ProPoclear

Re: ProPoclear

Alex Gough — Mon, 24 Jan 2011 16:42:22 GMT

To be fair in the most dramatic case I had, the cat did just miss the roof by a few inches. I must stop exaggerating. :)

Alex

Re: ProPoclear

J G Wray — Mon, 24 Jan 2011 16:36:19 GMT

[quote user="alex gough"]We stopped using propoclear soon after we got it in, animals were hitting the roof even when injecting through properly placed iv catheters, and we had a few phlebitis reactions too.[/quote]

Hm not my experience, with and without iv cannula. Do you have many animals who hit the roof?

Pain after injection of a new formulation of propofol in six dogs

E. Minghella,
P. Benmansour,
I. Iff,
J. M. Senior,
M. Mosing

Veterinary Record 2010;167:866-867 doi:10.1136/vr.c5736

This is the only ref cited by Pfizer. If this is a "device" to handle their general loss of interest in the product then who enjopys being told a half truth? I have asked if there's anything my practice could do to provide evidence, perhaps 12 dogs, 18 dogs, 24 dogs.......and an account of whether they "hit the roof" or whatever cirtieria the authors used to determine pain on injection, or not.

JGW

Re: ProPoclear

Gareth Dowdeswell — Mon, 24 Jan 2011 16:29:32 GMT

[quote user="alex gough"]

The report I saw in the Vet Record was adverse reactions reported by the VMD, not a paper by referral clinicians. Is there a paper too? We stopped using propoclear soon after we got it in, animals were hitting the roof even when injecting through properly placed iv catheters, and we had a few phlebitis reactions too.

Alex

[/quote]

Think the paper was from Liverpool vet school, not sure if it was a full paper or just case studies, think they recorded pain reactions from dogs with IV catheters.

When I used Propoclear in my previous job there were frequently pain reactions from cats, tho some of those may have been perivascular as we didn't use catheters. Don't recall any probs with dogs.

Re: ProPoclear

Alex Gough — Mon, 24 Jan 2011 16:22:44 GMT

Alex

Re: ProPoclear

Alan Tevendale — Mon, 24 Jan 2011 14:39:01 GMT

Got a letter this morning saying it was being withdrawn - not recalled though. It mentions the Vet record report. Not really a big issue anyway as we have changed back onto using propofol.

No dates for resupply as yet.

Re: ProPoclear

Anthony Todd — Mon, 24 Jan 2011 13:22:13 GMT

[quote user="David Killick"]Pfizer have just withdrawn it in Europe.[/quote]

Come on, do any of you really think the withdrawal is on humane or scientific grounds??

Re: ProPoclear

David Killick — Mon, 24 Jan 2011 13:05:12 GMT

Hi all,

Theres an article in the vet rec (last quarter of last year) regarding possible problems with pain on injection and phlebitis after injection and I heard a rumour Pfizer have just withdrawn it in Europe.

Best wishes

David

Re: ProPoclear

J G Wray — Mon, 24 Jan 2011 11:12:17 GMT

[quote user="i am ed"]I've heard rumours that propoclear is being withdrawn on the quiet - something to do with excessive local reaction. Anyone know if this is true?[/quote]

Well, we've all had the letter.

The cited reason is a paper in the Record.

I cannot see what the criteria for "pain" was.

Having been unaware of a "painful" response in my patients, I'm impressed that so many turn up at this referral centre.

It clearly means that I'm insensitive, if you see what I mean.

I have registered my astonishment with Pfizer and asked whether there is any merit in recruiting opinion from GPs in this matter, or whether this is only a matter for referral centres.

JGW.

Re: ProPoclear

Hannah Wynne Richards — Tue, 02 Nov 2010 11:02:19 GMT

Have'nt an opinion-I'm an alfaxan fan-so is my RVN who is brilliant at monitoring anaesthesia-and LOVES the flexibility of alfaxan

Wynne

Re: ProPoclear

Mark Hedberg — Mon, 01 Nov 2010 22:08:46 GMT

[quote user="Matt Gurney"]

Interesting. I did wonder why Pfizer were not promoting it at the London Vet Show and one of the reps just giggled when I mentioned it.

[/quote]

That can't be a good sign. :p

Re: ProPoclear

Matt Gurney — Mon, 01 Nov 2010 15:48:28 GMT

Interesting. I did wonder why Pfizer were not promoting it at the London Vet Show and one of the reps just giggled when I mentioned it.

Re: ProPoclear

Bob Russell — Mon, 01 Nov 2010 11:44:14 GMT

Not had contact with anyone from Fort Dodge Pfizer recently so not heard anything. Never had a reaction at injection site but the post induction apnoea was unsettling so we moved back to the white stuff.

If it is withdrawn it does make a bit of a mockery of the licensing system - have we really moved across to the high tech ''test it on a few beagles and if they survive get the VMD to rubber stamp the licence then watch what happens when vets start to use it on proper numbers of animals''.

I freely admit that many new products don't get a look in here until they have been on the market for at least a year. Cutting edge products are treated with a degree of caution for a similar or longer period but used after a lot of consideration.

Re: ProPoclear

Edward Jones — Mon, 01 Nov 2010 10:50:18 GMT

I've heard rumours that propoclear is being withdrawn on the quiet - something to do with excessive local reaction. Anyone know if this is true?

Re: ProPoclear

Rob Loxley — Fri, 16 Jul 2010 13:32:30 GMT

Interesting paper in this week's Vet Record comparing propofol/alfaxan in cats

Re: ProPoclear

Bob Russell — Fri, 25 Jun 2010 17:23:55 GMT

'Try well-brewed tea hot in a cracked mug with three sugars after tb testing the hundredth animal in an open farmyard on a filthy wet November day.'

