? Very sad cat. Pain management

Hello everyone,

I have been off forum for..a long time, a few years I think. And this is for a good reason. My 14 year old (15 in the summer) diabetic girl Barsa has been doing quite well. She's had diabetes for 4 years now. She's on Levemir, I'm really happy with it, it regulates BG so well.

On New Year's Eve we've all had a hell of a night, literally. It is said that the way you spend/meet New Year's (Eve) will show how you will spend the year. Here's hoping that is not true. Barsa had her usual food in the morning and then after about 3 hours the nausea and vomiting started. She's been vomiting all day and night that day, not continuously but everytime she ate something she'd vomit it all out, at first food but later even a syringe of water I tried to give her to compensate for dehydration, she vomited that water. The next morning she was better in a sense that she wasn't nauseous any more but you could tell she's in pain. So now it's day 3, she's not vomiting, not nauseous, eating (less though), no diaarhea, peeing (a little), defecated once but it was a bit like constipation although I'm not sure she's constipated (looked like small round balls of feces and very small stool), grooming ok, she's responding to people the usual. She's dehydrated (trying to give her water), but the bigger problem is she's in pain, it shows in the way she behaves, how she sits, sleeps, her facial expression..Maybe I sound silly, I know cats are known not to show pain but just from experience and knowing my cat I can tell she's not ok. She's very sad looking, hunched, it looks like something is bothering her. This has happened in the past but never lasted as long as this time. It might be pancreatitis which is not a straightforward condition to diagnose and also not an easy one to manage. I will take Barsa to vet on Friday for bloodwork to rule out other possible causes, like kidney and liver problems. But for now I would like ask everyone who knows, everyone who has experience and especially people who live in the UK the following questions and will ber very grateful for your responses.

1. How do you manage pain in your cat? If it's pancreatitis, what can I give her to help alleviate pain? What can I buy in the UK over the counter without prescription? Or what should I ask my vet for (meaning prescription) that works for your cat? The worst is to see my cat in pain and I just want to help her get through the days until she gets better

2. Nausea and vomiting. Again, which remedies/medications? I have Ranitidine which this time did absolutely nothing, but it could be because she vomited right after having it. I also have Slippery Elm Bark in my cupboard.

3. And in case I'm not thinking it throught well, what would you do in my place? Blood test is the right thing to do, correct? Would you do anything else? Like ultrasound? The cost is an issue but I might consider it if it's really needed.

To summarise I have a cat that's not young anymore. She seems to me to be in good health, diabetes well managed but every now and then she has this, unknown condition flaring up, sits in pain after food and I don't know why or what to do about it. And this time it is way way worse, 3rd day in pain. What to do?

P.S. I don't want to try and diagnose pancreatitis (ask for necessary tests) because I will spend a lot of money and the results will not be conclusive anyways (please do point it out to me if I'm wrong and you think I need to!), what I want is to manage it. Thank you to everyone who replies!

 

Definitely a vet visit as soon as possible. I would expect she would need bloodwork and possibly a urinalysis. Depending on what they find, an ultrasound may be needed. Since she is peeing very little, I also would have them check for a UTI.

She probably is dehydrated also. If they give her subq fluids, that may help her feel better. That is also something you can also do at home. You can get the supplies from your vet.

 

Could she be peeing little becasue of dehydration? I'm sure she's dehydrated because of how her fur looks. I'm trying to syringe feed her 5ml water but I can only do about two syringes in one go. So I've done it twice this evening. 20 ml (( not much. We did subq fluids in the past with my mum for Barsa (when she had ketoacedosis) but it's so stressful that I might ask vet to do it. Or persuade mum, she's a nurse.

 

Certainly does sound like it could be pancreatitis. There is a test for it... She needs a vet. If it's pancreatitis the treatment is usually sub q's for hydration, cerenia for nausea, and bupe for pain.

 

Vet visit for sure for a diagnosis, but I have had great success using Gabapentin for pain in my cats. Anti-nausea meds are also a must with pancreatitis.
Hope she feels better soon!

