View Full Version : Kayleigh started on Trocoxil
29th December 2011, 09:36 PM
Kayleigh has been having a bad time over the last month, she was already on 50mg Zitac 3x daily, 100mg Gabapentin 3x daily. She was diagnosed by MRI with CM only, back in August.
She has been very subdued, crying sometimes in the morning when her Gabapentin is due - it only seems to last 6-7 hours overnight. She has bright times during the day, and a good appetite.
I spoke to my neurologist on 23rd Dec, she arranged for me to collect the Trocoxil on Christmas Eve from my vets, which was started on Christmas Day. We were unable to arrange laboratory tests [haematology and clinical chemistry] which are recommended before we started the drug, but we are planning to have them done next week - and then I think they need to be tested annually.
From what I've read people seem to observe different time periods before the drug takes effect - up to 2 weeks in some cases.
We're quite concerned tonight - she snapped at Tommy when he jumped up onto the sofa next to her, she grabbed him by the ear [ she would never normally do that]. She was quite bright earlier, got excited when I was trying to do some clicker training with her, she leaps around and barks if she can't work out what you want! Maybe she did too much? She went for a walk but only 20 mins and the wind had died down - it was a bit cold though.
We have been limiting her to 20 - 25 mins on the neuros instructions. We also haven't been taking her out if it's very cold or very windy. Going to keep her in for the next few days at least, until we see some improvement.
Such an emotional rollercoaster again :( just wanted to share with people who understood.
29th December 2011, 09:52 PM
We have talked about Trocoxil in length over the phone. I will write it down again as it is better sometimes when you can read it back again.
And I think I got a clearer picture how it works with Ebony now. The very first tablet she took I didn’t see any improvement. The second tablet after the two weeks of her first tablet I saw improvement straight away. No more rolling about on the floor or even scratching. But she was very subdued for 2 days after taking a tablet. I had the same then you had with Tommy. Ebony snapped at Harley when he jumped onto the sofa next to her, very out of character for her, but this was the first or second day after her tablet. She is due her next tablet on the 5th January and I must say within the last week the scratching and rolling about is increasing.
It is an emotional rollercoaster and every time it just tares at you heartstrings.
29th December 2011, 10:50 PM
Thought I'd post this (copied and pasted from manufacturer's site) so that all are aware of guidelines/cautions. Note esp. contraindications for dogs with heart disease and dogs less than 5 kg. body weight, etc. Note not to use this with other NSAIDs or steroids.
Blood chemistry is recommended before treatment begins (to establish baseline values), after one month, and again before the third dose is given. Doesn't say anything about long-term monitoring after that except "as appropriate," which is problematic for me. I tend to err on the side of caution when monitoring due to long-term therapy with any medication, particularly with any NSAIDs.
Note what it says about concurrent treatment with other drugs that might be harmful to kidney function.
Contra-indications, warnings, etc
Do not use in dogs less than 12 months of age and/or less than 5 kg bodyweight.
Do not use in dogs suffering from gastro-intestinal disorders including ulceration and bleeding.
Do not use where there is evidence of a haemorrhagic disorder.
Do not use in cases of impaired renal or hepatic function.
Do not use in cases of cardiac insufficiency.
Do not use in pregnant, breeding or lactating animals.
Do not use in cases of hypersensitivity to the active substance or to any of the excipients.
Do not use in cases of known hypersensitivity to sulphonamides.
Do not use concomitantly with glucocorticoids or other NSAIDs.
Do not administer other NSAIDs within 1 month of the last administration of Trocoxil.
Mavacoxib exhibits an extended plasma half life due to its low rate of elimination. This corresponds to a duration of effect of 1-2 months after administration of the second dose (and following doses). Care should be taken to avoid treatment of animals that might not tolerate prolonged NSAID exposure. A maximum treatment administration of 6.5 months continuous therapy is recommended so as to manage plasma levels of mavacoxib in animals which exhibit reduced elimination.
Animals should undergo a thorough clinical examination before commencing treatment with Trocoxil and appropriate laboratory tests to monitor haematology and clinical chemistry are recommended. Animals with evidence of impaired renal or hepatic function, or with evidence of a protein or blood-losing enteropathy are not suitable for treatment with Trocoxil. It is recommended to repeat the clinical examination one month after commencing treatment with Trocoxil and prior to administration of the third dose with additional monitoring of clinical pathology as appropriate during treatment.
Mavacoxib is excreted via bile and in dogs with hepatic disorders reduced elimination and thus excessive accumulation could occur. For this reason dogs with hepatic disorders should not be treated.
Avoid use in any dehydrated, hypovolaemic or hypotensive animal, as there is a potential risk of increased renal toxicity. Concurrent administration of potentially nephrotoxic medicinal products should be avoided.
Ensure appropriate hydration and haemodynamic status when animals receiving Trocoxil undergo anaesthesia and/or surgical procedures or develop conditions which may result in dehydration or compromised haemodynamic status. The key aim of intervention is to maintain renal perfusion. Patients with underlying renal disease may experience exacerbation of decompensation of their renal disease while on NSAID therapy.
Adverse reactions of the digestive tract such as vomiting and diarrhoea were commonly reported, loss of appetite, haemorrhagic diarrhoea and melaena have been reported in uncommon cases. Gastrointestinal ulceration was reported in rare cases. Apathy, degradation of renal biochemistry parameters and impaired renal function has been reported in uncommon cases. In rare cases these may be fatal.
