Best practice guidelines advise monitoring bloodwork with your family DVM at least twice to three times yearly (in some cases more frequently if a patient has other concurrent diseases). This is to ensure that we are monitoring the working function of the kidneys, liver and other organs when on medication. Also, as animals age, we want to be more preventative in care, and spot problems sooner than later and adjust medications accordingly. If you are a client at Equilibrium, please ensure your family DVM keeps us updated with bloodwork results (send to our email).
Amantadine
Amantadine is a drug used to reduce chronic pain in animals. It was designed to treat viral infections in people, but was later discovered to help manage some types of pain. If a veterinary patient is prescribed Amantadine, it is often used in combination with other medications such as Gabapentin or Meloxicam. It is an NMDA antagonist so it works differently than other medications and can be used with drugs like Gabapentin and/or Meloxicam because it has a different mechanism of action. Possible adverse effects may include disorientation or confusion and for this reason we often suggest giving it as an evening dose. It is dosed once a day. Notify your DVM if this medication does not improve the patient's pain or discomfort. Give as prescribed. Ensure you let your DVM know which other medications your patient is on. In the case of a concern - discontinue the medication and contact your DVM. Not for pregnant animals (caution).
Cartrophen (Pentosan polysulfate)
The package insert is 
available here. Do not give within 24 hours of giving a non-steroidal anti-inflammatory such as Meloxicam.
Gabapentin
Gabapentin is a drug used to reduce seizures and chronic pain. It was was used as an anti-convulsant in people and is also used for this purpose in animals. It is a calcium channel blocker and is indicated for pain of the nerves and spinal cord. It is also used to reduce the pain associated with osteoarthritis of the joints. Because it has a different mechanism of action than non-steroidals such as Meloxicam, they are often used together. In fact, Gabapentin can help to keep the dose of Meloxicam lower (which may reduce the risk of adverse reactions). The liquid form dispensed at Equilibrium contains Sorbitol, not Xylitol, so is safer for longer term use. Give with food. May cause mild nausea when giving by itself. The dose is often increased periodically as 'accomodation occurs', particularly in patients who do not receive regular rehab therapies (rehab therapies often allow for lower dosing of medications include Gabapentin and we find we don't have to increase the dose as much when we see patient's regular for pain management with rehab modalities). Before modifying a patient's dose, please contact your DVM. This medication should not ideally be stopped abruptly as it may cause rebound pain (pain that is worse than prior to giving the medication). Do stop the medication if a patient exhibits more than mild sedation, disorientation or mobility issues (ataxia). When starting Gabapentin, it can be given for a couple days in the evening to offset sedation. It may take up to 10 days to see an effect as it takes that long (in some cases) to bioaccumulate in the body (there may be exceptions in patients with altered organ function).
Metacam/Meloxadin (Meloxicam)
Meloxicam (Metacam, Meloxadin) is a drug used to treat pain and inflammation or reduce fever in animals. It is a non-steroidal anti-inflammatory (NSAID). It is often prescribed to help patient's with pain associated with surgery, osteoarthritis or joint disease. This product is usually prescribed as a liquid. Ensure your DVM specifically indicates the amount you should give. For chronic pain, it is often prescribed with other medications like Amantadine or Gabapentin (multimodal therapy) which helps to keep the individual doses of these drugs lower. For chronic use in patients we often advise giving it at lowest effective dose, but do not advocate taking a patient off it suddenly unless they are having an adverse reaction (read below). Do not alter a patient's medication without veterinary advice unless you suspect an adverse reaction (read below). Sometimes this medication is given as an injection in clinic and can be continued at home 24 hrs later as a liquid. Only give once daily and with food. Adverse reactions - If your dog exhibits GI signs such as vomiting, upset tummy, retching, or diarrhea (with or without blood), discontinue immediately and contact your DVM or emergency clinic. Do not give a double dose if a dose was missed. Do not give to a patient that is dehydrated. Do not give within 24 hrs of giving Cartrophen (Pentosan polysulfate).
Tramadol
Tramadol is a controlled drug - meaning it can only be dispensed under specific circumstances and in limited quantities. The amount prescribed to you is monitored, and this is to prevent 'diversion' to humans. Humans have used this drug and it does have addictive potential. Do not administer a veterinary patient a human prescription. Do not take your patient's Tramadol. Tramadol is an opioid-like compound that helps to relieve chronic pain in humans. Not all dogs make the active M1 metabolite, so it's action is as a sedative TCA (tri-cyclic antidepressant). TCA's have been used to manage chronic pain in humans and it has it's place in veterinary medicine, but we need to ensure the patient's pain is managed on this drug vs. sedation. Tramadol can be used with drugs like Gabapentin and Amantadine. Care should be taken when using it with Metacam longer term. The Tramacet version in humans has been associated with GI ulceration in humans when used in human patients receiving NSAIDs. This drug is falling out of favor for longer term use, and at Equilibrium, we only advise using it for episodes of breakthrough pain for a few days (we do not prescribe Tramadol at Equilibrium and are not part of the TPP program). Unused quantities should be returned to your DVM (not held in your medicine cabinet).
Welcome to Equilibrium! We are a veterinary rehabilitation clinic focused on improving the well-being and mobility of dogs, cats and exotics in the Foothills region. You are here because you care, and we are here to help your best friend find their stride in life. Thank you for visiting!
Equilibrium acknowledges the sacred traditional territories of the Stoney Nakoda, the Blackfoot Confederacy, the Dene Tsuut'ina and the Metis Nation of Alberta, Region III.