Vetergesic overnight

RE: Vetergesic overnight

Former Member — Sun, 30 Aug 2015 22:41:03 GMT

I would second the use of Subcut Bup/Meth. I work in ECC and have also studied the vn cert, they don't mention it as it's off label, but many of the ECC doctors use SQ where there is a patient risk/benefit weigh up.

RE: Vetergesic overnight

SmegSlayer — Sat, 29 Aug 2015 19:11:36 GMT

You can get 10mg and 25mg tramadol tablets from summit pharmaceuticals.

What about Fentanyl patches? If they are having major surgery such as an orthopaedic this is usually planned in advance so you can apply the patch in readiness for when it starts to work

RE: Vetergesic overnight

elaine elder — Sat, 29 Aug 2015 12:59:42 GMT

I have also used methadone Im or IV every 4-6 hrs never at 2hrs unless it's a top up. Every patient will metabolise drugs differently so it's our job as nurses to continually assess what's appropriate there is no standard drug or dose that will be perfect for all.

RE: Vetergesic overnight

elaine elder — Sat, 29 Aug 2015 12:55:49 GMT

Yes it's variable as most sub cut analgesia is. It can take up to 2hrs for onset. However in our practice where appropriate analgesia wasnt been given it is an improvement. Decra online academy has some methadone cpds available. I have also worked with specialists some of which wrote your ECC cert that used to use it.

RE: Vetergesic overnight

hobbits — Fri, 28 Aug 2015 22:49:43 GMT

Hi, yes I've read the data sheet etc but it says that the half life can vary between 6-15 hours, which would make me very sceptical about assuming it lasting 12 hours in many cases. It's also not something taught in any of the analgesia cpd I've attended or the vn cert ECC so I was wondering if you had any papers etc to show efficacy at 12 hours in most patients? It would be an interesting use for situations where hosp overnight was warranted for pain relief but not possible for other reasons (financial etc) but currently I remain sceptical!

RE: Vetergesic overnight

Charlotte K — Fri, 28 Aug 2015 17:05:20 GMT

[quote user="hobbits"]

What is your reference for s/c methadone lasting 12 hours? We normally give i/v or I/m but Which lasts 2-4 hours but I can't see how giving it s/c would give adequate analgesia for 3x longer, although it will take longer to become effective.

[/quote]

if you contact Dechra they can give you some information on Comfortan and it does day if you give it s/c it lasts for 12hrs so we use it for some patients that require overnight analgesic.

RE: Vetergesic overnight

hobbits — Fri, 28 Aug 2015 11:48:38 GMT

RE: Vetergesic overnight

Emma Lawley — Fri, 28 Aug 2015 09:37:29 GMT

My understanding is that vetergesic doesnt work effectively subcut. should Be given IM or IV. Thanks for your posts everyone. I'll feed these ideas back to my practice

RE: Vetergesic overnight

elaine elder — Thu, 27 Aug 2015 21:45:51 GMT

in an ideal world the type of analgesia given should reflect the patients needs! But we leave our animals overnight and we generally use methadone 0.3mg/kg subcut which last for 12hrs. No it's not ideal for every patient some really should be on a CRI or 4hrly IV/IM but our level of analgesia is better than what it used to be.

I have sent cats home on oral vetergesic before (ie. post op fracture). Never heard of it being used in dogs. How do people feel about giving vetergesic sub cut In cats and dogs? I think it's ok for mild pain but don't think it's suitable for post op fracture repair. also do any of you routinely premed subcut? I dont like it as I think it's ineffective and would only do it if I really can't get IM!

RE: Vetergesic overnight

ereveley — Thu, 27 Aug 2015 17:06:13 GMT

HI, vetergesic can only be given p/o in cats. It isn't effective this route in dogs.

RE: Vetergesic overnight

Ben Ogden — Thu, 27 Aug 2015 16:27:59 GMT

[quote user="hobbits"]

Hi ben

What makes you say they've gone out of fashion? We use CRIs of analgesia frequently in ECC where boluses of methadone are not enough. Maybe OP is talking about to send home with the owners? I've never come across a clinic using PO in hospitalised dogs

[/quote]

Largely anecdotal from talking to colleagues from various practices. I always quite liked them, so it's good to here that places continue to use them. Interesting I had the Rep for animalcare in today and she produced reports on this and it came up that in cats there is a 100% oral transmucosal bioavailability (OTMB) with vetergesic/buprecare etc but only a 38% OTMB in dogs. I guess that should help you decide on how appropriate it is in the future. Should of asked her for a copy of the reports, perhaps I might have time to cal her the Friday before bank holiday Monday....

RE: Vetergesic overnight

Sal the 1st — Thu, 27 Aug 2015 12:06:25 GMT

yes thats what I guessed. I was genuinely interested in the oral vetergesic in dogs - so thanks for raising it :-), it wasn't something I had heard of before but prompted me to have a look around and see what people are recommending and doses etc

RE: Vetergesic overnight

Emma Lawley — Thu, 27 Aug 2015 10:38:59 GMT

The reason for this question is in our practice we have ACAs overnight which aren't able to give i/v or I/m injections only s/c injections, eg amox, Zantac Etc. We use tramadol mainly and the odd cri if they are very painful. One locum vet that came to us that used to work in referral mentionend that vetergesic could be given p/o so was just seeing what everyone else thought of this/done in practice.

RE: Vetergesic overnight

Sal the 1st — Thu, 27 Aug 2015 09:00:06 GMT

This thread got me interested because I have never seen vetergesic used orally in dogs. I did find this

http://www.orrongpharmacy.com/content/s_vet/vet_pain.htm

and wondered if oral vetergesic had anything to do with this?

http://www.vetnurse.co.uk/f/5/p/16515/127518.aspx#127518

specifically Paulette's post on page 6

'who can give medication in a veterinary practice? During normal working hours - only RVNs & enrolled student nurses are permitted to administer medication (oral, topical & parenteral routes). However, the RCVS have stated that if a lay staff member has been suitably trained, they are permitted to administer routine/basic medication orally & by subcutaneous injection during out of hours shifts.'

RE: Vetergesic overnight

hobbits — Wed, 26 Aug 2015 22:43:45 GMT

Hi ben

RE: Vetergesic overnight

Ben Ogden — Wed, 26 Aug 2015 16:59:57 GMT

Vetergesic is best given I/M or I/V but I have seen reasonable results orally in both cats and dogs. You can get tramadol made at strengths as low as 10mg also. I/V infusions of analgesics have gone out of fashion but that is also an option to consider.

RE: Vetergesic overnight

Julie-Anne Wilson — Wed, 26 Aug 2015 16:38:12 GMT

I've never seen vetergesic being given orally to dogs. At my current practice we give Buprenorphine, Methadone (I/V or I/M), Tramadol or Gabapentin overnight depending on case/cause, vet, how painful they are etc.

RE: Vetergesic overnight

Gemma21 — Wed, 26 Aug 2015 15:22:10 GMT

We mainly use vetergesic, methadone or recuvyra (if they've had orthopaedic surgery). Vetergesic given i/m or i/v depending on the Vet. Never given a dog p/o vetergesic but do with cats occasionally.