Meloxicam Dosage Questions

[mom2zeus]

Suzy, our 14 year old girl, had x-rays done last friday and vet said 60-40 in favor of bone cancer in the sholder. They couldn't get a really good x-ray without causing her a lot of pain and we don't want to knock her out if we dont have to due to her age. For now the plan is to wait 4-6 weeks and redo the x-ray to see if there is change. If it is cancer we don't plan to do any treatment other then keep her comfortable. She's on metacam once a day and 25 mg of tramadol 2x/day for pain. She can be a picky eater and I was thinking about asking the vet to switch her to the pill form of metacam, meloxicam, since it will be easier to make sure she gets it then mixing the liquid into her food. She's only 58 lbs and if I read the metacam dosage correctly she should get 2.9 mg/day. If you have a dog on meloxicam pills does this sound about right? The smallest the pills come in are 7.5 mg. How do you cut a pill in thirds? Does the metacam dose directly compute to the meloxicam dose? Any advice from those that give meloxicam would be greatly appricated. I want her to be as comfortable as possible and the best way is to make sure she gets her meds. I could stick with the metacam and squirt it in her mouth but a pill hidden in pb would be a lot less stressful for her

[Brindles]

Just go with half of the 7.5 mg pill. You can get a pill cutter at Walgreens. That's what I did for my girl and it worked beautifully for her. Meloxicam was the only drug she would respond to.

[Hubcitypam]

Kenny the GH mix was on it for a long time. He was 60 pounds and got 1/2 a 7.5 a day per my vet and Dr. Stack.

[Fiona3]

Our yellow lab Bailey is also on 1/2 of the 7.5 pill, once a day. This seems to be the preferred dose and works very well. I am so sorry that Suzy is going through this and experiencing pain. My thoughts are with you and your girl.

[KF_in_Georgia]

Sam (65 pounds) is another one getting half of a 7.5mg pill every day.

 

I cut all the pills in half as soon as I get home from the drug store. That way, I don't risk confusing this pill with his other meds, where he gets a whole pill or more than one pill at a time.

[tbhounds]

Did they take chest films too? I would question the Tramadol frequency--can be given every 8 hours as needed. Also you may want to consider adding gabapentin. Be very careful with the metacam dose-did you run blood work prior to starting the metacam-it's not the most renal friendly medication. Personally I would stick with the liquid as you can dose it more accurately. What you might be able to do is place it onto something tasty like pound cake and see if that works. You most certainly don't want to make cranky kidneys right now.

Edited October 25, 2012 by tbhounds

[LuvEarsies]

We use the liquid for our 14 y/o and we just squirt it right into his mouth. He loves the taste, it smells sweet to me so I think it is based on his reaction.

[Brindles]

Any NSAID can cause kidney and liver damage (and likely will if given long term), but Meloxicam is actually one of the more renal and gastro friendly NSAIDs. Either way, organ failure is the least of your concerns right now. At this stage of the game, just do what is easiest and most comfortable for her. For my girl, it was the pills in a spoon of peanut butter. She hated the taste of the liquid.

[tbhounds]

Any NSAID can cause kidney and liver damage (and likely will if given long term), but Meloxicam is actually one of the more renal and gastro friendly NSAIDs. Either way, organ failure is the least of your concerns right now. At this stage of the game, just do what is easiest and most comfortable for her. For my girl, it was the pills in a spoon of peanut butter. She hated the taste of the liquid.

So are you saying that if the op's hound has arthritis or a soft tissue injury it's ok that she develops acute renal disease? I understand that the likely hood this may be what we all fear but, until a definitive diagnosis is confirmed I don't believe it's ok to throw meds at her willy nilky. 1/2 of a 7.5mg tablet once a day of meloxicam is too high a dosage-period. I am well aware that all NSAIDs can induce renal and hepatic changes but, to claim that metacam is more renal and gastric friendly than other NSAIDs is just not correct--don't care what the stats say-when it comes right down to it it's an individual thing-some dogs will respond better or worse to certain medications-metacam is one.

