Metacam 2mg/ml injection for cats

Re: Metacam 2mg/ml injection for cats

Charlotte Marshall — Thu, 29 Jul 2010 23:09:59 GMT

We nearly had a disaster with vetoryl. Again identical boxes just a different flash on the corner. The client got handed out 30mg instead of 10mg tablets when the dog was on 10mg bid. Luckily the client noticed before she gave the dog any. However we have changed our dispensing routine now to prevent it happening again.

Re: Metacam 2mg/ml injection for cats

Mark Holmes — Wed, 28 Jul 2010 23:17:43 GMT

Seen noroclav norocarp accidents before and hence don't stock both but not the name change might look again. I change lots of needles much better, particularly for stroppy cat boosters. With regards to needle stick injuries ... They're a bugger in your tongue!

Re: Metacam 2mg/ml injection for cats

Catherine Williams — Mon, 26 Jul 2010 18:27:44 GMT

[quote user="katja wagner"]

I totaly agree with Evelyn,i always change to new needle after drawing up, particular dislike it when nurses draw up pre meds and give me the syringe with green needle attached after they used it on 2,3 different bottles and expect me to inject i.m. I stopped saying anything just grap a fresh needle myself.

If i change to new orange needle for first vaccines and distract with a few treats there is hardly ever a reaction from the animals which is great.

I must say that i have never come across another vet with same approach and tought that i am a bit strange in my ways so i am glad Evelyn doese the same!

katja

[/quote]

You're not the only vet with strange habits, I do exactly the same, if it'll go through an orange syringe then that is what I'll use and I always change the needle. Does get me stared at by the nurses sometimes but it is slowly rubbing off on them. I seem to get very few responses to injections, not sure if it's the fresh needle or the quiet no fuss approach (and bribery/distraction if nec) but it works so I don't plan to change either

Re: Metacam 2mg/ml injection for cats

sophia guymer — Mon, 26 Jul 2010 17:14:01 GMT

[quote user="Bob Russell"]Not had a problem but if you change to a fresh needle (I use a lot of yellow 25G needles!) the pet rarely notices[/quote]

After this thread have started doing this with every injection and though I have to admit I would have said I never had a problem, I can't but agree that it has made a big difference None of them noticed any of my injections today and even though I normally don't have much of a problem, I do ussually get some reaction. Nothing today. Converted.

Re: Metacam 2mg/ml injection for cats

Bob Russell — Mon, 26 Jul 2010 15:49:07 GMT

We managed to hand out a box of 20mg Benazocare despite 2 checks because the packaging was so similar. it was a good lesson for us and everyone really looks now.

Similarities in product appearance may be good for brand-image but is a nightmare for practices. ACP - both strengths very similar in appearance - one darker than the other.

Euthanasia solutions - why are they not ALL blue? We changed recently and it frightens the life out of me. Back to Euthatal!

Re: Metacam 2mg/ml injection for cats

Bob Russell — Mon, 26 Jul 2010 15:38:59 GMT

[quote user="Niall Taylor"]

[quote user="Evelyn Barbour-Hill"]you don't normally stick the same needle into the patient surely?[/quote]

Have you ever had a problem injecting the patient with the same needle as you used to draw up the drug?

Niall

[/quote]

Not had a problem but if you change to a fresh needle (I use a lot of yellow 25G needles!) the pet rarely notices. Lots of 'Browny points' with owners. He didn't notice - what a good vet you must be!!!!!

Re: Metacam 2mg/ml injection for cats

Michael Woodhouse — Fri, 23 Jul 2010 13:49:52 GMT

[quote user="i am ed"]Shall we move onto i/v vs intrarenal injection for cat euthanasia?![/quote]

You just know I'm going to say kidney!

Quick, painless, easy as seems as fast. Have never had a pain reaction. Even better - minimal or no restraint required - owner cat pet and cuddle head.

I found very quickly not to let go of cat after the injection of the can go with quite a thud!

Norbrook have changed Norocarp to Carprieve for the reason mentioned above! We instruct diabetic to use a needle a few times.