This is the most welcome drink in the world and is like nectar - tea at its best.

Re: ProPoclear

Kate Richardson — Fri, 25 Jun 2010 16:15:04 GMT

[quote user="Evelyn Barbour-Hill"]

Try well-brewed tea hot in a cracked mug with three sugars after tb testing the hundredth animal in an open farmyard on a filthy wet November day.

What's this "flat white" stuff? You surely don't mean you sully decent coffee by putting milky substances in it?

[/quote]

Sorry nothing you can do to persuade me to re-try tea now- my mother tried hard when I was 2 but no joy! Flat white is an Ozzie thing although Costa have now (finally) cottoned onto it- try one. Decent espresso with steamed milk, not one of those weak latte things bluh. I don't mind a nice cup of camomile tho...!

Sorry Wynne, should have said 'British' thing, although not sure if Wales or Scotland want to be included these days.....

Re: ProPoclear

Hannah Wynne Richards — Fri, 25 Jun 2010 15:03:10 GMT

Roboxley

How low is your low-dose ?

Wynne

Re: ProPoclear

Hannah Wynne Richards — Fri, 25 Jun 2010 15:01:19 GMT

Whoever said I was English ?????????????

Wynne

Re: ProPoclear

Evelyn Barbour-Hill — Fri, 25 Jun 2010 14:53:27 GMT

[quote user="Kate Richardson"]must be the only English person in the world who hates tea! Looks like dirty dishwater and can't stand the smell! - give me a nice flat white anyday.[/quote]

Try well-brewed tea hot in a cracked mug with three sugars after tb testing the hundredth animal in an open farmyard on a filthy wet November day.

What's this "flat white" stuff? You surely don't mean you sully decent coffee by putting milky substances in it?

Re: ProPoclear

Matt Gurney — Fri, 25 Jun 2010 14:01:22 GMT

Personally one of the best things that the Alfaxan reps did deliver was getting practices to look again at their premed drugs/doses, if the input we got was anything to go by, as IMHO a well pre-medded animal has a better induction, maintenance and recovery.

Vetoquinol sponsored a round table discussion of anaesthesia specialists which came up with a document of recommendations for standards of anaesthesia. This is published on the AVA website www.ava.eu.com and is definitely worth a read.

Matt

Re: ProPoclear

Colin Cameron — Fri, 25 Jun 2010 14:00:35 GMT

[quote user="robloxley"]as IMHO a well pre-medded animal has a better induction, maintenance and recovery[/quote]

I agree. I've been working to this principle for years!

One thing is puzzling me. If we use these drugs for induction because they are short acting then surely by the time we get to the end of the operation they will be out of the system and hence have little bearing on recovery compared to either the premed or the maintenance drug?

On the same theme, apart from the short time around induction, is the BP not mainly affected by the premed and maintenance ( eg volatile) drug.

Re: ProPoclear

Matt Gurney — Fri, 25 Jun 2010 13:55:32 GMT

He he. There is less hypotension with alfaxan but it doesn't mean poor old propofol is out of date.

I think dose wise you can say morphine and methadone are equipotent. I don't like the nausea and salivation you get with morphine and also methadone acts at the NMDA receptor as well as its opioid actions. Methadone does make some dogs bradycardiac and also can make them pant - I haven't used morphine for ages so couldn't offer a comparison. As long as the BP is ok I don't worry about heart rates in the 50's. I use methadone 0.3mg/kg for dogs and that lasts around 3-4hrs. For cats I use 0.2-0.3mg/kg for painful procedures but there is also work to suggest that buprenorphine 0.02mg/kg is as good.

Re: ProPoclear

Colin Cameron — Fri, 25 Jun 2010 13:51:09 GMT

[quote user="Kate Richardson"]

I must be the only English person in the world who hates tea! Looks like dirty dishwater and can't stand the smell! - give me a nice flat white anyday.

[/quote]

Who is making your tea? They obviously need some intensive training! I assume flat white is the other well known source of caffeine. Now, this made badly is insipid mud! Made well is better but still looks like mud! Let's hear it for tea!! ( Made properly of course). Off for a cuppa now. Bye.

Re: ProPoclear

Rob Loxley — Fri, 25 Jun 2010 13:45:49 GMT

For starters, I have used both alfaxan and propofol - currently still on the milky stuff - and wasn't convinced of any significant difference with alfaxan bar cost.

[quote user="Hannah Wynne Richards"]I haven't used it with propofol-didn't have it then, so I admit I'm going on what the rep said[/quote]

How often should we believe everything (anything?) the rep says??

[quote user="Hannah Wynne Richards"]but if you zonk everything with an alpha agonist to ensure sufficiently sedated to always be able to give slowly, then that will really knock BP[/quote]

If giving low dose alpha 2 agonists as part of the premed (and I mean sub-datasheet doses), the extra sedation is good and the not obvious effects on bp (oscillometric machine on most ops, even most cat neuters since the machine is there in theatre and takes approx 10 seconds to connect up to the patient and set going). Have you tried this?

[quote user="Hannah Wynne Richards"]She is EXCELLENT at monitoring, and says isoflurane anaesthesia is more controllable followinf Alfaxan induction-and I believe her[/quote]

Not saying this isn't true, but being unblinded to your change in drug, how can you tell it's not a placebo effect?

Personally one of the best things that the Alfaxan reps did deliver was getting practices to look again at their premed grugs/doses, if the input we got was anything to go by, as IMHO a well pre-medded animal has a better induction, maintenance and recovery.

Re: ProPoclear

Colin Cameron — Fri, 25 Jun 2010 13:44:51 GMT

[quote user="Hannah Wynne Richards"]it's time to top up my tea levels[/quote]

Absolutely agree with this! Premed is beginning to wear off!! Cheers to one and all!