Terrified of methadone!

Re: Terrified of methadone!

Katie Mack — Wed, 12 Nov 2014 21:31:45 GMT

I love it!! It's top class analgesia. We have used it routinely on a day-to-day (0.3mg/kg) basis for about 5 years and I have only ever seen one adverse reaction requiring reversal! We only ever administer it IM or SC. Be brave.... You'll love it!! :-)

Re: Terrified of methadone!

Louise Northway VNCertECC NCert(Anaesth) RVN — Wed, 12 Nov 2014 15:50:49 GMT

We use methadone (Comfortan) regularly in my practice in dogs and cats around 0.3mg/kg and we find it has no more cardiorespiratory effects that other opiates at this dose.

Re: Terrified of methadone!

SmegSlayer — Sat, 13 Sep 2014 15:27:23 GMT

I used it for the first time last summer while locuming at the RVC after 10 years of ACP/Vet.

I was really scared of it, mainly because I knew nothing about it- none of my other practices had even had it in stock. I read up on it and the theatre nurse talked to me about it's pros and cons and how to give it carefully etc. She really put my mind at rest and after seeing it in use, especially after exlaps and orthopaedics, I relaxed a bit. I won't say I was completely converted because I was only there for a month and didn't really have the time to get used to it.

Re: Terrified of methadone!

paula morgan — Sun, 17 Aug 2014 18:36:19 GMT

I like it too, we also give it sub cut before our bitch spays go home and for inpatients if needed as it last 12 hours x

Re: Terrified of methadone!

Kathryn Welsh — Sun, 17 Aug 2014 01:15:26 GMT

It tends to be first line in Vets Now trauma cases - although have been using Fentynl iv recently as well... Love methadone - short term (4hours), less nausea, more potent. Don't be afraid!! x

Re: Terrified of methadone!

Steph Phillips — Thu, 07 Aug 2014 18:51:56 GMT

I'm a big fan of Methadone but I'm a bit of a wimp with it too! I use 0.2mg/kg routinely (dogs and cats) and up it to 0.3mg/kg for a particularly painful patient and I'll top up from there if necessary. Avoid bolusing IV (if you want to give I/V to minimise I/M's, then dilute 1:10 and give SIV over about 10mins) and you should avoid severe CV and resp depression.

Obviously be careful with your trauma patients if they are head trauma - Methadone is nowhere near as bad as Morphine but it can still have emetic effect.

You can sometimes get a bit of a dysphoric effect from cats - we trialled Methadone for cat speys but reverted back to Bupe because they were having painful recoveries - not sure if it was dysphoria or the short half life of the drug?

Re: Terrified of methadone!

Nick Shackleton — Wed, 06 Aug 2014 19:38:05 GMT

I don't like the use of vetergesic due to it's long acting time 6-8hrs whereas methadone can be repeated every 4hrs. Great for trauma or orthopaedic patients. Also good for your routine surgeries such as birch spays/dog castrates. Less likely to see nausea that's associated with morphine. Plus vetergesic is only a partial agonist and has a slow onset time of around 30 mins and has a varied duration of relief 3-8hrs. Used methadone in a variety of patients in my last practice for 5.5 years and never saw a problem with with. We used to use dose of 0.4mg/kg in dogs and 0.1mg/kg in cats

Re: Terrified of methadone!

Jade Simmons — Wed, 06 Aug 2014 18:24:52 GMT

We use methadone at 0.3mg/kg but think you can go up to 0.5mg/kg (poss 0.4mg) of your worried perhaps organise a lunch and learn with dechra- caroline is fantastic and she can answer all your questions. We definitely see a difference in bitch sorts and ortho ops. Comfortan is the only liscenced methadone for animal use I think. We use alfaxan and Sevo and have no problems.

Re: Terrified of methadone!

Feezy — Wed, 06 Aug 2014 16:14:18 GMT

Thanks lovely people!!! Just need to get used to it I think!

Re: Terrified of methadone!

Nicola Smith — Wed, 06 Aug 2014 15:15:36 GMT

You can reverse with butorphanol in an emergency. We got protocol from dechra and keep it on the wall. We use it loads now and really like it. Found for ops cardio depression much less now on sevo vs iso. We use mid range dose 0.3 as standard and top up if nec. We wouldnt be without it now. Just be aware with ops you will need lower anaesthetic agents.

Re: Terrified of methadone!

rachel w — Wed, 06 Aug 2014 14:42:09 GMT

We've only been using methadone for about a yr and i was worried when we first started using it but after seeing how our patients are after it i am very impressed i still triple check my doses and ck whatever the vets have put on the hosp sheets, but sef post ortho ops and exlaps have been a lot more happy and able to go home sooner on this than vetergesic

Re: Terrified of methadone!

James Colver Cert. Ed, RVN — Wed, 06 Aug 2014 13:22:23 GMT

Remember also that it is reversible! (although Naloxone is a rather expensive drug to keep in stock)

Re: Terrified of methadone!

Mark Hedberg — Wed, 06 Aug 2014 10:28:56 GMT

Weigh your patient and calculate your doses - methadone is useful stuff and safe in veterinary medicine. Every medicine can be abused or misused; don't blame the drug this time.

Use it as the instructions (or your veterinary surgeon) directs and you'll be ok.

Re: Terrified of methadone!

Becky Winter — Wed, 06 Aug 2014 08:35:22 GMT

I wouldn't say it's ace and safe! But - it provides a stable anaesthesia for longer ops such as orthopaedic ones or long soft tissue ops. Yes there are depressive effects to cardio and resp but the benefits are a controlled anaesthesia with much less use of isoflo which is good for patient and nurses nerves. It also provides excellent pain relief used post op but not to be used in already compromised patients. I would say give it a try before you completely disregard it. As long as your vet is assisting you with doses then it will be absolutely fine. Hope that helps Becky xxxx