Re: Metacam 2mg/ml injection for cats

Martin Atkinson — Fri, 23 Jul 2010 11:00:07 GMT

[quote user="i am ed"]

So, we've done fresh needles. Shall we move onto i/v vs intrarenal injection for cat euthanasia?!

[/quote]

Intra-renal works well especially in cachectic old cats, is rarely painful, technically much easier especially in a grumpy old cat with poor veins, unconciousness comes as quickly as IV in most cases and the owners can generally hold the cat themselves which they appreciate.

Back on thread again, I had a diabetic cat of my own and I habitually re-used the same syringe for more than a week with no discomfort to the cat and no apparent hygiene considerations, and a big saving on the insulin left in the syringe tip! Would I advise a client to do that or do it in the clinic myself??? Probably not

Re: Metacam 2mg/ml injection for cats

salome2001 — Fri, 23 Jul 2010 01:37:26 GMT

I'm with ed on the different coloured needles for dom/anti... And with the norbrook brands actually: I've seen a LOT of clinical note typos with those two names.

I absolutely agree with the concerns about the similar packaging. Not so much an issue if you send a client out the door with an advocate 6pk rather than a 3pk apart from on the practice finances (funny how they never report that mistake but scream blue murder if you err in reverse!). But if they can package baytril tablets with three different colour flashings on three identically sized boxes, why is it hard to make really different looking bottles??

Re: Metacam 2mg/ml injection for cats

Edward Jones — Fri, 23 Jul 2010 01:07:50 GMT

True, or domitor in a blue bottle (into a syringe with a blue needle) and antisedan in an orange bottle (into a syringe with an orange needle). Don't know where I am with all the new versions ;-) no doubt all with incompatible licences too.

Still, I never could get my head around the logic of naming noroclav and norocarp, especially with the danger of substituting noroclav 50mg with norocarp 50mg in a cat...

Re: Metacam 2mg/ml injection for cats

Evelyn Barbour-Hill — Fri, 23 Jul 2010 00:50:23 GMT

[quote user="i am ed"] Shall we move onto i/v vs intrarenal injection for cat euthanasia?![/quote]

But we could edge back towards the original post and ask why manufacturers insist on putting different drugs in almost identical packaging. There are ingenious devices to prevent you from putting halothane where isoflurane should go, or nitrous oxide where oxygen should go, so why is the Dopram package so similar to the Torbugesic? (No, I never have used the wrong one, but came close once or twice until I put a Magic Marker to good use).

Re: Metacam 2mg/ml injection for cats

Edward Jones — Fri, 23 Jul 2010 00:39:21 GMT

[quote user="Michael Woodhouse"]Have often had comments along the lines of 'he hates needles' and then they ask if I have really jabbed the horse.[/quote]

We all get that, I promise ;-) I'd vigourously defend your preference for the way you do things, regardless of how I like to do it. Veterinary never ceases to amaze me how different people can get the same results by such different means.

So, we've done fresh needles. Shall we move onto i/v vs intrarenal injection for cat euthanasia?!

Re: Metacam 2mg/ml injection for cats

Michael Woodhouse — Fri, 23 Jul 2010 00:21:06 GMT

[quote user="i am ed"]How do you grab a skin twitch when doing an i/v in a horse without decent help?[/quote]

I did really mean intramuscularly - vaccinations etc. I do pull the skin fairly taught for jugular IV and put needle just above my thumb.

Have often had comments along the lines of 'he hates needles' and then they ask if I have really jabbed the horse.

Re: Metacam 2mg/ml injection for cats

Edward Jones — Fri, 23 Jul 2010 00:11:17 GMT

[quote user="Michael Woodhouse"]

[quote user="Martin Jones"]

Clearly, you shave your legs, sir.

[/quote]

Pardon?

[/quote]

I think the meaning is that, if you have hairs, a plaster is really just as painful if you pull it off quickly or slowly. The only way it hurts less is if you shave your legs. Or something like that.

