apomorphine 1mg/ml vs 10mg/ml SC

RE: apomorphine 1mg/ml vs 10mg/ml SC

Rob Davis — Sat, 23 Feb 2019 10:54:22 GMT

[quote user="Sarah Keir"] Thinking about those raisins...[/quote]

Which almost certainly would been fine being left where they were.....

RE: apomorphine 1mg/ml vs 10mg/ml SC

Sarah Keir — Wed, 20 Feb 2019 20:24:58 GMT

I was reading something over the past few weeks showing that when emesis is induced in dogs and even when they get to the stage of dry heaving or vomiting bile, only 90% of stomach contents are brought up. Thinking about those raisins...

RE: apomorphine 1mg/ml vs 10mg/ml SC

Evelyn Barbour-Hill — Wed, 20 Feb 2019 16:44:47 GMT

[quote user="KathW"]

[quote user="Evelyn Barbour-Hill"] Or if they would prefer to wait, we'll make them a pot of tea or some decent coffee, and offer them a Speccie or an Oldie or Country Life.

[/quote]

Evelyn Barbour-Hill not Heat, OK or You?

[/quote]

Those are catching the vomit.

RE: apomorphine 1mg/ml vs 10mg/ml SC

Lucy Fleming — Wed, 20 Feb 2019 11:50:03 GMT

[quote user="bob lehner"]

I had a look at the SPCs for Emedog and Apo-Go - seem to be identical in terms of active ingredient and excipients.

If people are finding the s/c route to be too slow then I can't see why one shouldn't take a wander down the Cascade on clinical grounds and go i.v. to get a quicker result. BSAVA Formulary supports this route.

After all, time could be crucial in some cases e.g where the owner has only become aware of the issue after a significant period of time, then decided to call the vet, then made their way to the surgery - stuff could be heading out of the stomach making serious consequences more likely......

[/quote]Definitely valid reasons!

RE: apomorphine 1mg/ml vs 10mg/ml SC

bob lehner — Wed, 20 Feb 2019 11:26:54 GMT

[quote user="Lucy Fleming"]Unfortunately the datasheet for Emedog states "for subcutaneous administration only". I can't see any other ingredients than apomorphine listed so see no specific contraindication for extra-label IV use. Not sure I would go to the trouble of an IV injection for most cases, though, but can see why you prefer. [/quote]

I had a look at the SPCs for Emedog and Apo-Go - seem to be identical in terms of active ingredient and excipients.

RE: apomorphine 1mg/ml vs 10mg/ml SC

Julie Innes — Wed, 20 Feb 2019 08:58:46 GMT

We always bring the dog through the back and the nurses (and student nurses) supervise the vomiting experience! lots of puppy pads make it relatively easy to clean up.

I wouldn't trust owners- a lot of the dogs we make vomit will immediately try to re-eat the offending object!! Also I like to make sure that everything is up and the dog is ok after the apomorphine. we are even nice enough to give them some puppy pads to go home in the car with, just in case!

RE: apomorphine 1mg/ml vs 10mg/ml SC

Lucy Fleming — Wed, 20 Feb 2019 08:43:23 GMT

[quote user="bob lehner"]

BSAVA Formulary states that i.v. route is the most effective for Apomorphine and recommends a dose of 20-40 mu g/kg i.v.

I've always used that.

[/quote] Unfortunately the datasheet for Emedog states "for subcutaneous administration only". I can't see any other ingredients than apomorphine listed so see no specific contraindication for extra-label IV use. Not sure I would go to the trouble of an IV injection for most cases, though, but can see why you prefer.

