Beyond NSAIDs in OA

Re: Beyond NSAIDs in OA

Martin Atkinson — Thu, 21 May 2015 14:52:11 GMT

[quote user="Anthony Todd"]

Just realise, to your enormous perpetual credit, that you are only the second person in the whole wide world to whom that achronym has been applied, and justly so.

[/quote]

Re: Beyond NSAIDs in OA

Anthony Todd — Thu, 21 May 2015 14:47:46 GMT

Just realise, to your enormous perpetual credit, that you are only the second person in the whole wide world to whom that achronym has been applied, and justly so.

Re: Beyond NSAIDs in OA

Martin Atkinson — Thu, 21 May 2015 14:13:04 GMT

[quote user="Anthony Todd"]FigJam[/quote]For a dino I'm surprised you're streetwise enough to know such urban slang Anthony - I had to look it up! However as you have now alerted me to it I will add it to my repertoire of dubious qualities.

Re: Beyond NSAIDs in OA

Rob Loxley — Thu, 21 May 2015 13:12:46 GMT

Our old catalogue for GenusExpress (?2006) put PLT at £195/1000 tabs; now Henry Schein says £498/1000 tabs

Re: Beyond NSAIDs in OA

Martin Atkinson — Wed, 20 May 2015 19:25:41 GMT

[quote user="Julian Earl"]I been a big fan f Trocoxil.[/quote]The one and only dog I gave it to had a life threatening bout of HGE 2 days later. Zoetis said it couldn't possibly be the drug that caused it as its out the serum within a few hours. I remain unconvinced and have not used it again as it has few advantages over anything else so I'm not taking the risk. Still we've opened this particular Pandora's box on here before.

Re: Beyond NSAIDs in OA

Julian Earl — Wed, 20 May 2015 19:12:28 GMT

I been a big fan f Trocoxil. More effective than other NSAIDs in my experience. Some dogs switched from another non-steroidal do better with the longer effect of Trocoxil. No apparent side-effects even in dogs receiving a GA. I am convinced on the effect of stopping the peaks and troughs of chronic pain, so avoiding hyperalgesia. I was dubious at first but extensive use has me convinced of the benefit.

HTH.

I never found Tramadol very effective for OA in dogs.

Re: Beyond NSAIDs in OA

Anthony Todd — Wed, 20 May 2015 16:08:52 GMT

[quote user="Martin Atkinson"] 'you know Martin you're not such a bad bloke, I used to think you were a complete arse'. I wonder if he muttered in sleep, 'bloody hell, that Atkinson is not so bad after all'?[/quote]

FigJam

Re: Beyond NSAIDs in OA

Martin Atkinson — Wed, 20 May 2015 15:42:42 GMT

[quote user="David Shepherd"] Bob Butler was with us, and on Zyban to stop smoking, so inclined to talk & ramble in his sleep [/quote]I remember 'asking' Bob not to smoke at dinner on a SPVS trip years ago and gave him a lecture on how anyone who smokes at the table must be ignorant. Some years later I was chatting to him over a beer and he said something to the effect of: 'you know Martin you're not such a bad bloke, I used to think you were a complete arse'. I wonder if he muttered in sleep, 'bloody hell, that Atkinson is not so bad after all'?

Re: Beyond NSAIDs in OA

Bob Russell — Wed, 20 May 2015 12:45:34 GMT

Seem to remember PBZ was 2p a tablet but PLT was 8p. Expensive stuff!

Re: Beyond NSAIDs in OA

Robin Grimmer — Wed, 20 May 2015 11:12:52 GMT

[quote user="Anthony Todd"]

[quote user="Bob Russell"]When I first qualified the ordinary dogs got phenylbutazone [/quote]

Yes, me too, and it worked well, especially touched up with a bit of pred but then the doom merchants killed it.

[/quote]

Do they still do bute for horses or has that been superceded now?

Re: Beyond NSAIDs in OA

Anthony Todd — Wed, 20 May 2015 11:08:04 GMT

[quote user="Bob Russell"]When I first qualified the ordinary dogs got phenylbutazone [/quote]

Yes, me too, and it worked well, especially touched up with a bit of pred but then the doom merchants killed it.

Re: Beyond NSAIDs in OA

Anthony Todd — Wed, 20 May 2015 10:49:52 GMT

[quote user="Bob Russell"]The best price I could get from a 'reliable' internet source was about 60p[/quote]

http://www.petdrugsonline.co.uk/prescriptions/p/predno-leucotropin-tablets-%28plt%29

I expect some sort of "processing fee" by return please.

No, sorry, a disbursement, like the solicitors.....

I can't find a real old price but it was pennies/tablet!

Why would a reputable drug company market them in such a big, therefore expensive, pack?

I suppose someone looked up how many they sold back in the day.

Re: Beyond NSAIDs in OA

Bob Russell — Wed, 20 May 2015 09:08:43 GMT

[quote user="Anthony Todd"]

[quote user="robloxley"]to control the costs[/quote]

Wow, they used to be so cheap! Can find them on line for 46p a single tablet; can't believe it!!

Then on some forum:

As with all steroids there may be significant alteration of fat, carbohydrate, protein and mineral metabolism. Excessive hunger and thirst may be seen. Gastrointestinal ulceration, suppression of the immune system and delayed wound healing may also be seen, but usually only at higher dosages.

See what I mean about a bad reputation! Total baloney of course.

[/quote]

But the dose of preds is pretty much a cat dose! I warn owners that irritancy is on a par with aspirin or ibuprofen in people. I suspect gastric issues are similar (or possibly less) than with some of the more usual OA drugs.

When I first qualified the ordinary dogs got phenylbutazone (red) tablets but the posh dogs got PLT!

