? So mad !!! Which is the least bad? Metacam or Onsior

[Ti-Mousse (GA) Pepe (GA)]

Not getting any help with vet clinics here... I wish I would live somewhere else! They all follow the same pattern in this stupid place but how about my ti-minou's life: his only life.. he's 9yo, too young to let go (but I feel he's about to) and I need him so much! He's getting tired to fight with no help.

Xrays showing a lot of inflammation, they diagnosed IBD and maybe tumor; I asked for prednisolone and buprenorphine. NO, not giving this to diabetes cats; NSAID only, Metacam or Onsior ... What a choice!! As I said I can easily cope with diabetes, I've been treating my Ti-Mousse for 4 years and he's accro and Pepe for 2 years! NO!! (they didn't even know about accro when I started there...)

The first worst thing is they told me to feed RX GI food to help with bleeding at initial visit 3 weeks ago which is full of carbs... Funny they didn't think diabetes was a problem then.... They just go by what they're told: RX food is healthy so they sell it without wondering about ingredients and quality and who they sell it to!

Second worst thing is if I had been going to this clinic for the 1st time, 3 weeks ago, the BW would have showed BG around 120 which is not considered diabetes specially with a stressed cat going to the vet; he would not have been tagged "diabetes" and they would probably have given me pred and bupe!!

and because of all this, I don't know how to help my ti-minou !! Metacam or Onsior ??

 

[Bron and Sheba (GA)]

Do you have any other options as far as vets go?
I used Metacam with Sheba for a few years and it made an incredible difference to her quality of life. But I know a lot of people dont like it on here. I think in Canada they use the cat only metacam for cats like in Australia and it’s safer than what they use in the US which is the metacam for dogs which is double the strength….and that is where a lot of the problem is.

I’ll tag @Wendy&Neko as she may have some suggestions seeing Ti-Mousse is an Acro kitty.

 

[Ti-Mousse (GA) Pepe (GA)]

Do you have any other options as far as vets go?

Unfortunately not...

I think in Canada they use the cat only metacam for cats like in Australia

I didn't know that; will have to check that and if that's it and you had a good experience with Sheba, I'll feel a little bit better!

 

[Wendy&Neko]

How about a third option, gabapentin? I'm assuming you want if for pain? Onsior is only supposed to be given for 3 days max, even says that on the manufacturers web page. Neko had buprenorphine daily for over 2 years with no problems. If Ti-Mousse's kidneys are OK, and you will be getting a cat specific dose of Metacam, it might be OK. Sorry, still not a fan, but if it comes down to that or nothing... More information, including cat dosing, in this post Metacam ! - Is it safe?

IBD cannot be diagnosed by xray or ultrasound alone. You need a biopsy to differentiate if from small cell lymphoma. Any chance they'd give you a referral to an internal medicine vet? This vet is clearly out their comfort zone. Of course you give pred to a diabetic if that's what they need to give them a better quality life. But you wouldn't give it if the cat has certain heart conditions. Neko couldn't have pred for that reason.

 

[Bron and Sheba (GA)]

The metacam for cats has to be 0.5 mg/ml and the dose is determined on the weight of the cat.
So Sheba who weighed 6 kg got 0.6 ml
You have to make sure that it is given with food. I used to give it with the evening meal. But no food..then no metacam.
And the kidney function needs to be checked first.
After a time, I was able to get the dose down to a half (0.3ml) and it was still as affective.
At the time, I thought I was going to lose Sheba. She was not walking much at all and I felt she was nearing the end. I have to say that the change in her was quite miraculous. And she lived for several more years.
What I like about it is that it reduces the inflammation in the body as well as gives relief from pain.

 

[Larry and Kitties]

Xrays showing a lot of inflammation

How about a third option, gabapentin? I'm assuming you want if for pain?

Buprenorphine and gabapentin are good for pain but do nothing for the inflammation. Both Metacam and Onsior are good for both pain and inflammation. I myself would give Onsior for 3 days.

