Meloxicam For Bunnies

Imagine this clinical scenario: you create an analgesic protocol for your clinic to ensure rabbits entering your care receive the best treatment available. Your research indicates meloxicam is the analgesic of choice as in comparison to opioids it has a reduced risk of gut stasis, which is a life-threatening complication in rabbits. Meloxicam also has a palatable oral form for easy administration. You have heard that the minimum suggested dose of 0.2mg/kg may not provide adequate analgesia, and you are unsure if the higher dose of 1mg/kg would be a safe standard protocol. What is the evidence comparing 1mg/kg and 0.2mg/kg of oral meloxicam for significant changes in pain behaviour, and kidney and liver biochemical analytes?

Description

Anesthetic and analgesic pharmacokinetic studies are continually helping us to revise our dosages and protocols for exotic species. A recent example is Meloxicam use in rabbits; while earlier formularies suggest a dosage of 0.2 mg/kg PO, a 2013 pharmacokinetic study suggested clinically useful dosages are likely much higher. See the following article for more information:  Pharmacokinetics of meloxicam in rabbits after oral administration of single and multiple doses.                                                                                               

Our current dosage recommendation for short-term use of Meloxicam in well-hydrated, normovolemic rabbits without evidence of renal dysfunction is 0.8-1.0 mg/kg PO. The authors of the study conclude: “Plasma concentrations of meloxicam for rabbits in the present study were proportionally higher than those previously reported for rabbits receiving 0.2 mg of meloxicam/kg and were similar to those determined for animals of other species that received clinically effective doses. A dose of 1 mg/kg may be necessary to achieve clinically effective circulating concentrations of meloxicam in rabbits, although further studies are needed.”

Formulations:

There is a suspension for cats and a more concentrated one for dogs, as well as tablets, injections and sprays. The spray hasn’t been used much with rabbits, and tablets, whilst they can be used in rabbits, are more difficult to give than a liquid. It is probably because of the tasty liquid formulation that this drug has been used so widely in rabbits. As a very general rule, the cat suspension is not concentrated enough for any but the smallest rabbits, so the dog one is usually used.

Uses/benefits of Meloxicam For Bunnies:

Metacam is an NSAID, or non-steroidal anti-inflammatory drug. It’s used to treat pain, inflammation, stiffness, arthritis, and other related conditions. In rabbits, the drug is mostly used to treat severe pain caused by injury or osteoarthritis. It’s also used to treat rear limb weakness and paralysis, which is relatively common in rabbits. Since Metacam is not officially approved for use in rabbits, its use is mostly reserved for conditions where the rabbit is in moderate to severe pain.

Risks and concerns:

Liver disease can lead to reduced metabolism of the drug, and it can build up to dangerous levels as a result. Dehydrated or shocked animals, or those with other reasons for reduced blood flow to the kidneys, can suffer kidney damage with drugs of this class. It’s therefore important to make sure rabbits are hydrated during treatment, and vets may opt to give it at the end of surgery when normal blood pressure is restored. Durgs of this class can also cause gastrointestinal bleeding. It’s unclear how much of a concern this is in rabbits as they do not vomit, and blood is difficult to see in the faeces, but this concern should be borne in mind. Very importantly, it should not be given with other anti-inflammatory drugs or steroids.

Dosage

Small mammals: Rabbits: 0.3 – 0.6mg/kg subcutaneously (underneath the skin) or by mouth every 24 hours; (this equates to 0.2 – 0.4ml/kg ie millilitres of liquid per kilogram of your rabbit’s bodyweight, if using the dog liquid.) Studies have shown that rabbits may require a dose exceeding 0.3mg/kg every 24 hours to achieve optimal plasma levels of Meloxicam over a 24-hour interval. Doses of 1.5mg/kg per day (1ml per kilo of the dog liquid) subcutaneiously or by mouth were well tolerated in healthy rabbits in good hydration for 5 days.

Prices of Meloxicam For Bunnies

$35.10 – $75.90

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