Metacam in cats

Re: Metacam in cats

Rajat — Tue, 24 Jul 2012 18:25:55 GMT

[quote user="Bob Russell"]It takes no more than a second for someone to be distracted and get it wrong! Yes you should check the label but a court would crucify anyone that did make this type of mistake as it is so unforgivable. How many bottles get returned to their rightful place?[/quote]

Exactly- regardless of checking anyone can make a mistake - we have to make life less complicated not more- cannot see why it is suddenly easier to use 2mg/ml - say 1 kg cat (smallest Id give metacam to extrapolating age) - 0.2mg/kg is 0.2mg =0.04ml - very do-able with 1 ml syringes!

Aagh the cascade, actually making things potentially more dangerous for pets in this situation!!

Re: Metacam in cats

James Laidlaw — Tue, 24 Jul 2012 16:40:36 GMT

[quote user="Thomas Johnson"]

I find it very frustrating that they didn't apply for a change of license for the cat and dog Metacam, it would have been much simpler to be able to give the 0.2mg/kg dose from the original bottle. They would probably argue that the lower concentration allows for more accurate dosing...

[/quote]

I think that was the exact wording the rep gave me when it came out!

Re: Metacam in cats

Thomas Johnson — Tue, 24 Jul 2012 16:00:32 GMT

Re: Metacam in cats

James Laidlaw — Tue, 24 Jul 2012 14:01:43 GMT

How does it work with the cascade if there is a licensed form available? Is it accepted to use an unlicensed (albeit very well used and previously fine) form of metacam because the bottles look similar? Sounds like a lot of people are, I just wonder how this would be viewed if you were unfortunate enough to have a problem?

We have both, the dog metacam actually still says "for dogs and cats" on the label, while the cat one has a slightly darker purple label (if you squint!) and says metacam for cats on it.

Re: Metacam in cats

Bob Russell — Tue, 24 Jul 2012 13:16:34 GMT

It takes no more than a second for someone to be distracted and get it wrong! Yes you should check the label but a court would crucify anyone that did make this type of mistake as it is so unforgivable. How many bottles get returned to their rightful place?

It should be unnecessary for anyone to write DOG or CAT on them!

ACP used to be a worry as the only immediate difference was the LA was a deeper yellow than the SA. Labels were almost identical. However we don't stock the cat meloxicam anyway and are careful with the dosing. Keep things simple even if technically off-licence!

Re: Metacam in cats

James Laidlaw — Tue, 24 Jul 2012 11:58:27 GMT

Can't you just put the bottles in a different location?

Or label them? CAT and DOG in big letters would work?

Or just read the label before drawing it up?

I understand they look similar and mistakes can be made and all, but how long does it take to read a label before you draw something up - shouldn't that be the standard approach to drawing up anything?

Re: Metacam in cats

Bob Russell — Tue, 24 Jul 2012 11:02:35 GMT

Use Loxicom injection for dogs and Metacam for cats so the bottles don't get mixed up. Tell the rep why sales of Metacam dog is dropping. It is totally irresponsible for manufacturers to produce different strength products in similar bottles.

I worry enough about torbugesic and ketaset in similar bottles so we have changed brand of torb to get round this one.

Product branding should never be dangerous!

Re: Metacam in cats

Alastair Franklin — Tue, 24 Jul 2012 10:09:10 GMT

[quote user="Joyce Whitehead"]

Whereas Boehringer has got the data to allow the "cat" injection to be used prior to the oral product. It is yet another example of odd off licence applications that make little sense, but I guess we have to jump through the hoops.

[/quote]

I think this is nearest to the issue, at least to my understanding. The research data (for cats) officially pertains to Meloxicam cat, at the lower concentration, and therefore per the rules, one must use that.

The fact that there exists the same drug, from the same manufacturer, albeit at a different concentration and as far as I'm aware, with no difference in preservatives, stabilisers, etc is, unfortunately, irrelevant (if we are following the rules and the cascade). Our hands are (theoretically) tied to using the exact combo that has undergone the licensing tests, at the recommended intervals. Logic and common sense may, however, tell us a different story.

[quote user="Lorna McHardy"]

I couldn't agree more (trainee nurses or not), and am, in fact, aware of several instances of overdosing due to the two almost identical bottles. Where I have a say, I won't stock both. And "dog metacam" is licensed for both dogs and cats, unless they've changed that.

[/quote]

had a mental shudder reading that when I recalled an (almost) situation from a while back. Exclusively SA charity practice. Someone in their wisdom decided to order LA Metacam injectable (20mg/ml), on the basis it was cheaper. It made it onto the shelf, but not for long!

Re: Metacam in cats

Lucie Allcutt — Tue, 24 Jul 2012 08:41:09 GMT

[quote user="Michael Woodhouse"]

Sorry for being dumb - when using the 'cat' injection how soon afterwards do you give the oral product? In either case the oral product is not needed for 24 hours.