 

[Bron and Sheba (GA)]

If it’s an ongoing issue I would go with the metacam as it can be given longer

 

[Sienne and Gabby (GA)]

Onsior is also primarily used for post-operative pain and inflammation management. As others noted, it's prescribed for a maximum of 3 days. I would ask the vets what the indication for Onsior is. (This is the link to the package insert with all of the information.) If they can't tell you what the drug is used for, they shouldn't be prescribing it.

Do you have a relationship with any of these vets? Given how well you know your cat, I would hope you can find a sympathetic ear.

 

[Elizabeth and Bertie]

At the time, I thought I was going to lose Sheba. She was not walking much at all and I felt she was nearing the end. I have to say that the change in her was quite miraculous. And she lived for several more years.
What I like about it is that it reduces the inflammation in the body as well as gives relief from pain.

Bron, I had a similar situation with my old tortie, Sophie, bless her. ...Metacam enabled her to have another couple of years of life, and she died age 21. She also had some kidney disease, but she couldn't tolerate other pain killers and so Metacam was our only option. Her kidney disease did not worsen while on it.

Eliz

 

[Ti-Mousse (GA) Pepe (GA)]

How about a third option, gabapentin? I'm assuming you want if for pain?

I'm looking for anti-inflammatory and pain. Unfortunately vet will not prescribe anything unless she sees him again and do another abdominal palpation to see if there's anything different since our last visit not even a month ago!

Any chance they'd give you a referral to an internal medicine vet? This vet is clearly out their comfort zone.

I will ask her when she calls supposedly Friday afternoon if she has time or next week...
Your link on Metacam is very interesting, thanks. Looks like I'm stuck with that!

 

[Noah & me (GA)]

Metacam is formulated differently in the US and Canada, which is which I don't know right now.
No buprenorphine for diabetic cats? That's a new one. Both Nigel and Noah did well on oral and the transdermal saved Noah's life. Their numbers never ever changed.
I cannot diagnose anything but nothing makes an animals life more miserable than pain and we all know how good they are at hiding it.
This is the strength and dosing I used, it's always at or near the top of my profile.
Transdermal BUPE
Noah Strength 0.16mg/0.1ml. Dose 0.05ml twice daily.
Andy Strength 0.16mg/0.1ml. Dose 0.05ml Every 8 to 12 hours as needed.

 

[Ti-Mousse (GA) Pepe (GA)]

The metacam for cats has to be 0.5 mg/ml and the dose is determined on the weight of the cat.
So Sheba who weighed 6 kg got 0.6 ml

Thanks for mentioning the formula for cats, they had prepared Metacam for dogs with a calculation for Ti-Mousse 7 kg which was giving 1.7 ml!
I insisted for the cat one which I finally got with instructions of filling the syringe up to 5 to be conservative because he's 7 kg. There is way too many ml in there....(see attached). I won't give him that. I'll have to see how to dose using another syringe or go by drops. I prefer to go very slowly....

 

[Ti-Mousse (GA) Pepe (GA)]

I myself would give Onsior for 3 days.

I already gave him the maximum 3 days on Onsior last week and it seemed to help a little. So I was wondering if I could give him a 2nd course next week but after reading, it looks like a no-go!

 

[Noah & me (GA)]

There is way too many ml in there

Two years in some junior college and someone with green hair and a tongue stud knows more than you ever will. I have an inept tech just like that, one day I will put a pickle fork through her eye.
Ti-Mousse deserves better than this and is not some object of fascination for head scratching techs. Start cracking some skulls!
et maintenant tu peux embrasser mon cul

 

[Ti-Mousse (GA) Pepe (GA)]

Do you have a relationship with any of these vets? Given how well you know your cat, I would hope you can find a sympathetic ear.

I see vets at that clinic but they just go by-the-book. I don't have a "real vet" for my kitties...someone who cares. It's not easy to find a good one but it's so important ! I have to search for another clinic. This one is the biggest one around, modern and expanding all the time; it looks more like a business than a caring place for animals.

 

[Noah & me (GA)]

looks more like a business

and do the letters "VCA" appear anywhere on the building?

 

[Ti-Mousse (GA) Pepe (GA)]

Two years in some junior college and someone with green hair and a tongue stud knows more than you ever will. I have an inept tech just like that, one day I will put a pickle fork through her eye.
Ti-Mousse deserves better than this and is not some object of fascination for head scratching techs. Start cracking some skulls!
et maintenant tu peux embrasser mon cul

You made me laugh and you're good in French!! Next time I'll go to the vet I'll remember "cracking skulls" and "pickle fork through her eye" !! I'll feel better after...

