents, I wouldn't lower the dose of metacam. I wouldn't be hesitant to give .15 - .20 of metacam once per day to keep her quality of life given her prognosis. Personally, I've found the lower or minimal dosing does zilch. And the saying is, quality not quantity, is that correct? Karla's had .3ml metacam for a time with no negative effects. I am no expert or vet, however.

Agreeing with angieluv and tonyshuman's positivity and Infirmary advice. Their Infirmary knowledge is stronger and expansive. Discuss all with your vet and sometimes vets have open ears to everything that we (as caregiving disabled bun parents) report on our disabled kids.
 
Per infirmary advice learned here and from naturestee, I give metacam or tramadol to Karla with food - and follow-up with drinks of water for hydration.

Mixing .1 ml tramadol with 1 T. canned pumpkin :) makes Karla lap it up with no bitter taste! Unsweetened applesauce may be an option, too.
 
Thank you so much for all of this - wow, that's amazing Karla has been on metacam for so long but appears happy and has such a wonderful bunnymum. How did she become a disabled bun? I am interested to hear about how she is in herself i.e. quality of life/happiness?

With situations like Karla and Lara, it's the constant weighting up of quality of life. However, it's not like we're in a life and death here but I know Lara finds it hard to get comfortable with this bulging absess on her tummy. The vet said that there is no point operating on her now what with her internal chest tumors growing too....the tummy absess sticks out at the side (where her mammories would be), it's growing, firm and sits on top of her top foot when she sits. On top of the internal tumors, this makes everything worse than it needs to be. I just want her to be able to rest.

I appreicate the advise regarding Tramadol (weighing the doses up together) and need to speak to the vet next Sat 6th Nov when we see him about this, and her spine (no, he has not tested this), and possible blood work. I might suggest we do another x-ray to check the progression of the chest/lung tumors. She is not bulging her eyes or lifting her head up to breath as vet said she would do as tumor increases size and presses on nerves etc...

I give Lara the Metacam in a piece of apple cut into a tiny cube, then with the end of a chop stick, I press in a "tunnel"/ cave and then squeeze the syringe of metacam right in. She then takes it right out of my hand and licks up the juicy drops. It's not the flavoured one and saves me picking her up!!

I'll keeping updating the situation. Thank you again for the advice this forum is very comforting, I feel so helpless and sad most the time about this situation.
 
That is a good point about giving the Metacam with food--that may really help prevent stomach bleeding. Thanks for the input!
 
Yes, I believe that is the only way to give any medication...I have Lara eat her pellets, then wait about an hour to have her eat her bowl of herb salad (mint, basil, dill, curly/flat leave parsley & cilantro) and then she has metacam followed by more pellets - phew - well, she is a rex with a serious appitite (she is not over weight - see avatar photo).
 
angieluv and tonyshuman, I learn so much from your postings!! thank you always for your input and dedication to helping others with your infirmary knowledge.

Randy, too, as I nodded my head about getting rabbits direct Vit D from unfiltered sunshine. The pool of first-hand knowledge benefits all our companions. (shaking head yes)

BunnieRosanna, here is Karla's thread:
http://www.linedgroundsquirrels.com/KarlasPage.html

Another disabled photo link: Warning. photos are larger.
http://www.linedgroundsquirrels.com/DisabledKarlaPhotos_Marie.html

BunnieRosanna ~ Karla hopped fine, then incurred fractures during the time she was in for her spay surgery. When she was home recovering, we noticed something was wrong. Second opinion vet saw fractures in the xray whereas the 1st vet was less reluctant to disclose things when I took Karla back for a follow-up, or maybe he didn't know. I stopped going to the vet who spayed Karla.

We learn from each other on RO.:agree Our 2nd disabled girl Tamm has a mass on the side of her abdomen. Tamm was in for xray on Wednesday to check for growth. Steatitis? My hubby and I opt not to remove; rather, let voluptuous, less-abled Tamm live a happy contented life for as long as she can... That she has right now...

If I can be of input for anything else, pls PM.

-------------------------
With situations like Karla and Lara, it's the constant weighting up of quality of life. However, it's not like we're in a life and death here but I know Lara finds it hard to get comfortable with this bulging absess on her tummy. The vet said that there is no point operating on her now what with her internal chest tumors growing too....the tummy absess sticks out at the side (where her mammories would be), it's growing, firm and sits on top of her top foot when she sits. On top of the internal tumors, this makes everything worse than it needs to be. I just want her to be able to rest.
--------------------------- Agreed. -----------------------------------------------------------

myheart may have input on her boy Patrick who had a tumor. You may want to PM myheart?

Karla is continually assessed by myself, and our vet, and the chiropractor whom she sees every 2 months for spinal adjustments. Ciproflaxin drops were stopped recently because her fur had been completely removed around her R-eye, that gets clogged tear ducts. Another sanctuary friend with hospice care kids noted Cipro- did the same for one of her bunns.

Marietta has a condition where the cartilage is deteriorating in her spine.

Treasure your bunns ~ and they treasure your TLC & specials-needs caregiving too!
Quality of life, :hug2:so lucky to have your Love.

Kisses to Lara,
 
BunnieRosanna wrote:
Thanks - don't see her acting in pain (shivering, teeth grinding, standing still & not moving)....BUT have noticed this in the last week:

1. a sigh of air, slight squeek noise like passing a bit of gas, as she is lifting her bum up for a pee? rabbits do not fart?? cannot tell if coming from front or back end! she does not stop eating or widens eyes as if in pain so not sure what this is. Never happened before.

2. Her back two legs acting SOMETIMES like they have gone a bit 'dead'. Either one of them, not both, drags a little like it's been left behind a bit, and her bottom bum and back drops down a little.

What is this??
Click to expand...


Guys.....

Over the weekend I have realised she is definitely NOT farting, she is making a noise, a squeak - when she goes for a pee.

Secondly, her hind leg, the one nearest her absess has gone LAZY now, she is standing funny and her balance is off. She has it sticking out to the side to balance.

Now, she is weeing not in her box which is out of character. This is not all of the time, but on occasion.

I have been watching her like a hawk all weekend, I have been by her side ALL weekend.

I have moved the vets appointment to Wednesday and have increased her Metacam to 0.15.

Her appitite is still incredible but I'm thinking this leg and bladder issue is nerve problems from the absess/tumours now :?

Does anyone agree that giving her some metacam about midday (about 0.5) would be a nice top-up for her when we are not there? (I have a pet sitter that can swing by to give her a bit ona piece of apple).

We give her the main dose about 8pm so I'm thinking midday the following day would be ideal? I know it only says once per day but my girl is not getting better and I want to make her comfortable? any advice?

 
TreasuredFriend - amazing information and big WOW about Karla, what a trooper she is. Thank you for sharing, I have learnt a lot. :pray:

I have PM'd myheart about her boy Patrick.

You are a star!


 
I don't know for sure as I have only had to give Metacam in one situation--post-neuter. It is supposed to last for 12 hours, so I would play it by ear as far as the pet sitter goes. If she's acting like she's in pain, then go for it. I would expect her to actually need an additional dose nearer the 8 hour after the last dose mark, rather than in the middle of the day.
 
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