# Metacam liquid - how soon expect results?



## karlaj

Hi. Have posted this message previously, to wrong place. Hope I am right, now! Just wondering if anyone can tell me how long, roughly, metacam liquid can take to work? Our elderly dog, tom, had 1st dose saturday - vet said possible to see improvement in a 'couple of days' but there is no noticeable difference yet. Am a bit anxious, in case arthritis isn't at the root of his problems, and therefore the metacam won't work at all, but not sure how long to give it before taking him back to vets? Also, I've been giving dose in evening - would morning be better, to ensure a more comfy day? Any help, thoughts or advice would be so much appreciated because i am breaking my hearty over him being so quiet, and distracted. 
Many thanks


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## rona

My vet said within 12 hours for the pain relief, but I assume it may take a few days for the anti inflam to start having any affect.
Did you give the enhanced first dose that they recommend?

I don't like NSAIDs so have mine on Tramadol and Cartrophen injections


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## Nukawin

Depending on whats causing the pain, I find that Metacam isn't always going to work. 

I hope it does in your case tho, it really shouldn't take long to kick in, but I find it depends on how severe the pain is.


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## karlaj

Hi
Thank you both so much for your replies - Tom hasn't been at 'yelping' pitch with his pain - and there's a question mark, really over what's causing his behaviour with some level of pain, potentially arthritic, seeming the most likely culprit. He does seem to suffer after more strenuous exercise, and vet felt quite a lot of resistance when gently manipulating his limbs. As I say, though, he's not overtly in agony, just very withdrawn, and sleeping a lot, rather lethargic, yet capable of suddenly seeming himself again, although he does tire quite quickly. He's had blood and urine tests and regular check ups - none of which have revealed any other significant issues. I hear what you are both saying in that there may be preferred alternatives to Metacam, that its anti-inflamatory powers may not kick in immediately, and that it may not work in all cases. All we can do is monitor him, I guess, and get him back to the vet if it looks like we're on the wrong track.

Thanks so much again - I really appreciate it. I am a very worried person, with a much-loved dog who is simply not himself, by a long way :-(


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## Burrowzig

My dog has been on Metacam for 2 weeks today. I noticed an improvement the third day, she was a lot less stiff and happier in herself. She's still limping though - will have a little play but soon wants to stop. She has a rest then has another play. She has restricted movement, likely arthritis, in both hips and shoulders. The vet said to reduce the dose a bit after 2 weeks, but as she's still limping, I don't see how I can.


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## karlaj

Hello
Thanks so much for your post - glad your dog responded so quickly, but sorry she's not over the limping yet. Our vet also said about reducing to a maintenance dose, in time, but I guess that would be dependent on how the dog is, so I'm sure you're right not to consider reducing it yet. Did you start on the dose per kilo, or with a 'loading dose'? One of the other replies here mentions starting higher, but we weren't told to do this... Just wonder if it might have been more effective, more quickly, if we had! Good luck with your dog and I really hope she continues to improve


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## DogWalker1234

Burrowzig said:


> My dog has been on Metacam for 2 weeks today. I noticed an improvement the third day, she was a lot less stiff and happier in herself. She's still limping though - will have a little play but soon wants to stop. She has a rest then has another play. She has restricted movement, likely arthritis, in both hips and shoulders. The vet said to reduce the dose a bit after 2 weeks, but as she's still limping, I don't see how I can.


I would never ignore a vet's advice on dosage myself, but instead would seek further guidance after explaining my concerns. There are very good reasons they give you a specified dose schedule and while it's tempting to think 'more is better' if the drug is not working as you'd expected, all drugs have potential side effects and even their intended effects tend to be nonlinear - meaning due to tolerance, sensitisation, etc., sometimes 'more is worse'. Also there are other treatments and so another possibility for your dog is that 'different is better'.

As with people, I expect the initial dosage includes a margin of safety and is probably a fair amount less than the average pet can safely tolerate. But I've never felt any confidence in my ability to make that judgment. There is a reason vets went to vet school, after all!

If I ever doubted my vet's judgment I would seek a second opinion. Obviously no-one wants their pet to suffer but playing 'armchair vet' is never a good idea in my opinion.


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## karlaj

Hi
Our vet said possibly reduce dose 'if all going well,' - no specific timescales were predicted, just that the Metacam liquid can be reduced from 1 unit per kg to approx 2/3 of that amount, as a maintenance dose. 
She didn't however mention the loading dose (of twice the daily amount) to be given on day 1 - yet it does recommend this on the leaflet. Wondering how much that affects initial take up by the dog's system?


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## rona

DogWalker1234 said:


> I would never ignore a vet's advice on dosage myself, but instead would seek further guidance after explaining my concerns. There are very good reasons they give you a specified dose schedule and while it's tempting to think 'more is better' if the drug is not working as you'd expected, all drugs have potential side effects and even their intended effects tend to be nonlinear - meaning due to tolerance, sensitisation, etc., sometimes 'more is worse'. Also there are other treatments and so another possibility for your dog is that 'different is better'.
> 
> As with people, I expect the initial dosage includes a margin of safety and is probably a fair amount less than the average pet can safely tolerate. But I've never felt any confidence in my ability to make that judgment. There is a reason vets went to vet school, after all!
> 
> If I ever doubted my vet's judgment I would seek a second opinion. Obviously no-one wants their pet to suffer but playing 'armchair vet' is never a good idea in my opinion.


