First-time dental... Metacam?

Status
Not open for further replies.
FarmKitty

FarmKitty

Member Since 2020
Hello everyone!

My name is Sarah and I am here to get some advice on taking my cat, Dixie (14 years old), to her first dental to handle her gingivitis.

I have taken her to two different vets for dental estimates.

Vet #1 was going to prescribe:
  • 14 x Aventiclav 62.5mg Tab
  • 10 x Feline Fortiflora Probiotic Single pack
  • 10 x Buprenorphine 0.8mg/ml
  • 5 x Gabapentin 100mg/mL Beef
I then went to Vet #2 who has more of an interest in dentistry and they were going to prescribe:
  • Buprenorphine SR 3mg/mL
  • Metacam inj. 5mg/mL
  • Metacam Oral Suspension 1.5mg/mL
I vaguely remember coming across people here talking about Metacam and how it can be dangerous/lethal for kidneys. I see that it has a warning on the FDA site (although I am in Canada). I'm not sure how it differs between countries.

Dixie didn't show any kidney problems on her last lab (I have the results in my spreadsheet tab), but she is an older cat (14 years) so from what I understand, her kidneys are probably compromised just from that.

My question: Is one of these sets of medications safer than the other? Do you think it would be ok for me to ask Vet#2 if they could use the same medications that Vet #1 uses?

Also, if anyone has any good, reliable links that has information on this then I would love to see them! I am having trouble finding them through googling.

Obviously, I will trust what the medical professionals say over anonymous internet posts... but I would like to have some advice/confidence in how to talk to the vet and express my worries without seeming too crazy :eek:
 
FarmKitty said:
I vaguely remember coming across people here talking about Metacam and how it can be dangerous/lethal for kidneys. I see that it has a warning on the FDA site (although I am in Canada). I'm not sure how it differs between countries.
Click to expand...

The reason there was a warning on the FDA site in the US was because there were problems and deaths when they gave the Metacam to cats.....but the Metacam they gave was Metacam that was the dog strength (1.5mg/ml) and that was the problem. The US does not have Metacam that is specifically for cats. They have to use the dog Metacam.
In Canada, the UK and Australia we all have cat specific Metacam which is 0.5mg/ml. This is the oral dosage I am talking about

FarmKitty said:
  • Metacam inj. 5mg/mL
  • Metacam Oral Suspension 1.5mg/mL
Click to expand...
Your vet has quoted you the dog strength of the oral Metacam so I would definitely get back to him on that and check why he is giving you the dog streng when the cat strength id available. I'm not sure of the correct strength for the injection but I would also check on that as well.

I used oral Metacam for my cat for over 2 years and it was safe for her. But I followed the directions and did not give it when she would not eat or drink.
Out here in Australia they use Metacam a lot for dentals and arthritis and it is very effective.

Hopefully there will be others that can comment on the medication with the vets.
I gave bupe to my cat and she was completely out to it for 8 hours so I didn't use it again , but others like it.
With the 5 x Gabapentin 100mg/mL, how much is he going to give. I think 100 mg is a lot...and it also depends how often he is going to give it.
I will tag @Wendy&Neko as she will be able to comment on them.
 
Hi Sara and Dixie WELCOME TO FDMB
I hope you've found all the information you came here for. If theses anything else you need just ask!
jeanne
 
Is Dixie expected to get extractions? I don't think you'll need heavy duty pain relief described if it's just a cleaning. Neko's dental vet wanted to used Metacam with some major dental work (I am in Canada too) and she had kidney disease at the time, I said no, so he didn't. You are the customer - you get to suggest what you want. My general practice vet was not a fan of Metacam either, she used buprenorphine or gabapentin (or both) for cats in pain. Neko tried gapapentin for a while, I think the highest dose she got was 50 mg, so the dose does seem a bit high, but I'm no expert on gabapentin. We stopped giving it after a while cause it just seemed to make her super sleepy.
 
100 mg of Gabapentin is a sedative dose amount ... were they wanting to use it for pain management? The dose is supposed to be much lower for that, something like 5 mg/kg.
 
Thank you all for your advice. I wanted to post an update on what I did for the sake of anyone in the future researching things like I did.

I ended up going with Vet #2 because they had experience and interest in pet dentistry. I explained my concerns to them and they said that, in their experience, cats experience pain even if they are on gabapentin and buprenorphine. So they typically prescribe the low dose of Metacam (I guess the dental estimate sheet was wrong about the strength). They said that the key thing is to make sure the cat is well-hydrated, so they give fluids on the day of the procedure and also often bring the cats in days before for SQ fluids.

The vet offered Onisor (also NSAID) as an alternative to Metacam, which is theoretically more protective of the kidney. Although, the vet wasn't too convinced that it was better.

After a lot of googling (way too much googling), I decided to allow Dixie to get the Onisor. However, I think I would have also been comfortable with the feline-strength Metacam as well. From what I looked at, it seems like the issues with Metacam in the US could stem from a lack of vet training on dosing it correctly.

Dixie had her dental a week ago and ended up getting 6 teeth extracted. She needed only 2 extractions, but the other teeth were bad enough that, even with a cleaning, they would probably be extracted within the year. Dixie ended up having Onisor injection, 3x Onisor 6mg tablets, Buprenorphine Slow Release injection, and SQ fluids the day before the dental. The recovery went excellent. She didn't appear to be in any pain at all and acted pretty much normal except for some constipation and she was a bit wobbly jumping off things.

All in all, I am very happy that I talked to you guys to get confidence to voice my concerns to the vet, and I am happy with my choice of medication. Every cat is different, but Dixie's lab work for her kidney's was good so I felt comfortable giving her the Onisor. She only has her front teeth left so this will likely be her first and last dental she will ever need! If she needed a cleaning in the future then I might reconsider her medications based on her lab work.

My one regret it that I did not do the dental sooner. I knew that she would need a dental when I got her (5 months ago), but I kept putting it off. First, was because of getting her diabetes under control. But then the second reason was because I was just scared about making the choice regarding her pain medication. I didn't want to make the wrong decision and ruin her kidneys. I spent too many nights thinking about what to do, but when the vet said that the NSAID would ensure she wasn't in any pain, then I decided to go that route.

Since the dental, Dixie's BG has been getting lower and lower! Oh how I wish I had done this all sooner.
 
Status
Not open for further replies.
Back
Top