? MICIO BG's keep rising despite insuline increases:acromegaly or pain?

MISSY + Simone&MICIO (GA)

MISSY + Simone&MICIO (GA)

Active Member
Micio has been going through some very rough time lately: his BGs were a continuous up and down for several months but maintaining an ok range. In the last 10 days or so it doesn't seem insulin is effecting him as well and his numbers are reaching mid 200's; his legs got so much worse that he seems not been able to control them and he kind of falls sometimes, especially on the litter box (I have to hold him when he poo cause his back legs give up). All Micio does lately is just sleep, eat, drink and takes many trips to the litter box; he only hangs around in the kitchen area and just lays on the ground, moves super slow and doesn't get stimulate with nothing, not even laying on the sun (his favorite thing). At times he seems confused and slowly walks around in circles or wondering like he's lost.
Also his growths all over his body are uncontrollable and huge; last month the vet try to express a big sebaceous cyst on his tail but didn't solve much and said there's nothing we can do ( I'm not sure about that, that thing looks so big, weird, swallen and painful...).
Vet also run some blood work (updated on the LABS chart) and SDMA and BUN don't look good. Vet says pancreatitis may be likely.

At this point, since mouth infections are no more the culprit, I don't know if pain or some hidden inflammation are to blame....or is this the end stage of Acromegaly?

Micio always had the greatest appetite but in the last week it decreased and I have the feeling he's in a lot of pain. I'm going to call the vet and see if he thinks we should give him pain medications or something: Do any of you have cats with pancreatitis and what meds are they on?
Can Buprenorphine be given for long term pain management? Can it be purchased online (WHERE, please?) or ONLY through the vet?
Thank you for any suggestions
 
MICIO&Simone said:
Can Buprenorphine be given for long term pain management? Can it be purchased online (WHERE, please?) or ONLY through the vet?
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Yes, Neko was on it long term, almost 3 years, for her arthritis pain. Though there is Solensia now as an option specifically for arthritis. Both are only available through the vet. Bupe is a narcotic, and as such a controlled substance. Bupe made a world of difference in Neko's comfort. From lethargic and not very interactive to out and playing again.

See this post for meds: A Primer On Pancreatitis
 
Wendy&Neko said:
Yes, Neko was on it long term, almost 3 years, for her arthritis pain. Though there is Solensia now as an option specifically for arthritis. Both are only available through the vet. Bupe is a narcotic, and as such a controlled substance. Bupe made a world of difference in Neko's comfort. From lethargic and not very interactive to out and playing again.

See this post for meds: A Primer On Pancreatitis
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Thanks for the suggestions and the link...Micio is definitely lethargic and based on what I'm seeing, looks like Ataxia also applies to him as well.
Was really hopingBuprenorphine could be purchase through a pharmacy, my vet charges astronomical amount of $$ for meds ...last time I've got some from the clinic it was $11 per 0.3mg, twice a day = $22 per day, is that right?
 
If you can, get your vet to write a prescription for bupe at a compounding pharmacy. Neko liked the “chicken soup” flavour best. Otherwise you just get pre-filled syringes at a vet and those are very expensive. Look around at the websites that provide vet meds too, I am not familiar with the US ones, but know people have gotten bupe vials that way.
 
Yes, as Wendy said, Buprenorphine can be used long term and is only available through a vet or by Prescription. My vet sells me bottles of it and I just draw it up in an oral syringe. I don’t get the pre-filled syringes but usually they will provide an oral syringe with the medication that is marked with the correct dose. I do not know what compounding pharmacy your vet usually works with. Wedgewood Pharmacy is very good. I am really sorry to hear about Micio’s difficulties. I know this hurts your heart. ❤️
 
Thank you, I'll ask my vet about that.
You're right, watching my Micio declining day after day, is heartbreaking...not having any human kids, this 2 cats means the world to me, I would do anything for them.
 
Suzanne & Darcy said:
Yes, as Wendy said, Buprenorphine can be used long term and is only available through a vet or by Prescription. My vet sells me bottles of it and I just draw it up in an oral syringe. I don’t get the pre-filled syringes but usually they will provide an oral syringe with the medication that is marked with the correct dose. I do not know what compounding pharmacy your vet usually works with. Wedgewood Pharmacy is very good. I am really sorry to hear about Micio’s difficulties. I know this hurts your heart. ❤️
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@Suzanne & Darcy I was able to get my vet to prescribe Buprenorphine for Micio so I can get it from a local compounding pharmacy but he only wants to dispense 0.6ml (0.1ml given twice a day for 3 days at a 0.3mg/ml strenght) but any pharmacy, Wedgewood included, won't be able to make unless the minimum amount is 5ml. Trying to get the vet to allow the 5ml but dubt it cause he told me that, being a very controlled substance, he cannot give it out too much and/or get in troubles...is that right?
Paying the vet $11 per 0.1ml of a prefill syringe just doesn't sound right, period....neither I can afford it for long term
Just want to hear what others do, thanks
 