Anyway, I find it shocking how much easier injections are with a fresh needle, be it into a cat, dog, cow or horse (never found a benefit with sheep - much thinner skin in comparison to size of needle, I suppose).

How do you grab a skin twitch when doing an i/v in a horse without decent help?

Re: Metacam 2mg/ml injection for cats

Michael Woodhouse — Thu, 22 Jul 2010 23:40:14 GMT

[quote user="Martin Jones"]

Clearly, you shave your legs, sir.

[/quote]

Pardon?

Re: Metacam 2mg/ml injection for cats

Martin Jones — Thu, 22 Jul 2010 23:38:30 GMT

Clearly, you shave your legs, sir.

Re: Metacam 2mg/ml injection for cats

Michael Woodhouse — Thu, 22 Jul 2010 23:10:29 GMT

[quote user="katja wagner"]If i change to new orange needle for first vaccines and distract with a few treats there is hardly ever a reaction from the animals which is great.[/quote]

I use green needle that I draw the vaccine up with, but make sure you get a good tight scruff. If the skin is taught they don't feel it. Same when injecting horses in the neck, handful of skin and they don't even notice the needle.

Like if you pull a plaster off.

Re: Metacam 2mg/ml injection for cats

Edward Jones — Thu, 22 Jul 2010 22:30:23 GMT

[quote user="robloxley"]Now, I'm not advocating reusing needles lots of times, merely that I couldn't find any evidence (on an albeit quick search) to support changing the needle after drawing the drug up[/quote]

The difference in pain reaction is enough for me, especially when injecting particular drugs. Sharp needles enter veins more easily as well. Anecdotal, subjective and personal experience of course.

Re: Metacam 2mg/ml injection for cats

katja wagner — Thu, 22 Jul 2010 20:33:53 GMT

If i change to new orange needle for first vaccines and distract with a few treats there is hardly ever a reaction from the animals which is great.

I must say that i have never come across another vet with same approach and tought that i am a bit strange in my ways so i am glad Evelyn doese the same!

katja

Re: Metacam 2mg/ml injection for cats

Kate Richardson — Thu, 22 Jul 2010 20:20:52 GMT

[quote user="Martin Jones"]Sorry, is it just me or are we all a little edgy today?[/quote]

I'm not edgy, I'm always this way!!!!!

[quote user="Martin Atkinson"]

Out of 6 cats I've ever put on Metacam, 2 have died of renal failure (and before anyone says anything: yes... they were both checked for renal disease before medication and they were on the correct dose, one was young and one was middle aged) - I think that is pretty poor failure rate. Maybe I've been unlucky but how can I dispense it with confidence anymore? I won't touch the stuff in cats and have to say its not my first choice in dogs either.[/quote]

I think you have been really unlucky. I use metacam a lot in cats and dogs, and even in cats diagnosed with renal failure and haven't had any problems with it. In some cats, they actually do better, if they have pain from arthritis and concurrent renal disease, I have seen the kidney parameters improve with the use of metacam, probably because they have reduced pain and feel better, so eat and drink better. The only times I have seen problems with metacam have been in a dehydrated cat who was receiving metacam despite not eating and drinking for a few days, and in a cat that had a massive overdose (40kg dog dose as opposed to a 4kg cat dose!!!!!!) And that one recovered with aggressive fluids etc. Having said that I always advise that if not eating and drinking as normal (whether they have kidney disease or not), not to give the metacam on those days. So I believe that normal hydration and normal blood pressure is the key to safe use of metacam (or other nsaids for that matter.)

See still smily, not edgy at all...but haven't had my tea yet!!!

Re: Metacam 2mg/ml injection for cats

HMC — Thu, 22 Jul 2010 15:58:05 GMT

I agree with the fresh needle side of the debate. And I shall be experimenting with insulin needles inside normal ones: 10/10 for ingenuity there!!

But just to play devil's advocate, a client once told me that human diabetics can use the same needle for 2-3 times, I think (it's kind of hard to believe); I can't remember if the person who told me was diabetic or just heard that on the grapevine... does anyone know what the situation really is?

