long term metacam question

I was speaking to John about Bertie's Metacam dosage the other day, and we've now brought it down to a 3kg dose, twice a day. He wants me to keep reducing it, by 1/2 a KG dose at a time over a few weeks. When I asked what was the limit, he said that I could go down to nothing, and see what happens. If he shows any signs of trouble, to go back in high again, but bring it down quicker, and this should rectify it.

I'm a little nervous about bringing it down to nothing, but at the same time, I'd be both interested to see Bertie's response, and also give him a break from medication. With him being on this stuff for the rest of his life, I would like to be able to have breaks every now n then, provided bertie doesn't suffer as a result.

I'm very tuned in to his signs of pain, and am confident that I'd know pretty quickly that he needed pain relief, but wondered if any of you had any experience of this approach, or any thoughts on it.
Thanks

i wondered about this as Foxglove was on Septrin and Metacam twice a day for most of her life and I often wondered about the effects of this if any so would be interesting to hear other people's thoughts.

Is Bertie on Zantac too? I seem to think this is advisable with long term Metacam use as Metacam can cause stomach ulceration.

yeah, this one's tricky Vanessa, and I've had the zantac discussion with John a couple of times. He basically said to me that although this is a common idea, he has only ever seen one case of ulceration in a rabbit on long term metacam, and that rabbit was not a healthy one. He knows that other vets and specialists recommend Zantac to go with Metacam, but that he has yet to see any evidence of a need for it. Should he develop any problems from metacam, that he'll treat those as they arise rather than medicate him preventively.

Id be very interested to see how it goes with Bertie Jay as daisy is on metacam twice a day and while im hoping he wont be on it forever i am worried about how he is going to be when he comes off it.....Im thinking that it must be addictive in some way.

I've not had a rabbit on long-term Metacam so am not really qualified to respond to the question but wanted to say that with rabbits on short-term painrelief we seem to work the other way, starting low and working up to the desired doseage.

I found with Mack and Caspian that as their pain was variable on a daily basis medicating could be very hit and miss and it was hard to know whether to dose them right up constantly or take each day as it came.

I don't suppose anyone knows if over a prolonged period of time certain painkillers become less effective, like opiates for example.....

I don't know that John starts high and reduces for all conditions, but I did ask him why he did that for Bertie when he first put him on Metacam, and he said that he'd been in so much pain for such a prolonged period (and was having daily stasis) that he just had to drench him with pain relief, get him comfortable and eating/pooing again normally, then look at the dose. So he started off on 10kg dose twice daily, and it took about 3 days for him to respond. He's on 3 now, but I suspect he could easily come down to a few drops, and then we'll see wether or not to take the plunge and go without

I'll ask him about acquired resistance when I speak to him next

My vet told me last week it can cause quite bad side effects but then again, she said some of her patients take it all their lives, so I think it's best to discuss this with your vet.