Could use some input on Pain medications

[Deb & Spot]

I posted on the Lantus Land FB page also, but thought I'd drop over here too.

I could use some input in regards to pain meds for my Civvie Ralphie, who was dx'd with cancer in his GI tract. He does not seem to be in pain, but I know that he is not as comfortable as he could be. His tummy has fluid buildup and that has to be uncomfortable. I would like to have the vet prescribe some pain meds for him. If anyone has any experience with different types of pain meds, would you please share them with me? I guess what I'm looking for is what pain meds you used and if they helped and what type of side effects did you see. My boy is on limited with with me and I want to make him as comfortable as possible. Thanks so very much for your input.

I am waiting for the vet to call me back, so any information will be greatly appreciated.

 

[Dyana]

I've only used Bupe. And only after dentals and pancreatitis. Mostly, I eventually had to halve the dose because J.D. would walk all wobbily.

I hope your vet calls you back and you get some pain meds.

Super Big Hugs to you, my friend.

 

[Carl & Polly & Bob (GA)]

Deb,
Sorry to hear the news about Ralphie.
The only pain med I have any experience with is Bupe. I was giving it to Bob just before he crossed. The vet game me pre-drawn syringes with .2 doses, but I only gave him .1 at a time. The big side effect was drowsiness. It seemed the relieve the pain well. I tried .2 once, and he was just a lot more zoned out. I gave it to him every 8-10 hours. The goal was to make him comfortable, and it seemed to do that.

 

[Josie & Ripley (GA)]

((Deb and Raphie))
My only experience with pain med for Ripley was Tramadol. I gave her 1/4 pill (not sure of exact dosage amt) every 8 hrs during a bout of p'titis a couple of months ago, then another round during her last few days before we let her go. I hated having to pill her, so there may be other preferable meds that others can recommend. I didn't see any adverse side-effects; the med didn't make her drowsy, but a little more alert. Not sure if her alertness was due to feeling lack of pain or due to feeling a little 'wired' from the med.

Here's some info from Mar Vista.

:YMHUG:

 

[Lauren&Tommy (GA)]

Deb, I only have experience with Bupe as well. Tommy gets .15ml every 12 hrs and it does seem to help. I hope that you get the answers you need to help Spot feel better!

 

[mariko]

(((Deb)))
I have used buprenorphine too, for Lucy's pancreatitis.
Vet prescribed 0.2mg/ml concentration bupe, to give 0.25cc every 8-12 hours.
0.25cc made her walk like a fist-time ice skater, but it didn't make her a zombie, just wobbly.
0.15cc wasn't enough, so I ended up giving her 0.2cc to begin with.
As the condition improved, I slowly reduced. I had to experiment a bit to find a perfect dose and schedule for Lucy.
Sending vines to Ralphie.

 

[Deb & Spot]

Thank you all so much for your quick responses. Now that I think about it, I remember that Ralphie took Tramadol a few years ago and he was all zoned out on it. Maybe I'll see if we can try the bupe. Ali had that after her tooth was pulled.
I will be away from my computer for a few hours.....maybe I'll make a stop at the vet's before heading home.

 

[julie & punkin (ga)]

I just posted this for Donaleen/Ozy regarding pain meds. Dr. Lunn is the expert on acromegaly in the US, currently at North Carolina State Univ (at Raleigh). She was specifically advising me regarding pain for acro cats, but i don't know why it would be any different for any other cause of pain.

He may have pain from arthritis or from the pancreatitis. Here is an email conversation I had last year with Dr. Lunn regarding pain relief for our kitties. I gave punkin bupe for months. In my opinion, keeping them comfortable outweighs any other concern. As you've said, you'd rather have quality of life for him.

On Mar 1, 2012, at 6:44 PM, Julie wrote:

Hi Dr. Lunn!

I'm wondering if you can suggest a good painkiller for Punkin. I think most of the acromegalic cats use Gabapentin or Tramadol. For some reason, our new vet seems reluctant to try either of those. The vet said Gabapentin is primarily for nerve pain so she didn't think it would be helpful for punkin's acro. She said Tramadol tastes incredibly bad and a lot of cats have trouble with the taste.

We started him on Bupe on Tuesday night and while i think it works to make him more comfortable, someone else (not a vet) raised the concern with me that a narcotic is addictive and he could develop a tolerance to it. She suggested he also could become irritable if we were, for some reason, delayed giving it to him. The way I left things with the vet is that he has a 50 day supply of Bupe, and we are giving .2ml BID during that time. If it doesn't seem like it's working, then the vet and I will talk about trying one of the others.

Someone on the Feline Diabetes.com suggested you might have experience/ideas on pain relief for the acro cats. Do you think using Bupe on him for long-term is a problem?

Thanks for the input!

Julie

From: kathylunn
Subject: Re: Punkin Update? Question on Pain Meds
Date: Fri, 2 Mar 2012 07:46:24 -0500
To: julie

Hi Julie

I think gabapentin is worth a try as the pain in acromegaly could be associated with nerve pain - all pain is transmitted by nerve fibres. Tramadol does taste bad, but there are ways around that such as putting it in a gelatin capsule or having it compounded.

Buprenorphine is a narcotic, but so is tramadol. It is really hard to know if cats get addicted to these drugs, but my feeling is that if they help the pain and keep them comfortable with no side effects, then we should use them. I have not seen tolerance develop.

Often pain is best controlled by a combination approach. That can include gabapentin, amantadine, tramadol or buprenorphine, non-steroidals, fish oil, and Cosequin or Adequan. For pain due to arthritis often the non-steroidals are best as they control the inflammation as well as the pain. However there are not a lot of good choices for cats and they are not a good idea if there is renal disease. I would certainly add on cosequin and fish oil if you are not doing those. Acupuncture can be helpful too.

If buprenorphine is the only thing that works, then I would be comfortable continuing it.

Good luck!

Kathy

 

[carolyn & jesse (GA) & spock]

I used Bupe with Jesse (SCC in his sinus cavity). I gave it to him SubQ because I didn't want to traumatize him by giving it orally. My vet gave me Bupe that is made to be given SubQ. I hope you're able to help Ralphie be more comfortable.

 

[Sienne and Gabby (GA)]

Hi, Deb. My civvie, George, had an intestinal CA. The vet gave me bupe for him so I could dose him as I saw he needed it. He was really easy going and it was no problem giving it orally. I've used injectible bupe with Gabby after a dental.

 

[Deb & Spot]

Thank you all. Made it to the vets and they gave me some bupe....enough for 2.5 days. I got 5 pre-filled syringes to give orally 1.5 mg. doses. He's gotten two doses so far, but I did not give him the entire dose, but half. He seems to be doing well with that and has been up and walking around and even participated in the family Christmas Eve gathering.

 

[rhiannon and shadow (GA)]

I'm using Bupe for Shadow right now. Both Bupe and Tramadol have made Shadow dysphoric in the past. So the vet and I decided to try the smallest dose (0.1) and it is making a big difference. No dysphoria and Shadow is actually playing again.

Merry Christmas!