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VetInternist, Board Certified Veterinarian
Category: Dog Veterinary
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Experience:  Staff Internist and Medical Director
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My dog Diva is on Meloxicam 7.5mg to remove her pain from a

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My dog Diva is on Meloxicam 7.5mg to remove her pain from a back injury. I want to prevent a stomach ulcer.... what should I use with the Meloxicam to help that?
Although a potential side-effect, stomach ulcers from appropriate, short-term treatment with NSAIDS aren't extremely common. Veterinarians often prescribe antacids such as H2 blockers (Pepcid) or proton-pump inhibitors (Prilosec) or other gastro-protectants like Carafate (protects damaged stomach tissue from acid) or misoprostal (a hormone that promotes the formation of mucus to protect the stomach.

There isn't a lot of literature that suggests the use of the medications reduces the chance of forming a stomach ulcer, but in theory there should be some benefit. The most beneficial way to prevent the formation of an ulcer is to only use the medication for a short term. I typically use meloxicam for 3 days or less in my patients. If longer therapy is necessary, I typically reduce the dose of this drug and use a second pain-killer like Tramadol on top of the meloxicam. You should speak to your veterinarian about Tramadol and the appropriate length of time to use meloxicam.

When I do use an NSAID like meloxicam and feel that additional stomach protection is necessary, the most common drug I use famotidine (Pepcid). I typically use 10 mg by mouth twice per day for dogs over 40 lbs. There are side effects to this medication, but they are usually mild and rare.

Let me know if you have any other questions,

Dr. Shadwick
Customer: replied 7 years ago.
she has a severe back/shoulder area in pain... mobile vet gave her Tramidol 50mg (1 1/2 twice a day) and told me only 1/2 Meticam per day... problem is the tramidol doesnt work that well for Diva. A full Meticam does ..
We both think this will be long term treatment for Diva... the injury is most likely a disc problem. We can not afford to do surgery on her and I wouldn't anyway with her age and weight. (80lbs)...

Can the famotidine with the meitcam be long term? maybe 1/2 morning with a 1 tramidol and the other half in the evening with an additional tramidol? plus the famotidine?
Tramadol alone doesn't work well for many dogs, but it does seem to work well in combination with drugs like meloxicam. 7.5 mg of meloxicam for an 80 lb dog is a pretty large dose and I wouldn't use that long term for one of my dogs. Because we do not have a current doctor-client-patient relationship I cannot make specific prescription recommendations. I can tell you that I don't recommend long-term, large doses of meloxicam in any patient (I consider 7.5 mg in your dog to be a large dose).

When I try to manage pain over the long term I like to use multiple medications to reduce the toxic side effects of the medications we use. Non-steroidal anti-inflammatory drugs (NSAIDS) like meloxicam are an important component of pain control in dogs like your girl, but I try to use them sparingly because long-term use can lead to more than just stomach ulcers (liver and kidney damage are also possible). For a dog that needs long term pain control I would start with Tramadol and a low dose of an NSAID and add a drug like gabapentin if more pain control was necessary. Low doses of these medications in combination seem to work better than any one of them individually.

Speak to your veterinarian about combining these medications to help make your girl more comfortable. Although she may be a little more uncomfortable with a reduction in the dose of meloxicam, she may be better off in the long term once we start the other medications. The famotidine can be given in combination with these medications, but it may only help prevent the stomach ulcers; it won't have any benefit on the liver or kidneys.

I hope this helps,

Dr. Shadwick
Customer: replied 7 years ago.
thank you I understand now... and agree... but i will mention the gabapentin to our vet ...

thank you and happy holidays...
Happy Holidays to you too!

Let me know if you have any other questions.

Dr. Shadwick

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