Buprenex

[DiabeticMom]

Hi,
Chong has been on and off Buprenex for the last few weeks for pancreatitis. I thought she was done recently but then slowly the pain came back so I stated Bupe again. I gave it yesterday morning around insulin time and again yesterday evening, 1/2 hour after insulin. Two hours later she was up and wired, and seemed uncomfortable. I was able to pet her until she calmed but she was still thumping her tail which she does when all is not well. She is fine this morning.

There are times she got energy from Bupe but I've never seen her irritable like that. I have about 10 days supply on hand so don't want to throw it out and start something new if I don't have to.

Too close to insulin?

I start Bupe for a few days and then stop it hoping the pain and pancreatitis is gone. How do you know without stopping the pain meds?

Thanks for the help.

Barb & Chong

 

[Vicky & Gandalf (GA) & Murrlin]

Re: Brupenex

Hi Barb,
Buprenex/buprenorphine can cause agitation in some cats. I don't think the proximity to the insulin shot is related. Have you tested her BG?

You could have her blood tested for pancreatitis, the test is called feline Pancreatic Lipase Immunoreactivity. If she is still suffering after a month's time, there may be something else going on, so it might be a good idea to get the pancreatitis confirmed. Also, some vets do an ultrasound to check the inflammation in that area as there are other conditions such as triaditis which involve the liver, gut and pancreas. There are other things you can for pancreatitis such as B12 vitamin shots. Steroids also may be given, but I would consider that a last resort.

 

[DiabeticMom]

Hi,
Thanks. She had an ultrasound which is where the pancreatitis diagnosis came from. They said they didn't want to do the pancreatitis blood test because there is nothing they can do about it and it's costly. Unfortunately (or fortunately) the last time I was in her blood work was done without that test and it is good.

Is there anyway for me to know without a blood test? How about with UTIs. Can human UTI strips give me any info?

The Bupe calms it down and it lasts for awhile but then the pain comes back again. As weird as it was last night, she is fine this morning and not in pain. If I don't give her anything, at one point I'll start to see the pain build and then give her more Bupe. Should I do it that way or keep her on a regular schedule of Bupe.

She is also getting fluids every third day. I can make that every day or every other. She doesn't like it but will work with me.

She gets a B12 shot once a week but I forgot it last week and remembered it at 10 days.

I tested her BG last night when she was agitated and it was 177.

I've notice that she feels better when her BG is about 200 and gets pissy when it drops too much below 170 although I give insulin so it does drop below. I free feed up until about 2 hours before insulin & BG test.

Hope that's not too much info. Basically, should I give Bupe on a regular basis and is there any way to know if the pancreatitis is gone without blood work? Her belly never did hurt.

Thanks
Barb & Chong

 

[Blue]

Re: Brupenex

How much was the u/s? I think a blood test fPLI for pancreatitis is cheaper and much less disruptive to the cat. Ask how much a blood panel would be with the fPLI test included, and you will see the diff .... it's important for you if you have a cat who seems prone to pancreatitis issues.

For pancreatitis, you pretty much have to test when there is an attack, much like a fever.... there is no point in waiting till the next day to take your temp... test when you feel hot. I get the feeling that some cats are just prone to attacks / flares, so after a couple tests, I never bothered to test Shadoe again as I recognized the signs.

I gave her 1/4tab Pepcid AC 10mg tabs, BID about 30min before ps and foods. I did not give her fluids regularly, or bupe, unless she still seemed 'off' after the pepcid. For fluids, I had to time them for her rising numbers because fluids can bring down BG lower. Sometimes only 50cc BID was enough fluids for her, plus I always souped her food to get more liquids in her.

That method worked well for months until I switched vets and was advised to give her weekly shots of B12 which ended up eliminating her need for pepcid or bupe or fluids. The B12 shots took care of the inflammation so well, she had only 1 minor issue after starting the B12 shots. To remember, I gave her shots on Thursdays, not sure why that day but I could remember it.

Now, my Oliver had continuous gray area pancreatitis; his blood test always showed around 3.5 to 4.0. I started giving him the B12 shots because they could help him as well and he is also 10yrs old, which is the age when you should consider giving a cat B12 shots. Oliver could not handle bupe at all; it knocked him right off his paws and he'd lie around like a drooly drunken sailor. He is much better on gabapentin.

For the fluids, how much are you giving her every sitting? I bet if you give her a smaller amount but give every day or every other day, you will have better results. Imagine if your dr said you must drink a gallon of water every 3 days.... would you like to spread that out over the 3 days or sit down and drink it all at one time.... smaller amounts are easier on the heart as well.
What gauge needles are you using for giving fluids? My vets have always tried to give me 18ga; they are fast and the fluids go in quickly, but those needles are like harpoons and must feel uncomfortable, plus your cat may have some discomfort with fluids going in so quickly. I always got 22ga UTW needles for fluids but would accept 20ga UTW if they had no 22s. My Shadoe hated getting fluids with the 18s, and would try to slink away, but with the 22's, it took a bit longer but she was OK with that size needle.