[/quote]

No I wasn't too clear! Cat metacam injection given pre-op....then oral cat metacam given 24hrs later. If they have been given "dog" metacam injection they then have to wait 48hrs (ie an extra 24hrs) before they can get the oral cat metacam.

Re: Metacam in cats

Busybee — Tue, 24 Jul 2012 08:11:39 GMT

[quote user="Michael Woodhouse"]Just swap to Loxicom, no need to worry.[/quote]

I was thinking the same but then saw this in the Loxicom 5mg/ml injectable data sheet - "Do not use an oral follow-up therapy containing meloxicam or other NSAIDs in cats, as no safe dosage for repeated oral administration has been established."

Re: Metacam in cats

Michael Woodhouse — Tue, 24 Jul 2012 00:28:28 GMT

[quote user="Lucie Allcutt"] I give a 0.2mg/kg sc dose (using the 2mg/ml solution for injection) pre-op *generally* - followed by oral at 0.05mg/kg - however at branches that don't have "cat" injectible metacam I have been told that we need to wait 24hrs before allowing owners to administer the oral cat metacam and I just can't sort out why this is so. [/quote]

Sorry for being dumb - when using the 'cat' injection how soon afterwards do you give the oral product? In either case the oral product is not needed for 24 hours.

I see they have a nice datasheet indication for following up the 'cat' injection with oral, but since you are not using the oral at the same time you are not off licence starting with the 'dog&cat' product then following up the next day orally.

Just swap to Loxicom, no need to worry.

Re: Metacam in cats

Joyce Whitehead — Mon, 23 Jul 2012 23:47:32 GMT

I think from memory that the issue is that the licence does not allow "dog" metacam injection to be used before oral cat metacam, so you are working off licence. Whereas Boehringer has got the data to allow the "cat" injection to be used prior to the oral product. It is yet another example of odd off licence applications that make little sense, but I guess we have to jump through the hoops.

Before the cat metacam injection was introduced we did on many occasions use the injectable prior to the oral, but have now stocked both to try to avoid being off licence.

Re: Metacam in cats

Lorna McHardy — Mon, 23 Jul 2012 23:19:20 GMT

[quote user="Rajat"]

[quote user="Lucie Allcutt"]I give a 0.2mg/kg sc dose (using the 2mg/ml solution for injection) pre-op *generally* - followed by oral at 0.05mg/kg [/quote]

We do the same but use the 5mg/ml. Having 2 concentrations in is confusing and with several trainee nurses can lead to errors and overdosing if not careful.

[/quote]

Re: Metacam in cats

Rajat — Mon, 23 Jul 2012 23:00:11 GMT

[quote user="Lucie Allcutt"]I give a 0.2mg/kg sc dose (using the 2mg/ml solution for injection) pre-op *generally* - followed by oral at 0.05mg/kg [/quote]

We do the same but use the 5mg/ml. Having 2 concentrations in is confusing and with several trainee nurses can lead to errors and overdosing if not careful.

I don't see how 0.2mg/kg is going to be different regardless of strength used...

Re: Metacam in cats

Lucie Allcutt — Mon, 23 Jul 2012 21:26:52 GMT

[quote user="CatherineThomas"]

Because that is what the boehringer reps tell you. We had a visit from the rep shortly after they brought out the injectable metacam cat and she was telling us that if we use metacam dog it is off licence to continue with oral metacam cat therefore we should be using metacam cat. I think it's just another way for them to try to sell you more. I can't see how it can actually make any difference to the efficacy or safety of using it. We just ordered in the cat injectable stuff so that we are doing it properly. It is slightly more expensive but we use it for all of our ops so both dog and cat bottles get used up in plenty of time and there's no wastage.

[/quote]

Ah! Well that's frustrating - so my patients don't get the benefit of pain-relief when they should have it all because of some kind of technicality? :-(

Re: Metacam in cats

Lucie Allcutt — Mon, 23 Jul 2012 21:23:52 GMT

[quote user="Michael Woodhouse"]

Lucie - the concentration is irrelevant - what dose are you giving?

[/quote]

Yes, I thought so too - but no-one can tell me why 5mg/ml is different from 2mg/ml!

I give a 0.2mg/kg sc dose (using the 2mg/ml solution for injection) pre-op *generally* - followed by oral at 0.05mg/kg - however at branches that don't have "cat" injectible metacam I have been told that we need to wait 24hrs before allowing owners to administer the oral cat metacam and I just can't sort out why this is so.

Re: Metacam in cats

CatherineThomas — Mon, 23 Jul 2012 21:21:30 GMT

Re: Metacam in cats

Michael Woodhouse — Mon, 23 Jul 2012 21:08:41 GMT

Lucie - the concentration is irrelevant - what dose are you giving?

If it needs NSAIDS I start orally after 24 hours.