Changing NSAIDs

Re: Changing NSAIDs

Rob Loxley — Thu, 01 Aug 2013 16:30:27 GMT

[quote user="Rob Reid"]What would other people do in this situation[/quote]

As per data sheet give oral dose of Cimalgex on the morning of surgery 2hrs preop. Likewise Previcox. Obviously this involves working this out pre-op!

Re: Changing NSAIDs

Rob Reid — Thu, 01 Aug 2013 14:31:38 GMT

Thanks for your replies so far.

[quote user="Stephen Courtney"]

If really concerned, phone the drug company and speak to the technical vet.

[/quote]

Vetoquinol were consulted in this case and their advice (slightly surprisingly? ) was not to use cimalgex post-op but to switch over to metacam (which us surgical members were more comfortable with anyway.)

[quote user="Michael Woodhouse"]

If I swap a dog from one medication to another then I usually suggest missing a single day. It is just damn cruel keeping a dog off analgesia for a fortnight whilst something magical is supposed to happen. These drugs don't have crazy long half lives.

[/quote]

It just made me think a bit about when I switch NSAIDs in more chronic cases as well. I've always tended towards Michael's approach when I've done this in the past and have to say I haven't had any problems. It just got me thinking about this 1-2 week washout period that's quoted in the formulary / datasheets and whether I should be paying more attention to it......but then for me reducing the patient's pain levels has always taken precedent. Does everyone else take this approach or do they strictly observe the datasheets?

Re: Changing NSAIDs

Stephen Courtney — Thu, 01 Aug 2013 13:35:05 GMT

Agree with Michael.

People get so worked up! Keep calm and give an injection on the day, and carry on as normal the following day.

If really concerned, phone the drug company and speak to the technical vet.

Re: Changing NSAIDs

Evelyn Barbour-Hill — Thu, 01 Aug 2013 13:34:57 GMT

I'd do what the surgical team propose.

I'm tempted to say "why not?" but I guess that's inviting a clobbering.

Re: Changing NSAIDs

Michael Woodhouse — Thu, 01 Aug 2013 13:26:43 GMT

We would do as you - no tablet day of surgery. Use usual injectable NSAID (we use carprofen) and then continue tomorrow with usual.

The only thing I'd change on is something long acting like Troxcil.