PLT in dogs

RE: PLT in dogs

Bob Russell — Tue, 05 Apr 2016 10:03:01 GMT

We have only had one fatal gastric bleed and that was with meloxicam!

I would still consider PLT a pretty much end stage drug and it has more than its fair share of mild to moderate side effects. Mostly steroid type.

The five gastric bleeds suggests possible unofficial ibuprofen supplementation or possibly not enough of a wash out period after finishing other drugs. Or bad luck of course!

RE: PLT in dogs

Dalriata — Sun, 03 Apr 2016 16:19:25 GMT

We were never taught about PLT at vet school but I learned about it "on the job" in my first practice (where I was also forced to learn Fahrenheit as boss refused to have Celsius thermometers in the practice.... old school!).

I have found it to be a wonder drug for end stage OA - ie after we have gone through 3 different NSAIS plus pardale and amantadine/tramadol and there is still reduced QOL. I imagine if we could look in the joints the PLT would be more effective in cases where there is basically no cartilage left and no joint fluid.

However Considering I must have put less than 20 dogs on the drug I have had 5 fatal gastric bleeds which I have attributed to the PLT. Anecdotal evidence only, and of course these are older dogs with numerous problems who are less likely to recover from a bleed anyway. We also had a case that needed tail amputation recently and ended up with a terrible non-healing wound, I blamed the PLT but could have been wrong.

I've also used it in dogs with OA that have asthma/Westie lung or skin problems, and added in extra preds when needed which has worked well.

RE: PLT in dogs

Anthony Todd — Thu, 31 Mar 2016 17:51:23 GMT

[quote user="John Flynn"]carprofen [/quote]

What's it's status now?

Was supposed to be the answer to a teenage prayer back in the day?

RE: PLT in dogs

John Flynn — Thu, 31 Mar 2016 16:53:58 GMT

[quote user="David Mills"]Almost tempted to continue rimadyl and add in preds. [/quote]

that is what i would do - haven't used plt for 10 years.

or simply increasing the carprofen dose without the preds dependent on current dosing.

RE: PLT in dogs

Malcolm Ness — Wed, 30 Mar 2016 21:01:36 GMT

[quote user="Bob Russell"]I have had dogs on them for years (before newer NSAID's) and never seen diabetes problems[/quote]

We were seeing Cushingoid signs, not diabetes. Pot belly, thin skin, muscle weakness, comedones etc.

RE: PLT in dogs

Anthony Todd — Wed, 30 Mar 2016 20:29:06 GMT

[quote user="robloxley"]Are you talking about Pardale or PLT???[/quote]

PLT, never used Pardale [paracetamol plus codeine but without pred.]

RE: PLT in dogs

Rob Loxley — Wed, 30 Mar 2016 19:43:02 GMT

[quote user="Anthony Todd"]

[quote user="Malcolm Ness"]That's what we thought too.[/quote]

I/we didn't give it for long, probably max 5 days then repeat as, and if, necessary. I wonder if longer or continuous dosage gives the problems 'cos I used it a lot and AFAIK [?. some would say] I/we didn't see diabetes with it, or any side effect.

PS perhaps that's where the "5 day limit" comes from?? I/we didn't know about that 'cos there wasn't NOAH etc. and it was only because we got max response by then so didn't continue any drug beyond that anyway.

[/quote]

Are you talking about Pardale or PLT???

RE: PLT in dogs

Bob Russell — Wed, 30 Mar 2016 17:42:34 GMT

Blood tests suggest quite marked 'corticosteroid' changes especially considering there is only 1mg per tablet.

I have had dogs on them for years (before newer NSAID's) and never seen diabetes problems that I can put down to medication.

Nice to have a 'salvage' option on the shelf which helps often.

RE: PLT in dogs

Anthony Todd — Wed, 30 Mar 2016 17:04:54 GMT

[quote user="Malcolm Ness"]That's what we thought too.[/quote]

RE: PLT in dogs

Malcolm Ness — Tue, 29 Mar 2016 22:01:27 GMT

[quote user="Bob Russell"]Considering the very low prednisolone dose in the drug, it is surprising how much effect it has on blood samples.[/quote]

That's what we thought too.

[quote user="Bob Russell"]Not a first choice drug but a great one to have in the armoury. [/quote]

Yep.

RE: PLT in dogs

Bob Russell — Tue, 29 Mar 2016 14:20:01 GMT

I have had my elderly staffie on PLT for some months. I have changed her on to Previcox for now (+tramadol) and will give her a break until she needs to go back on PLT.

Considering the very low prednisolone dose in the drug, it is surprising how much effect it has on blood samples.

Most of the patients that get PLT are on borrowed time and both owner and patient seem pretty happy with the extra 'quality time'.

Not a first choice drug but a great one to have in the armoury.

RE: PLT in dogs

Malcolm Ness — Tue, 29 Mar 2016 13:54:19 GMT

[quote user="Mike Dale"]How do you use Paracetamol Malcolm? The data sheet for Pardale only allows about 5 days at a time. How long a rest do you leave between courses? I used PLT as a front line choice in preference to phenylbutazone to great effect and no side effects before the cartrophems and melixicams were invented.[/quote]

I use Pardale V and start at around two tablets, three times daily for a typical labrador. Review after a short time (5-7 days) and abandon if no effect or consider reducing the dose a little if possible. I always use paracetamol as second drug - when the response to long term NSAID, usually meloxicam or carprophen in my hands, is becoming inadequate. I am aware of the licensing implications but neither Tramadol nor GabaP are licensed at all and nothing has been trialled in combination and that is what we are doing in this scenario.