Unfortunately no bupe and no pred that could help my ti-minou; only Metacam or a renewal of Onsior for 12 days when it's a one-shot 3 days max! I think this is scary.

 

[Ti-Mousse (GA) Pepe (GA)]

and do the letters "VCA" appear anywhere on the building?

No, not yet... but it could come!

 

[Noah & me (GA)]

It is scary and that's why so many of your friends are here.
Lyane, you cannot buy followers here like on other sites. Those fourteen people didn't just appear one day, they chose you because of who you are. Don't let this drag through the long weekend and have your bank account emptied because a vet refused to learn something new. Promise?

 

[Bron and Sheba (GA)]

This is the syringe that is in with the metacam here

 

[Tom & Thomas (GA)]

When my Thomas became severely arthritic, meloxicam proved a wonder drug. He went from needing a step-stool to get up on the bed to scrambling up trees again.

I don't know the situation in Canada, but in the US metacam/meloxicam is packaged only for use with dogs. It got a bad rep for cats because it was being administered at too high a dose. Cut the canine dose in half and you'll have what's right for a cat.

There is a lot of to-and-fro about feline use of NSAIDs, including much to found here in the forums. An NSAID should, however, break the pain cycle quickly and later other remedies can be phased in. Even with long-term use, many feel that the benefits outweigh the risks, especially for an older cat suffering significant pain. When you read about using an NSAID for just three days, that may refer to post-operative use, as opposed to long-term treatment.

I attach some older, 2010, consensus guidelines for long-term use of NSAIDs to treat pain in cats.

 

[Ti-Mousse (GA) Pepe (GA)]

It is scary and that's why so many of your friends are here.
Lyane, you cannot buy followers here like on other sites. Those fourteen people didn't just appear one day, they chose you because of who you are. Don't let this drag through the long weekend and have your bank account emptied because a vet refused to learn something new. Promise?

I know my friends are here and you're one of them! The Forum is my 1st place for help and support ; where I feel good to be.
I can promise this New Year's weekend will be for my Ti-Mousse (not going anywhere, not inviting anybody) just enjoying the time left with my ti minou.

 

[Ti-Mousse (GA) Pepe (GA)]

When my Thomas became severely arthritic, meloxicam proved a wonder drug. He went from needing a step-stool to get up on the bed to scrambling up trees again.

I don't know the situation in Canada, but in the US metacam/meloxicam is packaged only for use with dogs. It got a bad rep for cats because it was being administered at too high a dose. Cut the canine dose in half and you'll have what's right for a cat.

There is a lot of to-and-fro about feline use of NSAIDs, including much to found here in the forums. An NSAID should, however, break the pain cycle quickly and later other remedies can be phased in. Even with long-term use, many feel that the benefits outweigh the risks, especially for an older cat suffering significant pain. When you read about using an NSAID for just three days, that may refer to post-operative use, as opposed to long-term treatment.

I attach some older, 2010, consensus guidelines for long-term use of NSAIDs to treat pain in cats.

Tom, thanks for the documentation, this is so useful! The more we read, the more we learn and can take good decisions! Nice to see that you are always there with us!
One of my concerns was about the dosing; in post 20, Bron is dosing Sheba 6kg using the ml syringe and in post 12, it is the dosing for Ti-Mousse 7kg using the kg syringe. There seems to be a huge difference!

 

[Ti-Mousse (GA) Pepe (GA)]

This is the syringe that is in with the metacam here
View attachment 65998

There was no ml syringe in the box, only the per kg one! I can always get one at the drugstore but it looks to me there is a big difference between the 2 dosing methods. I prefer yours....

 

[Bron and Sheba (GA)]

One of my concerns was about the dosing; in post 20, Bron is dosing Sheba 6kg using the ml syringe and in post 12, it is the dosing for Ti-Mousse 7kg using the kg syringe. There seems to be a huge difference!