[quote user="Evelyn Barbour-Hill"]Why not put the dog in a kennel and ask the owners to come back in an hour? Or if they would prefer to wait, we'll make them a pot of tea or some decent coffee, and offer them a Speccie or an Oldie or Country Life.[/quote] Because they got the dog into this mess, they should be partly responsible for the consequences? More seriously though, no particular reason. We might do that if it was in the day time. OOH i find I can usually have the dog emptied out, the clean up done, the bill paid and be on my way back home in less than an hour (and I've been bitten by clients very poor timekeeping before, so tend not to rely on them leaving and coming back at a particular time!) I find a lot of clients seem reassured by having seen the animal's stomach emptied to the point of no more raisins, or seeing the little green blocks of rat bait.

RE: apomorphine 1mg/ml vs 10mg/ml SC

KathW — Tue, 19 Feb 2019 19:38:32 GMT

[quote user="Evelyn Barbour-Hill"] Or if they would prefer to wait, we'll make them a pot of tea or some decent coffee, and offer them a Speccie or an Oldie or Country Life.

[/quote]

Evelyn Barbour-Hill not Heat, OK or You?

RE: apomorphine 1mg/ml vs 10mg/ml SC

Evelyn Barbour-Hill — Tue, 19 Feb 2019 13:27:11 GMT

[quote user="Lucy Fleming"]I find it much easier to clean up properly after them in the surgery. Give the owners a cat litter tray with an inco sheet in it and get them to catch. [/quote]

Why not put the dog in a kennel and ask the owners to come back in an hour? Or if they would prefer to wait, we'll make them a pot of tea or some decent coffee, and offer them a Speccie or an Oldie or Country Life.

RE: apomorphine 1mg/ml vs 10mg/ml SC

Bob Russell — Tue, 19 Feb 2019 13:24:44 GMT

I have previously used a tiny dose i/v. A fraction of the datasheet dose.

Always seems to work and of course they could have more if it ever was to be needed.

Not sure if the new stuff can be used i/v so used about half the dose s/c. Worked fine.

RE: apomorphine 1mg/ml vs 10mg/ml SC

bob lehner — Tue, 19 Feb 2019 11:45:32 GMT

BSAVA Formulary states that i.v. route is the most effective for Apomorphine and recommends a dose of 20-40 mu g/kg i.v.

I've always used that.

RE: apomorphine 1mg/ml vs 10mg/ml SC

Anthony Dennison — Tue, 19 Feb 2019 08:39:41 GMT

[quote user="Neil Wheadon"]

A bit of a tangent. So that's where you are . are you on the left between the motorway and Clitheroe? Fabulous area, I'm there in May talking about 2 week trips and flying bikes at the cycle touring festival in Clitheroe.

neil

[/quote]

Yes that's the one. It's our main hospital, we've got 17 other branches across Lancashire. Saw an advert for that event, did wonder if anyone here was going to go!

RE: apomorphine 1mg/ml vs 10mg/ml SC

Lucy Fleming — Tue, 19 Feb 2019 08:29:53 GMT

[quote user="Aine Seavers"]What does did you use of the apo-go?[/quote] 0.04mg/kg IM or 0.08mg/kg SQ. I can't remember what the data sheet said but seem to recall it was quite a bit higher.

[quote user="Michael Woodhouse"]They can puke in the car park and we can hose down afterwards. You're not being sick in my surgery if I can help it.[/quote] I find it much easier to clean up properly after them in the surgery. Give the owners a cat litter tray with an inco sheet in it and get them to catch.

[quote user="Anthony Dennison"]I can usually fit in another consult whilst we wait! [/quote] I don't think I can recall ever seeing an emesis case that wasn't either out of hours or during lunchtime!

RE: apomorphine 1mg/ml vs 10mg/ml SC

Joyce Whitehead — Tue, 19 Feb 2019 08:26:38 GMT

When we could get Apogo here Aine, we used to freeze the remains of the vials in small aliquots. Made it a bit more economical. The new Emedog we have is much larger quantities to inject. I think I’ve only used one lot since we changed, and it did seem to take slightly longer than the old stuff.