I understan where you are coming from but, to say organ failure is the least of her concerns is irresponsible of a response. If this is OSA and the op decides to treat even palliatively then she does not need "organ failure" complicate matters.

Edited to add-I am all about keeping this hound comfortable too-this is why I suggested the op ask their vet about increasing the Tramadol frequency and adding gabapentin. There are safer ways to control pain rather than give an excessive dose of a NSAID.

Edited October 25, 2012 by tbhounds

[Hubcitypam]

1/2 of a 7.5mg tablet once a day of meloxicam is too high a dosage-period.

I find that very interesting. My vet at the time when I had Kenny calculated the dosage for him and came up with the same dose as Dr. Stack which was 1/2 a 7.5mg tablet.

He did fine on it for years...and mine came from Mexico at .07 a pill. Beat the heck out of liquid.

Edited October 25, 2012 by Hubcitypam

[tbhounds]

1/2 of a 7.5mg tablet once a day of meloxicam is too high a dosage-period.

I find that very interesting. My vet at the time when I had Kenny calculated the dosage for him and came up with the same dose as Dr. Stack which was 1/2 a 7.5mg tablet.

He did fine on it for years...and mine came from Mexico at .07 a pill. :jawdrop: Beat the heck out of liquid.

At 0.1mg/kg the op's hound should receive 2.6 mgs/day. There are safer ways to control pain. Hopefully, this is the reason her vet chose to prescribe the liquid. Also we are assuming her kidney and liver values are normal in the first place-perhaps this hound has a history we are not informed about.

Edited October 25, 2012 by tbhounds

[TwiggysMom]

I am so sorry to hear about Suzy's possible osteo diagnosis. I hope she gets to be one of the ones where this is a false alarm.

 

Twiggy was on Metacam. I asked about giving meloxicam because it is so inexpensive. Her oncologist was quite wary of that because it is much harder to customize the dosage. I found the best price from a reliable on-line pharmacy at KV Pet. I also bought the 100ml size bottle. That was the most cost-effective way for me to buy it.

 

We chose Metacam over piroxicam because her oncologist felt it has fewer side effects. (Deramaxx was out of production at the time)

 

Despite careful dosing, it caused bad ulcers where she couldn't keep food or water down, and also caused bloody diarrhea. I'm not trying to scare anyone away from using the medication, just making the point that if she had been on a higher dosage (like splitting a human meloxicam tablet), her ulcers would likely have occurred even earlier or been worse.

Edited October 25, 2012 by TwiggysMom

[Brindles]

Any NSAID can cause kidney and liver damage (and likely will if given long term), but Meloxicam is actually one of the more renal and gastro friendly NSAIDs. Either way, organ failure is the least of your concerns right now. At this stage of the game, just do what is easiest and most comfortable for her. For my girl, it was the pills in a spoon of peanut butter. She hated the taste of the liquid.

So are you saying that if the op's hound has arthritis or a soft tissue injury it's ok that she develops acute renal disease?

 

You know that's not what I was implying.

[tbhounds]

Any NSAID can cause kidney and liver damage (and likely will if given long term), but Meloxicam is actually one of the more renal and gastro friendly NSAIDs. Either way, organ failure is the least of your concerns right now. At this stage of the game, just do what is easiest and most comfortable for her. For my girl, it was the pills in a spoon of peanut butter. She hated the taste of the liquid.

So are you saying that if the op's hound has arthritis or a soft tissue injury it's ok that she develops acute renal disease?

 

You know that's not what I was implying.

Than you shouldn't have written it--however, I understand your feelings behind it.

[JJNg]

I agree with tbhounds that giving 1/2 of a 7.5 mg meloxicam tablet is too high. I would only consider that a reasonable dose for a dog over 80 lbs. And rather than kidney or liver issues, I'd be more concerned about the potential for GI ulceration and even perforation, which can happen very quickly. I remember reading reports of dogs that had died from GI perforation caused by meloxicam, and most of the dogs were on the generic human tablets instead of the veterinary liquid. IMO, not worth the risk to save some money.

