Concerns over long term use of metacam and paracetamol

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My 2 year old bitch has just been diagnosed with hip dysplasia on both sides and early stages of arthritis in one of her stifles. Both hips are showing signs of OA. She was on metacam for 2 weeks  with no improvement and my vet has added half a 500g tablet of paracetamol twice a day(she weighs 32.8kg). They have also suggested she takes gabapentin and amantadine as well, this seems an awful lot of meds and I am unsure about the last 2 having read about them and the vet didn’t offer any advice when I asked about them. I advised the vet that I wanted to see how she did on just the metacam and paracetamol before adding anything more are these also ok to take long term?  Is ok for her to be on these additional meds long term – should I be asking for tests to be done to check they are not doing her any damage. There isn’t a lot of choice up here in the scottish highlands and the vets do not advocate any supplements – so looking for some guidance please. I have had her on Joint Aid since she was 7 months and have just started her on golden paste, bone both , 1 x green   lipped muscle capsules a day , 1/8th tsp of magnesium, calcium and boron powder, 3tsp omega 3 oil , there anywhere I can check if these are ok to take with her meds and if these doses are ok for her weight as I’ve drawn a blank on the net. Any info/advice would be great.

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Hi Lorraine,

Lynsey as done a pretty good job of answering your question so I’ll just add some vet advice. 2 weeks of NSAIDs is not very long to see a significant change in a long-standing condition such as your dog has and it is likely things will start to improve. It is appropriate for your vet to have added paracetamol at this point. I generally try to start new medications one at a time in order to judge their effectiveness but many patients do end up on 2 or 3 and occasionally more long term as their disease progresses. Your vet is welcome to contact me for free advice – via or another pain clinic that perhaps he/she has referred to in the past.

As Lynsey says – it is very important to consider external factors and not just rely on medicines and supplements. I’ve seen plenty of patients appear not to improve on a new medicine and then I’ve discovered the dog is still being allowed to run at full pelt, jump in and out of the car, and tumble up and down stairs, not to mention slipping around on laminate floors. It is easy to throw money away on medicines and supplements if you haven’t addressed these other factors.

Finally, there is often a great deal of tension and discomfort in the muscles/tendons/fascia associated with a joint problem and this doesn’t necessarily respond as well to NSAIDs (Metacam – type drugs) and may benefit from an assessment by a physiotherapist. I practice pain medicine through all of my clinics – but I still defer to my physiotherapist for a really good soft-tissue assessment

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