The best price I could get from a 'reliable' internet source was about 60p so I would be a little worried if someone could supply them for much less. The tablets did not have a batch number or expiry date on the label so they could have been out of date!!

I have had many dogs on them for years uneventfully. I did get into the habit of using the more modern drugs so they sat on the shelf. Results can be impressive!

Re: Beyond NSAIDs in OA

Anthony Todd — Wed, 20 May 2015 08:40:39 GMT

[quote user="robloxley"]to control the costs[/quote]

Wow, they used to be so cheap! Can find them on line for 46p a single tablet; can't believe it!!

Then on some forum:

See what I mean about a bad reputation! Total baloney of course.

Re: Beyond NSAIDs in OA

Rob Loxley — Wed, 20 May 2015 00:03:09 GMT

[quote user="Hannah Wynne Richards"]Theoretical disadvantages to PLTs but I've used them when the alternative was euthanasia, and seen good results[/quote]

I agree about not waiting til the dog is so bad to otherwise need euthanasia before trying PLT; they often do remarkably well (even if you taper the dose a little to control the costs)

Re: Beyond NSAIDs in OA

Joyce Whitehead — Tue, 19 May 2015 19:47:55 GMT

I haven't used plt for some years due to the pack sizes, although as previously said, the internet pharmacies might be our friend for once here. I'd just like to add that Pardale is really effective in some of these dogs, useful as it can be added to NSAID (not in this case maybe) but even on it's own it is very useful. I have also put some of these older really bad dogs on low dose steroids as it is sometimes the only alternative. One retriever I can think of was on them for at least 2 years before euthanasia, on memory I think about 2mg daily with Pardale and tramadol. Crippled with elbow arthritis before and NSAIDs stopped having a useful effect.

Re: Beyond NSAIDs in OA

Andrew Henfrey — Tue, 19 May 2015 19:17:36 GMT

Has anybody on the forum tried therapeutic laser? It seems to be getting pushed by companies as an alternative to NSAIDs, but the evidence base for effects seems mainly experimental.

Re: Beyond NSAIDs in OA

Anthony Todd — Tue, 19 May 2015 18:23:28 GMT

[quote user="Neil Wheadon"]the pred is fine and I have never seen issues [/quote]

Yes, back in the day pred was considered a "good drug" but this was before dosage abuse and Ovarid prejudiced everybody against steroids.

So, back then, adding pred to anything was perceived to be good independent of dose.

Re: Beyond NSAIDs in OA

Anthony Todd — Tue, 19 May 2015 18:18:00 GMT

[quote user="Hannah Wynne Richards"] Theoretical disadvantages to PLTs[/quote]

Tell me what they are please; I'd accept prejudice ,but no others unless you call 5mg of pred a disadvantage to a Lab?

I had a friend who had depomed into most joints for rheumatoid arthritis. Total disaster after a short period of improvement!

Got another friend [that's two!] was on pred for crohns [spelling] very sensitive to dose down from 5mg daily to 4mg and depression immediately.

Re: Beyond NSAIDs in OA

Neil Wheadon — Tue, 19 May 2015 18:11:53 GMT

[quote user="Bob Russell"]With PLT a labrador will be getting 2-3 mg prednisolone daily. I still don't know the mechanism of action but I would strongly recommend that vets who have not prescribed PLT, order some online and give them to a patient or two.[/quote]

Long term locum 2 years ago, so got follow up. 2 labradors significantly better on PLT having not tolerated NSAID's in their various guises. Glad to read Malcolm Ness recommends too (where is he?) Go on give it a go, the pred is fine and I have never seen issues and was told the Cinchophen was the ingredient that helped.

Neil

Re: Beyond NSAIDs in OA

Hannah Wynne Richards — Tue, 19 May 2015 17:44:49 GMT

Theoretical disadvantages to PLTs but I've used them when the alternative was euthanasia, and seen good results. They do make me sneeze when I'm counting them out though.

Wynne

Re: Beyond NSAIDs in OA

Bob Russell — Tue, 19 May 2015 15:41:25 GMT

[quote user="Mark Rowland"]

Any specific joints affected (intraarticular injections)

[/quote]

Elderly arthritic labrador. My bet would be most joints!

Re: Beyond NSAIDs in OA

Mark Rowland — Tue, 19 May 2015 15:21:35 GMT

Any specific joints affected (intraarticular injections)

Re: Beyond NSAIDs in OA

David Shepherd — Tue, 19 May 2015 10:24:38 GMT

[quote user="Bob Russell"]

With PLT a labrador will be getting 2-3 mg prednisolone daily. I still don't know the mechanism of action but I would strongly recommend that vets who have not prescribed PLT, order some online and give them to a patient or two.

My staffie was struggling even on trocoxil and she is back to being happy on PLT.

Having removed PLT from my armoury of drugs for a few years we now have a handful of patients on them and everyone seems really happy. Cost is an issue if you buy a tub of 1000 but that is what the internet is for!

[/quote]

Vivid memories of a SPVS sailing/CPD trip to the Western Isles a few years ago; Malcolm Ness was giving us a talk on OA control, and recommended PLT (Poorly Leg Tablets) when NSAID were giving poor control. Bob Butler was with us, and on Zyban to stop smoking, so inclined to talk & ramble in his sleep a lot. In the middle of the night a voice was heard from his bunk; "Bloody hell, he's told us to use PLT!"

I've often used PLT since, to good effect. I have no other evidence base.

David

Re: Beyond NSAIDs in OA

Liz w — Mon, 18 May 2015 23:22:02 GMT

Another suggestion is to look into tumeric in the diet. I've had a couple of clients who have used it - both for themselves and their pets and had positive results. ( I didn't suggest it - in both cases they had read about it and decided to give it a go).