Penny is doing conservative management for knee ligament damage and included in her treatment plan is one week deramaxx and adequan injections and I have a couple questions.
1) Deramaxx was prescribed for one week to reduce the pain and inflammation in the knee and provide us with a jump start on the healing process. But I am unsure if the dosage prescribed is appropriate for her condition.
I look at the product label http://www.deramaxx.com/content/Clinic_Insert.pdf
and it states doasge
"Dosage and Administration:
Osteoarthritis Pain and Inflammation: 0.45 – 0.91 mg/lb/day
as a single daily dose, as needed.
Dosage and Administration:
Postoperative Orthopedic Pain and Inflammation: 1.4 – 1.8 mg/lb/day
as a single daily dose, as needed,
not to exceed 7 days of administration"
They prescribed 75# Penny 75mg tablet and to only give 1/2 per day~ so only .5mg per lb the lowest possible dosage.
Since this is only for one week for an acute problem don't you think she should be on the higher end?
2) The adequan injection site: they told me I could do them sub q and that that would be fine, but I basically insisted that it be given IM as that's what the website and other posts here say to do. Then they gave it to her in her back muscle saying it didn't need to go to the knee muscle that it will spread around and go to where it needs to. Said if I wanted the knee muscle that they would do it but that it made no difference.
I read the product insert and it says http://www.adequancanine.us/images/A...ductLabel.pdf,
"Studies in rabbits showed maximum blood concentrations of PSGAG following IM injection were reached between 20 to 40 minutes following injection, and that the drug was distributed to all tissues studied, including articular cartilage, synovial fluid, adrenals, thyroid, peritoneal fluid, lungs, eyes, spinal cord, kidneys, brain, liver, spleen, bone marrow, skin, and heart.
Following intramuscular injection of PSGAG in humans, the drug was found to be bound to serum proteins. PSGAG binds to both albumin and chi and betaglobulins and the extent of the binding is suggested to be 30 to 40%. Therefore, the drug may be present in both bound and free form in the bloodstream. Because of its relatively low molecular weight, the synovial membrane is not a significant barrier to distribution of PSGAG from the bloodstream to the synovial fluid. Distribution from the synovial fluid to the cartilage takes place by
diffusion. In the articular cartilage the drug is deposited into the cartilage matrix.
Serum and synovial fluid distribution curves of PSGAG have been studied in dogs and appear similar to those found in humans and rabbits."
So does it make a difference or not? Where is the best place to inject it?
I also read about loading dose being twice week for four weeks and I asked about this and she said she usually does and has success with 1xweek for six weeks. I think we compromised at 2xweek for 2 weeks then once a week for 4 weeks as that's basically two vials worth. Sound okay?