[4My2Greys]

I agree with tbhounds that giving 1/2 of a 7.5 mg meloxicam tablet is too high. I would only consider that a reasonable dose for a dog over 80 lbs. And rather than kidney or liver issues, I'd be more concerned about the potential for GI ulceration and even perforation, which can happen very quickly. I remember reading reports of dogs that had died from GI perforation caused by meloxicam, and most of the dogs were on the generic human tablets instead of the veterinary liquid. IMO, not worth the risk to save some money.

 

My vet who has gone out of his way to help me save money said he would not feel comfortable using the pill form of meloxicam when we were discussing Bruiser's metronomic protocol because of the very reasons you stated.

 

[PatricksMom]

That's a low dose of Tramadol--have you talked to your vet about increasing the Tramadol? It's very safe, and also inexpensive if cost is an issue. I've used 1/2 7.5 mg. tablet without any trouble, but not for longer than 2 weeks.

[Brindles]

Any NSAID can cause kidney and liver damage (and likely will if given long term), but Meloxicam is actually one of the more renal and gastro friendly NSAIDs. Either way, organ failure is the least of your concerns right now. At this stage of the game, just do what is easiest and most comfortable for her. For my girl, it was the pills in a spoon of peanut butter. She hated the taste of the liquid.

So are you saying that if the op's hound has arthritis or a soft tissue injury it's ok that she develops acute renal disease?

You know that's not what I was implying.

Than you shouldn't have written it--however, I understand your feelings behind it.

 

Your opinion doesn't change my mind about it.

[TheFullHouse]

Oh Trish, I'm so sorry to see this. I have no advice, just prayers for your family and Suzy.

[mom2zeus]

Thanks for everyones input. We are going with the pill form and she is getting 1/3 of a pill once a day. I'm cutting them in half and then shaving off the extra to take it down to 1/3. She is also on pepcid to help protect the stomach. Suzy actually doesn't like the tast of the liquid. As soon as we fed her with no pain meds in it she ate with no problem. She's only getting the pills on a full stomach. I am aware of the dangers of NSAID's and am cautious. Suzy's kidneys and liver values are in the normal range. We will be upping the tramadol but want to start her on a lower dose so she gets used to it since it can make her sleepy. Last thing we want is to drug her to the point she's stumbling around and falls. If it's cancer a fall could shatter the bone To be honest, in my heart I know it's cancer and I think I knew that even before the x-rays Friday. She is acting very different then she ever has in the past when she was stiff from athritis or an injury. I'm hoping I'm wrong and if so she will not be on the meds long term, only a few weeks, and we always watch any of the dogs when they start a medication or are on something long term.

[kudzu]

What a sad & frightening time for you. Very sorry you are going through this.

 

My female GH is the first dog for whom I ever used the human, generic meloxicam. She is 60 lbs & gets 1/3 of a 7.5mg pill. When my 72 lb male GH was with us & having bad days he sometimes got 1/2 pill but usually only 1/3 as well. Personally, I feel comfortable splitting a meloxicam pill into 1/3's. No it isn't exact & I have some worry that if a dose is shorted my dog will be in pain. However, if my dog is hurting that much then I would likely be adding tramadol as well. I would rather this than risk the GI damage since it is more than just a belly ache or bit of nausea. When my little 45 lb lurcher foster needed an NSAID for an injury I decided splitting a tiny meloxicam pill into 1/4 was impossible to do semi-accurately. We opted for carprofen.

 

Just for the record, my understanding of meloxicam, going back to about 10 years ago when we first started using it, is that it actually has a lower safety margin for GI damage in comparison to Rimadyl & Deramaxx. Had always thought this may have been a big reason Metacam was marketed as a liquid. I think a dog in the 55-60 range is the smallest for whom I would ever use the human pills unless it was just a dose or two. I simply am not comfortable using an excess of NSAID on dogs. We each have to make the decision we feel best & that is mine.