Re: Metacam 2mg/ml injection for cats

Evelyn Barbour-Hill — Thu, 22 Jul 2010 15:08:33 GMT

[quote user="robloxley"]

[quote user="Evelyn Barbour-Hill"]Once you've stuck it through that rubber stopper (and don't kid me that a quick wipe with spirit makes any difference), the sharpness is reduced, the needle is not sterile, and the silicone coating may have gone.[/quote]

Since we're on this, here is some research on needle reuse from a quick Pubmed search:

J Gen Intern Med. 1989 Mar-Apr;4(2):97-100. Disposable insulin syringe reuse and aseptic practices in diabetic patients.

Diabetes Care. 1979 Nov-Dec;2(6):418-20. Reuse of disposable syringe-needle units in the diabetic patient.

Now, I'm not advocating reusing needles lots of times, merely that I couldn't find any evidence (on an albeit quick search) to support changing the needle after drawing the drug up - and these are studies in people reporting comfort, infections etc. after MULTIPLE reuse. Yes needles may be cheap, but consider also that every time you fiddle changing needles it raises the risk of needlestick injury, and the material cost, waste and cost of waste disposal do add up.

Do you change the needle after drawing up the Lepto bit of the vaccine before mixing with the DHPPi powder and then again before vaccinating the dog?

[/quote]

No, I stick the same needle into the dry bottle (which is not a multi-use bottle) and I put a fresh needle on to inject the dog. Clients notice and appreciate it.

I really don't want to get into a big debate here. I'd just say that I would not care to be injected with a needle that was, avoidably, not sterile and was less sharp that it could have been. I consider what I do to be best practice. I'm surprised that sticking the same needle in the patient as you stuck in the bottle is still done by the younger members of this forum, but there you go.

The cost of waste disposal of needles is utterly minute compared with all our other waste disposal costs. Needlestick injuries are very rare in this practice, and those that I can recall happening did not happen while changing needles. They were mostly due to being careless with a syringe with uncapped needle.

Re: Metacam 2mg/ml injection for cats

Rob Loxley — Thu, 22 Jul 2010 14:47:26 GMT

Since we're on this, here is some research on needle reuse from a quick Pubmed search:

J Gen Intern Med. 1989 Mar-Apr;4(2):97-100. Disposable insulin syringe reuse and aseptic practices in diabetic patients.

Diabetes Care. 1979 Nov-Dec;2(6):418-20. Reuse of disposable syringe-needle units in the diabetic patient.

Do you change the needle after drawing up the Lepto bit of the vaccine before mixing with the DHPPi powder and then again before vaccinating the dog?

Re: Metacam 2mg/ml injection for cats

Evelyn Barbour-Hill — Thu, 22 Jul 2010 14:21:54 GMT

[quote user="Niall Taylor"]

[quote user="Evelyn Barbour-Hill"]you don't normally stick the same needle into the patient surely?[/quote]

Have you ever had a problem injecting the patient with the same needle as you used to draw up the drug?

Niall

[/quote]

I haven't done that in the last twenty years. (Except occasionally when having for some reason to use the same insulin syringe I used to draw the dose)

Needle as presented is sterile and very sharp, and some of them have a silicone coating.

Once you've stuck it through that rubber stopper (and don't kid me that a quick wipe with spirit makes any difference), the sharpness is reduced, the needle is not sterile, and the silicone coating may have gone.

No, I didn't notice problems specially in the old days, but then you don't notice injection pain much if you are accustomed to causing it, and the occasional infection would probably be unnoticed or dismissed. In any case, how much does a needle cost?

Re: Metacam 2mg/ml injection for cats

Martin Jones — Thu, 22 Jul 2010 13:57:55 GMT

[quote user="Kate Richardson"]

So these would be avoidable mistakes.

[/quote]

Agree entirely: by far rthe best way of avoiding mistakes would be to refrain from producing two different strengths of solution in similar packaging, intended for a species notoriously sensitive to overdose..........

Sorry, is it just me or are we all a little edgy today?