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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Vet
Satisfied Customers: 28486
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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Could you tell me if you would use metacam in a c section

Customer Question

Hi could you tell me if you would use metacam in a c section on a dog, if so would you administer it prior to removing the puppies or straight after the removal of the last puppy Thankyou
Submitted: 1 year ago.
Category: Vet
Expert:  Dr. Michael Salkin replied 1 year ago.
There are three reasons why I would administer a narcotic rather than the nonsteroidal antinflammatory drug (NSAID) meloxicam in conjunction with a c-section:1) A narcotic is more effective against visceral pain.2) Although not part of the label, it should probably not be used or used with extreme caution in dogs with active bleeding as might occur during a c-section.3) Inhalant anesthesia appears to increase the risk for renal toxicity of NSAIDS (KuKanich, B. et al. 2012).Please respond with further questions or concerns if you wish.
Customer: replied 1 year ago.
So what drug would you use and would you use it before or after removing the puppies
Expert:  Dr. Michael Salkin replied 1 year ago.
I administer a low dose of the narcotic buprenorphine intravenously as soon as the pups are removed. In that manner I haven't depressed their respirations but the dam receives the appropriate analgesia prior to awakening. There doesn't appear to be enough buprenorphine moving into the milk to affect the pups although in rats is has been found in maternal milk. The distribution of this drug hasn't been well-studied in dogs. Please note that the UK label states that it is contraindicated preoperatively for c-section due to concerns for respiratory depression in the offspring.Please continue our conversation if you wish.
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Customer: replied 1 year ago.
A vet gave my bitch a metacam injection aswell as vetagisic then propophol ( excuse spelling) then did the c section only 1 puppy came out alive, she passed 1 puppy 2 hrs prior to having c section as she went into primary enertia, I contacted the vet to arrange the op all puppies came out with heart beats, but would not come round so we had 7 dead pups, it is my belief that this vet over loaded this dog and killed these puppies , we have never had this before as the metacam was administered after the last puppy was removed , what do you think
Expert:  Dr. Michael Salkin replied 1 year ago.
The combination of meloxicam (Metacam) + buprenorphine (Vetergesic/please clarify if that's what you meant to type) + propofol should be circumspect for the reasons I posted above. If the meloxicam were only administered post-surgery, I can't quibble with its use. Thank you for your kind accept. I appreciate it. Please continue our conversation if you wish.
Customer: replied 1 year ago.
so do you think that the metacam killed these puppies? she injected 2.0mls metacam then vetergesic 1.5mls then general anaesthesia was induced using iv propofol given to effect of 29mls , I had better add this animal is a 64kg newfoundland thankyou
Expert:  Dr. Michael Salkin replied 1 year ago.
If a drug were responsible it would more likely be the buprenorphine causing respiratory depression in the pups. Meloxicam's worrisome effects involve the dam. What I can't know is how well anesthesia was monitored during the surgery. Hypoxia (lack of oxygen to the tissues) and hypotension (low blood pressure) are always considerations during anesthesia and are particularly worrisome when neonates are involved.
Customer: replied 1 year ago.
so from what you have said so far it is safer for the puppies to give the pain relief after there removal prior to stitching up the dam
Expert:  Dr. Michael Salkin replied 1 year ago.
Correct. That's the standard of care.
Customer: replied 1 year ago.
Thankyou so much
Expert:  Dr. Michael Salkin replied 1 year ago.
You're quite welcome.You may receive an inappropriate follow-up from the site ostensibly sent by me. It wasn't and I apologize in advance should you receive it.