I think this is standard guidance/instructions from vets about Metacam 

The initial dose being given is a loaded dose, this then changes to the recommended dosing for the size of dog according to the manufacturers.
Vets must have discovered that many dogs do not require the full dose and therefore, if they feel the owner is competent to judge, will advise reduction of the drug to a level the owner feels is still effective.
I don't feel that this makes anyone an armchair vet. If your dog isn't doing well You just keep the level of dosing at the recommended, if they are doing well you reduce the dose as advised by vet.
Vets cannot possibly judge an animals pain level more accurately than an experienced owner!
Vets know this, I can't see how you don't?


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## Burrowzig

I wasn't told to give a loading dose, but to give my dog the standard dose for her size - which is exactly what she's had. I certainly don't think 'more is better', I'm not an idiot - and my vet trusts my judgement about how my dog is.

She's due back for a review in 2 more weeks.


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## DogWalker1234

I would give it a week.

Drugs work on a schedule that depends on their half life - this is how long it takes for half the dose to get out of the dog's system. It's another way of saying how much build up in the system a drug has. Metacam has a half life of 15-20 hours. 

The maths is a bit complicated, but a daily dose of a drug with a half life of 16 hours would take about six days to build up to the target dose. 

The fact there was no loading dose in your case suggests the vet was concerned about possible side effects. But this means the desired dose will just take longer to achieve, it does not mean the dose needs to be raised or lowered before that happens.

Again, best advice I can give is to talk to your vet if you are unsure.


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## DogWalker1234

Burrowzig said:


> I wasn't told to give a loading dose, but to give my dog the standard dose for her size - which is exactly what she's had. I certainly don't think 'more is better', I'm not an idiot - and my vet trusts my judgement about how my dog is.
> 
> She's due back for a review in 2 more weeks.


I'm not calling you an idiot, I was just pointing out some of the reasons why people might think they can ignore a vet's advice. Sorry if it sounded like I was picking on you.


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## DogWalker1234

rona said:


> I think this is standard guidance/instructions from vets about Metacam
> 
> The initial dose being given is a loaded dose, this then changes to the recommended dosing for the size of dog according to the manufacturers.
> Vets must have discovered that many dogs do not require the full dose and therefore, if they feel the owner is competent to judge, will advise reduction of the drug to a level the owner feels is still effective.
> I don't feel that this makes anyone an armchair vet. *If your dog isn't doing well You just keep the level of dosing at the recommended*, if they are doing well you reduce the dose as advised by vet.
> Vets cannot possibly judge an animals pain level more accurately than an experienced owner!
> Vets know this, I can't see how you don't?


All very sensible to me, except the bolded bit. If its' been two weeks and the drug is not working, I'm calling my vet up. What's the point of continuing a treatment plan that has been shown not to work?


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## Burrowzig

DogWalker1234 said:


> The fact there was no loading dose in your case suggests the vet was concerned about possible side effects. But this means the desired dose will just take longer to achieve, it does not mean the dose needs to be raised or lowered before that happens.


I doubt it, she's had Metacam before with no discernable side effects.


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## DogWalker1234

Burrowzig said:


> I doubt it, she's had Metacam before with no discernable side effects.


As the dog gets older their bodies can change and it's not inconceivable that a previously safe drug could cause side effects.

There may be other reasons not to give a loading dose as well, e.g., a sudden large dose may be a shock to the liver and with such a short half life I would guess maybe some vets don't think it's worth the risk.


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## 912142

karlaj said:


> Hi
> Thank you both so much for your replies - Tom hasn't been at 'yelping' pitch with his pain - and there's a question mark, really over what's causing his behaviour with some level of pain, potentially arthritic, seeming the most likely culprit. He does seem to suffer after more strenuous exercise, and vet felt quite a lot of resistance when gently manipulating his limbs. As I say, though, he's not overtly in agony, just very withdrawn, and sleeping a lot, rather lethargic, yet capable of suddenly seeming himself again, although he does tire quite quickly. He's had blood and urine tests and regular check ups - none of which have revealed any other significant issues. I hear what you are both saying in that there may be preferred alternatives to Metacam, that its anti-inflamatory powers may not kick in immediately, and that it may not work in all cases. All we can do is monitor him, I guess, and get him back to the vet if it looks like we're on the wrong track.
> 
> Thanks so much again - I really appreciate it. I am a very worried person, with a much-loved dog who is simply not himself, by a long way :-(


You could offer him glucosamine and chondroitin supplements which will help ease his joints.


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## karlaj

Just to say I agree with Rona and with Burrowzig. We owners live 24/7 with our dogs and I'm sure our vets trust us to monitor and assess our pets, when following any treatment plan they have prescribed.

Upon rereading the exchanges, I think maybe Dogwalker thought it was me, trying to be an 'armchair vet.' Certainly not (as my vet bills will prove!!) All I was saying was that I thought Burrowzig was correct, to be unsure of reducing the recommended dose, whilst her girl is still evidently quite reliant on it. My impression was that, whilst Metacam _can_ be reduced, in appropriate circs, from 1 unit per KG to a maintenance level, it's a matter of how the dog is progressing, and the owner can certainly judge this.

The fact that Burrowzig also wasn't told to give a loading dose reassures me it wasn't an oversight on the part of the vet (because they are human, too!)

Happily, I can report Tom a little better last night and today - maybe he's turning a corner as Burrowzig's girl also did, a few days into the treatment.

I hope she continues to do well, and thanks for the reassurances re dosage and your comparable experiences in starting Metacam.


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## rona

So pleased Tom seems to be responding. Fingers crossed


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## DogWalker1234

Glad to hear Tom is doing better too. Hope it all goes well for you and everyone else.


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