There was no ml syringe in the box, only the per kg one! I can always get one at the drugstore but it looks to me there is a big difference between the 2 dosing methods. I prefer yours....

Is your metacam the one for cats? If so the syringe should be the same.
On mine each 0.1 is the amount to be given per kg and yours is for kg as well.
Can you take a photo of the box that the syringe came out of?

 

[PH&MonkeyPenPenFaFaTiger]

Hey, can you just get in from the pharmacy? In the place I live (Hong Kong), I can buy prescription meds from a pharmacy, it is not entirely legal but whatever.
Once I bought buy some cancer medicine for my cat. What I did was find a list of contact of pharmacies and ask them one by one. After asking like 20-30 I got my meds. The whole process took me only 2 hours.

 

[Ti-Mousse (GA) Pepe (GA)]

Is your metacam the one for cats? If so the syringe should be the same.
On mine each 0.1 is the amount to be given per kg and yours is for kg as well.
Can you take a photo of the box that the syringe came out of?

That's the box (French side); unfortunately the vet stuck her prescription label on the English side but it says "oral suspension for cats - Meloxicam at 0.5 mg/ml" and on the bottle it says the same. On the side of the box, for the dosage it says 0.1 mg/kg (= 0.2 ml/kg) day 1, then 0.05 mg/kg (= 0.1 ml/kg) and that's what you're giving. So everything is OK except for the vet instructions... I'll get a 1ml syringe at the drug store today and start his treatment.

Thanks so much Bron, a good thing you were there !!!

 

[Ti-Mousse (GA) Pepe (GA)]

Hey, can you just get in from the pharmacy? In the place I live (Hong Kong), I can buy prescription meds from a pharmacy, it is not entirely legal but whatever.
Once I bought buy some cancer medicine for my cat. What I did was find a list of contact of pharmacies and ask them one by one. After asking like 20-30 I got my meds. The whole process took me only 2 hours.

Here they are very very strict. But for the syringe, there should not be any problem at the drug store!

 

[Noah & me (GA)]

just enjoying the time left with my ti minou.

I've been thinking about this all morning. It almost sounds like you're saying "what little time" I have left with my ti minou.
The diagnosis was IBD and maybe a tumor. Maybe it's not a tumor and maybe if it is it's benign. Sometimes what looks like a few weeks turns into years. It's happened to me more than once, you both deserve a bit of luck don't you think?

 

[Ti-Mousse (GA) Pepe (GA)]

I've been thinking about this all morning. It almost sounds like you're saying "what little time" I have left with my ti minou.
The diagnosis was IBD and maybe a tumor. Maybe it's not a tumor and maybe if it is it's benign. Sometimes what looks like a few weeks turns into years. It's happened to me more than once, you both deserve a bit of luck don't you think?

Hope you're right!

 

[Noah & me (GA)]

me too

 

[Gracie85]

The syringe you were give will be much more accurate for you to use than the "ml" syringe. Yours is a much smaller diameter syringe, so it holds MUCH less liquid than the mL syringe. Look at the tips of both syringes, those will be the same size as they are made that way (in case the syringe is going to have a needle put on it, in order for a standard needle to fit, manufacturers make the tips the same size). The way you each photographed your syringe makes them look different.
The "ml" syringe holds a total of 1.0ml, and each numbered division on it holds one-tenth of that, or 0.1ml, and then they give a dose of half of that, the 0.05ml . Can you see how small that section is, and how difficult to be consistent and accurate with that?
The skinnier syringe you were given probably holds only 0.1ml (it looks like there is writing on the back side of it, can you read that?) and each marked number then represents 0.01ml of medicine. So then, you give a dose of 0.05ml, which means you go all the way up to the 5 on the syringe, which will be 0.05ml. But see how much easier it is to be accurate in filling the syringe to get the accurate dose? You are much better off using the tiny volume, skinny syringe where you can more accurately draw up and dispense the dose than changing to a bigger size syringe and trying to measure out a very small dose in it.

It's like needing a 1/8 cup of water, and having the choice of using the big glass 2-cup measuring cup to estimate half of the very bottom 1/4 cup mark, or using a small 1/4 cup measuring cup and filling half of that to get your 1/8 cup. The amounts are the same, but the smaller cup will get you a much better and more consistent measure each time.