RE: apomorphine 1mg/ml vs 10mg/ml SC

Aine Seavers — Tue, 19 Feb 2019 01:59:55 GMT

[quote user="Lucy Fleming"]be fair, we always used to use apo-go at a significantly lower dose rate also) thoug[/quote]

What does did you use of the apo-go? We rarely make anything vomit-unless chocolate.toadfish/aspirin/panadol and so mostly goes out of date. The 2 vial pack no longer here only the 10vial pack and very expensive.

Many of the vets use the tablet dissolved in water in the eye-i would perfer to stick with s/c injections where possible.

RE: apomorphine 1mg/ml vs 10mg/ml SC

Neil Wheadon — Mon, 18 Feb 2019 23:55:38 GMT

Or buy a ticket

Great event, BSAVA / London Vet Show for touring Cyclists

Sorry Evelyn, I know we've got our own thread, but you advertise dental stuff

http://cycletouringfestival.co.uk

Neil

RE: apomorphine 1mg/ml vs 10mg/ml SC

Gillian Mostyn — Mon, 18 Feb 2019 20:58:50 GMT

We could all meet up for a pint?

RE: apomorphine 1mg/ml vs 10mg/ml SC

Neil Wheadon — Mon, 18 Feb 2019 20:48:47 GMT

neil

RE: apomorphine 1mg/ml vs 10mg/ml SC

Anthony Dennison — Mon, 18 Feb 2019 19:37:26 GMT

[quote user="Michael Woodhouse"]God, NO! They can puke in the car park and we can hose down afterwards. You're not being sick in my surgery if I can help it.[/quote]

Not an option for us unfortunately - we're on the A59 between Preston and Clitheroe, it's a really busy road with a lot of lorry traffic and the car park isn't secure. We've got wipe down floors, we cover everything in newspaper so it goes on there.

RE: apomorphine 1mg/ml vs 10mg/ml SC

Michael Woodhouse — Mon, 18 Feb 2019 19:31:51 GMT

[quote user="Anthony Dennison"]leave them in a consult with the owners and some newspaper[/quote]

God, NO! They can puke in the car park and we can hose down afterwards. You're not being sick in my surgery if I can help it.

RE: apomorphine 1mg/ml vs 10mg/ml SC

Neil Wheadon — Mon, 18 Feb 2019 18:04:18 GMT

Anyone tried in the conjunctiva?

Faster?

Neil

RE: apomorphine 1mg/ml vs 10mg/ml SC

Clive Ansell — Mon, 18 Feb 2019 17:02:53 GMT

I start off with 0.04mg/kg and almost always works. Can always top up to the data sheet dose of 01mg/kg if needed, but have never had too.

Might be a bit slower, but no bother as can be doing something else usually.

RE: apomorphine 1mg/ml vs 10mg/ml SC

Anthony Dennison — Mon, 18 Feb 2019 16:38:52 GMT

Potentially a little, but I just give it to the dog, leave them in a consult with the owners and some newspaper on the floor, and get on with another job whilst I wait. Has the desired effect in the end, and actually I can usually fit in another consult whilst we wait!

RE: apomorphine 1mg/ml vs 10mg/ml SC

Lucy Fleming — Mon, 18 Feb 2019 16:20:52 GMT

[quote user="KMurphy"]Also, the volume required is really large. It means I always have to keep two boxes in stock in case of the two large labradors, one missing box of chocolates scenario... [/quote]

I've so far been successful at using it quite significantly below the suggested dose rate by the company (to be fair, we always used to use apo-go at a significantly lower dose rate also) though I've always warned the owner we may need to give more...

RE: apomorphine 1mg/ml vs 10mg/ml SC

KMurphy — Mon, 18 Feb 2019 14:53:57 GMT

[quote user="Judith Archbold"]Pleased I’m not the only one who has noticed.[/quote]

Yup, I've noticed it too! Was trying to come up with a plan B when the dog finally gave in and started vomiting. Phew!

Also, the volume required is really large. It means I always have to keep two boxes in stock in case of the two large labradors, one missing box of chocolates scenario...