Should doses exceeding 0.2 mg/kg of oral meloxicam be given to reduce surgical recovery time in rabbits and should twice daily administration be considered?

Eleanor Best

doi:10.18849/ve.v6i3.372

Abstract

PICO question In reducing surgical recovery time in rabbits (Oryctolagus cuniculus), should doses exceeding 0.2 mg/kg of oral meloxicam be given and is twice daily administration more effective than a single daily dose?  Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Nine papers were critically reviewed, yet no studies were found to directly investigate the effects of twice daily dosing with meloxicam postoperatively in rabbits. There were five descriptive, non-comparative case series; two nonblinded parallel group randomised control trials; one blinded, placebo-controlled parallel group randomised trial and one prospective, randomised crossover trial Strength of evidence Weak Outcomes reported The current recommended oral dose of meloxicam in rabbits of 0.2–0.3 mg/kg once a day was consistently described as inadequate for postoperative analgesia following surgery (Delk et al., 2014). Instead, higher doses of 1–1.5 mg/kg were required to reach a similar peak plasma concentration as found to be clinically effective in other species, such as canines, and provide a better degree of analgesia in rabbits (Montoya et al., 2004; and Delk et al., 2014). Although no studies were found evaluating twice daily administration of meloxicam, the available evidence suggests a dose exceeding 0.2–0.3 mg/kg daily is required for adequate postoperative analgesia in rabbits. Whether this increased dose could be given twice daily should be investigated, providing scope for future research Conclusion Further studies are required to directly assess the benefits of twice daily oral meloxicam. However, it is possible that a dose exceeding 0.2–0.3 mg/kg is required and therefore higher doses should be considered in these studies  How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care. 

Highlights

All rabbits were housed individually at a temperature of 21°C, with 16 hours of light and 8 hours of dark provided each day. o Rabbits were fed ad libitum water and a free choice of timothy hay and pelleted diet. o They were left to acclimate to the research facility for 5 days and were ‘habituated’ to handling before the study began
Each rabbit was clinically assessed through a physical exam, complete blood count, serum biochemistry and urinalysis prior to the study
Study suggests that 1 mg/kg of oral meloxicam administered once daily is safe for use clinically in rabbits with minimal gastrointestinal side effects

Summary

A Knowledge Summary by Eleanor Best BVSc MSc MRCVS 1*

Nine papers were critically reviewed, yet no studies were found to directly investigate the effects of twice daily dosing with meloxicam postoperatively in rabbits. There were five descriptive, non-comparative case series; two nonblinded parallel group randomised control trials; one blinded, placebo-controlled parallel group randomised trial and one prospective, randomised crossover trial Strength of evidence Weak Outcomes reported The current recommended oral dose of meloxicam in rabbits of 0.2–0.3 mg/kg once a day was consistently described as inadequate for postoperative analgesia following surgery (Delk et al, 2014). No studies were found evaluating twice daily administration of meloxicam, the available evidence suggests a dose exceeding 0.2–0.3 mg/kg daily is required for adequate postoperative analgesia in rabbits. Further studies are required to provide stronger evidence answering the query

Summary of the evidence

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Findings

Methodology Section