I use PLT occasionally and know it to be dramatically effective in some cases. However, in my experience long term use of PLT is often associated with obesity and muscle weakness - in the dear dark days beyond recall when many clinicians used it as first choice for any and all stiff dogs, I came across a lot of dogs that appeared Cushingoid, had abnormal ACTH stim and Dex suppression test results and then improved markedly when weaned off their PLT and given a standard NSAID instead.

RE: PLT in dogs

Rob Loxley — Mon, 28 Mar 2016 09:36:19 GMT

[quote user="Mike Dale"]The data sheet for Pardale only allows about 5 days at a time.[/quote]

We generally go at 10mg/kg BID longterm

RE: PLT in dogs

Anthony Todd — Sun, 27 Mar 2016 22:28:26 GMT

[quote user="Mike Dale"]The data sheet for Pardale only allows about 5 days at a time.[/quote]

I'd love to see the experimental evidence for that.

Actually the directive is even more severe...

Treat for a maximum of 5 days. [from NOAH compendium]

Strange, considering it's an over the counter medicine for humans, as is the codeine, and they can take it for much longer, willy nilly.

Even though it's probably a "historical blip" or. much more likely, a simple copy and paste from the European human regs, it sounds as if someone, somewhere, is enforcing something, so it must be gospel and strictly obeyed, much to the discomfit of loads of dogs.....

Another Dechra bandwagon product with no competition.......

RE: PLT in dogs

Joyce Whitehead — Sun, 27 Mar 2016 20:57:36 GMT

We regularly use Pardale off licence long term in arthritic dogs as an adjunct to nsaids (with consent). I seem to remember the 5 day licence thing was a historical blip and they have never gone to the effort of changing it. It helps a lot in some of these older dogs.

RE: PLT in dogs

Mike Dale — Sun, 27 Mar 2016 19:31:20 GMT

[quote user="Malcolm Ness"]

I would always use paracetamol ahead of Tramadol and or Gabapentin.

[/quote]

How do you use Paracetamol Malcolm? The data sheet for Pardale only allows about 5 days at a time. How long a rest do you leave between courses? I used PLT as a front line choice in preference to phenylbutazone to great effect and no side effects before the cartrophems and melixicams were invented.

RE: PLT in dogs

Anthony Todd — Sun, 27 Mar 2016 18:25:49 GMT

[quote user="David Mills"]Almost tempted to continue rimadyl and add in preds. [/quote]

Is bute still available? I never saw side effects with that either, and it worked well in severe arthritis, usually combined with pred.

Chronic pain relief should take precedence over possible side effects??

RE: PLT in dogs

David Mills — Sun, 27 Mar 2016 16:36:27 GMT

Thanks all for input. Dog currently doing well on plt so plan is to leave on for now. Damned expensive though. Almost tempted to continue rimadyl and add in preds.

Re paracetamol he was tried on that but no good hence trams and gabapentin.

RE: PLT in dogs

Neil Wheadon — Sat, 26 Mar 2016 14:51:40 GMT

[quote user="Bob Russell"]PLT's are probably the most undervalued and underestimated of drugs on our shelves. It seems there is a whole generation of vets that has not even heard of them.[/quote]

If only they were still as cheap as they should be. I find them a great product and would urge any newish vet to give them a go, the results can be better than NSAID's in lots of cases

In answer to Davids question, I have never seen an issue

Neil

RE: PLT in dogs

Anthony Todd — Sat, 26 Mar 2016 12:56:56 GMT

My guys wouldn't use them, adamantly, because they contained [a small amount!] of prednisolone.....!!!

Silly really, 'cos the amount of pred in PLT was very small.

RE: PLT in dogs

Bob Russell — Sat, 26 Mar 2016 11:52:50 GMT

PLT's are probably the most undervalued and underestimated of drugs on our shelves. It seems there is a whole generation of vets that has not even heard of them.

RE: PLT in dogs

Clare Tapsfield-Wright — Fri, 25 Mar 2016 20:00:28 GMT

my old lab with OA and neuropathy went on to PLT when metacam seemed to be less effective and she responded really well. She was on it for over a year , possibly two with no gastric problems until a couple of months before I lost her and omeprazole sorted it .

I also thought vivitonin helped a great deal , I thought she was depressed due to pain but think it was actually loss of cognitive function making her slow

RE: PLT in dogs

Mark Hedberg — Fri, 25 Mar 2016 18:34:18 GMT

PLT is a great option for when the nsaids don't do much anymore; definitely for the calcified neeve root neuro issue ones. Not a miracle deug, but very helpful for what i consider palliative care.

RE: PLT in dogs

Rob Loxley — Fri, 25 Mar 2016 17:40:16 GMT

We have a fair few on PLT - seem to do really well where NSAIDs/adjuncts are not working, and often for a long while. Longterm we tend to taper the dose - often the cost also has an influence on this, though have not seen any significant side effects.

RE: PLT in dogs

Anthony Todd — Fri, 25 Mar 2016 17:22:02 GMT

PLT almost always gave a dramatic and immediate vast improvement when clients complained of the cost or efficacy of the "modern" alternatives.

Always my first line until I stopped in about 2010. Don't think I can ever recall any side-effects.

PS Gotta be win for a dinoceutical [was VERY cheap, not now though...]