If an adverse reaction to the administration of Trocoxil occurs, no further tablets should be administered and general supportive therapy, as applied to clinical overdosage with NSAIDs, should be applied. Particular attention should be paid to maintaining haemodynamic status. Gastrointestinal protectants and parenteral fluids, as appropriate, may be required for animals that experienced gastrointestinal or renal adverse reactions. Veterinarians should be aware that clinical signs of adverse reactions may continue when supportive therapy (such as gastro protectants) is discontinued.
Do not use in pregnant, breeding, or lactating animals. The safety of Trocoxil has not been established during pregnancy and lactation. However, studies in laboratory animals administered other NSAIDs have shown increased pre- and post-implantation loss, embryo-foetal lethality, and malformations.
No drug interaction studies have been performed. In common with other NSAIDs, Trocoxil should not be administered simultaneously with other NSAIDs or glucocorticosteroids. Risks for interactions have to be accounted for throughout the effect period i.e. 1-2 months after administration of Trocoxil. Dogs should be carefully monitored if Trocoxil is administered simultaneously with an anticoagulant.
NSAIDs are highly bound to plasma proteins and may compete with other highly bound substances, such that concomitant administration may result in toxic effects. Pre-treatment with other anti-inflammatory substances may result in additional or increased adverse effects. To avoid such effects when Trocoxil is to be administered in replacement of another NSAID, ensure an appropriate treatment-free period of at least 24 hours before administering the first dose of Trocoxil. The treatment-free period should however, take into account the pharmacology of the medicinal products used previously. Should another NSAID be administered after Trocoxil treatment, a treatment-free period of at least ONE MONTH should be ensured to avoid adverse effects.
In the overdose studies, in common with other NSAIDs, adverse pharmacodynamic events occur affecting the gastrointestinal system. Similarly adverse reactions occurring at the use dose in the animal population principally involved the gastrointestinal system.
In overdose safety studies, repeated doses of 5 mg/kg and 10 mg/kg were not associated with adverse clinical events, abnormal clinical chemistry or significant histological abnormalities. At 15 mg/kg there was evidence of vomiting, and softened/mucoid faeces and an increase in clinical chemistry parameters reflecting renal function. At 25 mg/kg there was evidence of gastrointestinal ulceration.
There is no specific antidote for mavacoxib overdosage, but general supportive therapy, as applied to clinical overdosage with NSAIDís, should be given.
In case of accidental self-administration, seek medical advice immediately and show the package leaflet or the label to the physician.
Ingestion of Trocoxil may be harmful for children, and prolonged pharmacological effects leading to e.g. gastrointestinal disorders may be observed. To avoid accidental ingestion administer the tablet to the dog immediately after removal from the blister packaging.
People with known hypersensitivity to NSAIDs should avoid contact with the veterinary medicinal product.
Do not eat, drink, or smoke when handling the product. Wash hands after handling the product.
29th December 2011, 10:54 PM
Sorry Kayleigh isn't feeling well. I just hate all that our dogs have to go through and certainly understand being on the emotional rollercoaster. Hope that things improve for her real soon.
30th December 2011, 01:00 PM
Sorry Kayleigh isn't doing so well, and totally understand what you mean about the rollarcoaster. As you know Misty had been suffering throughout December too, our Scottish weather doesn't seem to help out beloved pups :(
We did speak to our Neuro about Trocoxil seeing as Metacam wasn't working, but she talked us into trying another NSAID instead. She wasn't keen on Trocoxil at all. I'm pleased to say the Carprieve seems to be working really well. I was sitting on the couch yesterday, when Misty took a flying leap off the floor and landed on my chest. I'm glad I don't have fake ones, otherwise they'd probably have popped :lol:
I do hope Kayleigh feels better soon :flwr:
30th December 2011, 04:53 PM
Sorry to hear Kayleigh is not feeling too good, its not nice seeing then unwell, I hope she is soon feeling better, bless her.
31st December 2011, 10:02 PM
Hows Kayleigh been feeling today?
1st January 2012, 08:58 PM
Thank you so much everyone - Kayleigh is feeling much better today!
Clare Rusbridge has been in contact with me and advised me to up Kayleigh's Gabapentin for now until the Trocoxil starts to help. The dosage is 10-20mg per kg 2-3 times daily, and Kayleigh is 7.5kg so she is now having 150mg three times daily.
It is lovely to see her looking happier and resting more comfortably. She's overdone it a bit today, charging around the garden, so a wee bit sore tonight - we will have to control that a bit better.
I know the neurologists all have different ideas about drugs, based on their experiences - and we don't know yet if the Trocoxil will help.
I was sitting on the couch yesterday, when Misty took a flying leap off the floor and landed on my chest. I'm glad I don't have fake ones, otherwise they'd probably have popped :lol:
That gave me a wonderful laugh, thank you!! One of those occasions when you actually relish being a bit sore from where they've jumped upon you! Misty is obviously doing well on Carprieve. It really is trial and error to find a combination that helps and then often that has to be changed many times :(
Pat, thank you for posting the info, I am planning to take Kayleigh in this week to get bloods done and discuss further monitoring with my vet.
1st January 2012, 09:09 PM
Great to hear she's doing well today, it's always such a relief to see them happy again isn't it :)
2nd January 2012, 12:42 AM
Glad to hear Kayleigh is doing much better. It's such a pain to get the medicine right.
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