A vet with good communication skills could have explained this, as could a well-trained technician. But so many don't have the skills, or the interest, or the time, so unfortunately you just get told "do this" with no reasoning why. If you take your syringe to the pharmacy and ask them, they can probably explain it in person which might work better than what I've attempted to write out to you.

(former professional research chemist here, hence my experience with this sort of thing.)

 

[Bron and Sheba (GA)]

The syringe you were give will be much more accurate for you to use than the "ml" syringe. Yours is a much smaller diameter syringe, so it holds MUCH less liquid than the mL syringe. Look at the tips of both syringes, those will be the same size as they are made that way (in case the syringe is going to have a needle put on it, in order for a standard needle to fit, manufacturers make the tips the same size). The way you each photographed your syringe makes them look different.
The "ml" syringe holds a total of 1.0ml, and each numbered division on it holds one-tenth of that, or 0.1ml, and then they give a dose of half of that, the 0.05ml . Can you see how small that section is, and how difficult to be consistent and accurate with that?
The skinnier syringe you were given probably holds only 0.1ml (it looks like there is writing on the back side of it, can you read that?) and each marked number then represents 0.01ml of medicine. So then, you give a dose of 0.05ml, which means you go all the way up to the 5 on the syringe, which will be 0.05ml. But see how much easier it is to be accurate in filling the syringe to get the accurate dose? You are much better off using the tiny volume, skinny syringe where you can more accurately draw up and dispense the dose than changing to a bigger size syringe and trying to measure out a very small dose in it.

It's like needing a 1/8 cup of water, and having the choice of using the big glass 2-cup measuring cup to estimate half of the very bottom 1/4 cup mark, or using a small 1/4 cup measuring cup and filling half of that to get your 1/8 cup. The amounts are the same, but the smaller cup will get you a much better and more consistent measure each time.

A vet with good communication skills could have explained this, as could a well-trained technician. But so many don't have the skills, or the interest, or the time, so unfortunately you just get told "do this" with no reasoning why. If you take your syringe to the pharmacy and ask them, they can probably explain it in person which might work better than what I've attempted to write out to you.

(former professional research chemist here, hence my experience with this sort of thing.)

Very well explained… and true.

 

[Ti-Mousse (GA) Pepe (GA)]

The syringe you were give will be much more accurate for you to use than the "ml" syringe. Yours is a much smaller diameter syringe, so it holds MUCH less liquid than the mL syringe. Look at the tips of both syringes, those will be the same size as they are made that way (in case the syringe is going to have a needle put on it, in order for a standard needle to fit, manufacturers make the tips the same size). The way you each photographed your syringe makes them look different.
The "ml" syringe holds a total of 1.0ml, and each numbered division on it holds one-tenth of that, or 0.1ml, and then they give a dose of half of that, the 0.05ml . Can you see how small that section is, and how difficult to be consistent and accurate with that?
The skinnier syringe you were given probably holds only 0.1ml (it looks like there is writing on the back side of it, can you read that?) and each marked number then represents 0.01ml of medicine. So then, you give a dose of 0.05ml, which means you go all the way up to the 5 on the syringe, which will be 0.05ml. But see how much easier it is to be accurate in filling the syringe to get the accurate dose? You are much better off using the tiny volume, skinny syringe where you can more accurately draw up and dispense the dose than changing to a bigger size syringe and trying to measure out a very small dose in it.

It's like needing a 1/8 cup of water, and having the choice of using the big glass 2-cup measuring cup to estimate half of the very bottom 1/4 cup mark, or using a small 1/4 cup measuring cup and filling half of that to get your 1/8 cup. The amounts are the same, but the smaller cup will get you a much better and more consistent measure each time.

A vet with good communication skills could have explained this, as could a well-trained technician. But so many don't have the skills, or the interest, or the time, so unfortunately you just get told "do this" with no reasoning why. If you take your syringe to the pharmacy and ask them, they can probably explain it in person which might work better than what I've attempted to write out to you.

(former professional research chemist here, hence my experience with this sort of thing.)

Don't need to go to the pharmacy after your very good explanation ! Thanks.