My experiences were in Canada, which won't help you. My vet needed to use a special prescription pad, that was filed with the province for tracking purposes. But I would get about a 3 months supply at a time. That amount was because the compounded solution was only good for 3 months at a time. Neko got a larger dose (twice a day) of the 0.3mg/ml strength. 0.1 seems rather a small dose. Maybe your vet is not familiar with what it takes to get a controlled substance prescribed? Maybe ask on the Feline Health forum what people have done to get buprenorphine? It does seem more vets are prescribing gabapentin for pain these days, though that also can have issues. but it might be easier for the vet.
 
I have usually gotten a bottle of Burenorphine from the vet with enough for a week or so, but my cats were not long-term users of it. As for the dose, one of my very small cats were on as small of a dose as .05 mL (of the 0.3 mg/mL concentration liquid.) It’s my understanding that typical doses for cats range from .01 to .04 mg per kg of body weight - depending upon the severity of the pain - to be given 2 or 3 times a day. Each state has their own regulations for dispensing a controlled substance, so I don’t know what those regulations are in your state. Apparently, 32 states exempt vets from the rules that human physicians must follow. It’s complicated. I’m really upset to think that Micio’s pain will not be controlled properly if you cannot get enough Buprenorphine from your vet to give on a regular basis. It’s not right.
 
So at $11 per dose for twice a day your daily cost would be $22. That really does seem like a lot for one day’s pain medication. I’m so sorry this is soooo hard to just try to help Micio.​
 
Burenorphine is a schedule III constrolle3d substance. Some states limit maximum script for 30 days and some for 90 days. I would looup your states requirements so you can quote it to your vet and get a least a 30 days supply at one time.
 
Suzanne & Darcy said:
I have usually gotten a bottle of Burenorphine from the vet with enough for a week or so, but my cats were not long-term users of it. As for the dose, one of my very small cats were on as small of a dose as .05 mL (of the 0.3 mg/mL concentration liquid.) It’s my understanding that typical doses for cats range from .01 to .04 mg per kg of body weight - depending upon the severity of the pain - to be given 2 or 3 times a day. Each state has their own regulations for dispensing a controlled substance, so I don’t know what those regulations are in your state. Apparently, 32 states exempt vets from the rules that human physicians must follow. It’s complicated. I’m really upset to think that Micio’s pain will not be controlled properly if you cannot get enough Buprenorphine from your vet to give on a regular basis. It’s not right.
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I am very upset too to see that all most of vets care for is just to make money rather then allow more people being able to afford meds for their pets. I'm lucky I can still do it even though the budget is getting tighter but really feel bad for those who can't. Unfortunately I'm at the mercy of this vet and he knows it and takes advantage by telling me he cannot dispense more than 0.6ml Bupe?! so I'll have to buy those syringes from him. Micio doing much better now, fingers crossed
 
Larry and Kitties said:
Burenorphine is a schedule III constrolle3d substance. Some states limit maximum script for 30 days and some for 90 days. I would looup your states requirements so you can quote it to your vet and get a least a 30 days supply at one time.
Click to expand...

How do I search/look that up, please?
Question: do vets get a % from online pharmacies if they recommend them to customers? They tried to offer the transdermal version of bupe (not sure if it they meant Zordium) and told me to give orally and I said "No, not the way it supposed to be giving" but they insisted and wanted me to order just from Wedgewood pharmacy once I could easily get it compounded by a local pharmacyby the day after for much cheaper...
Going to have a talk to my vet, hopefully by next week when he'll return from vacation and would love to gather more info about Bupe, the ways of giving it and the quantity it can be dispensed in my state (Indiana).
 
MICIO&Simone said:
How do I search/look that up, please?
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Google for: how may days of a schedule III drug can be dispensed at one time in x state
Typically the vets get a kickback if they specify an on0line pharmacy like then list it on the vet's website. I used to know the name of some 0f the Online websites but I have not used one for ages. If a vet says go to Chewy's or Wedgewood they do not get a kickback. When there is a kickback it is negotiated between the pharmacy and the vet.
 
Larry and Kitties said:
Google for: how may days of a schedule III drug can be dispensed at one time in x state
Typically the vets get a kickback if they specify an on0line pharmacy like then list it on the vet's website. I used to know the name of some 0f the Online websites but I have not used one for ages. If a vet says go to Chewy's or Wedgewood they do not get a kickback. When there is a kickback it is negotiated between the pharmacy and the vet.
Click to expand...

Thank you! I looked but still not able to find info for my state, will keep looking. Also though about asking a pharmacist but not sure he'll know about veterinarian dispense quantity
 
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