 

By the way, this may help : http://www.felinediabetes.com/FDMB/threads/article-on-pancreatitis-for-uk-residents.194915/

 

@KarenRamboConan Thank you, this is a very good useful article! Regarding Gabapentin, is this the one for humans? Which form and dose do you use?

Cerenia and Buprenorphine are both available in the UK, right? I think she was prescribed that once in the past (Buprenorphine) but no, it wasn't even a prescription. Vet gave us 2 buprenorphine filled syringes to take home with us and that was that. My problem is that I don't have anything at home for pain. I will have to book a consultation which is not cheap now and also wait a few days for it because they're fully booked, take poor sick cat to the vet just to get a one-off prescription. It's all taking too long. Is there anything I can buy online without prescription in the UK??

 

bump

 

hi. I'm in New Zealand now but am born and bred British.

It is doubtful you would be able to buy the type of pain relief needed without a script.

Is there no walk-in 24/7 ER vet hospital or practice near you? Perhaps phone BlueCross to see if they have a list or will see you.

Pusscat really needs a blood test to dx pancreatitis . I hope you manage to get Barsa to a vet a.s.a.p.

 

I used tramadol 10mg for pain for Sheba. That was for arthritic pain though. I used to get that from the vet.
You could ask for a script for ondansetron from the vet. It is used for nausea and is bought from the chemist. It is effective and can be given at the same time as cerenia if needed.
I would take kitty to the vet and get a test done to see if it is pancreatitis or something else.
If it is pancreatitis they will usually give subQ fluids, a pain injection and a nausea injection and some pain and antinausea meds to take home.
I hope Basra is feeling better.

 

Not sure Tramadol is available over the counter in the UK Bron. It didn't used to be.

 

@PussCatPrince - GA
I meant she would need a script/or vet. It is only available on script here too or the vet . If kitty is in so much pain I think Basra needs to see a vet

 

Ah gotcha. Me too.

 

Guys, I'm going to see the vet in a few hours. Reading a lot about medications, Buprenorphine specifically. Last time my vet gave us the syringe to take home and we injected subqutaneously but it is advised to do that orally. How on earth do you do that? I'm a bit worried.. Will I have to inject it in the gum? Is it going to be painful for cat?

I will ask the vet about Tramadol and between Cerenia and Ondansetron, which one to choose? Need to know what to ask for. I think if I can get the prescription then I can buy the meds on VioVet.

Thank you for your input!

 

What the vet recommends for pain relief will depend on the diagnosis. Tramadol may or may not be appropriate.

You use an oral syringe (no needle) to squirt a dose of buprenorphine between gum and cheek.

 

Noah hated the taste of oral Buprenorphine to the point it was stressing him out giving to him. We switched to a transdermal paste swabbed in the inner ear, it probably added two years to what would have been a miserable life.

 

Given orally just means you squirt it in the mouth. It's in a needless syringe.

 

I use a form of Gabapentin used for cats - 25mg tablets. I give 1/4 twice daily when needed. I recently discovered that it's hard/impossible to get in the USA, but I don't know about the UK. It's not an opioid or an NSAID, so it's a good choice for cats.
Only caveat : it's rare, but Gabapentin can drop blood sugars, so be careful.

 

So on day 5 we went to see the doctor. Barsa was feeling better by then and seemingly in no pain. Doctor looked at her teeth and gums, said that she's not really dehydrated and it doesn't look like anything kidneys related. Told us we can do a blood test just to be on the safe side but she wouldn't really recommend it because the cat seems to be ok now. Both Cerenia and Buprenorphine are injectables and they do not keep well so for this reason she said I need to come get them whenever I need them. We have agreed that because cat's condition is improving we should wait and see, if she gets worse rather than better then I can pick up the meds. One interesting thing was that upon examination Barsa didn't like to be touched at the back of her spine, vet said that her tummy is not tense, on the contrary it's quite relaxed so it might be she's having some muscle pains. But the thing is, when it looks like she's in pain (sitting down hunched with her head forward..meatloaf position?), it usually happens shortly after she's eaten. So yeah..I still don't know what the cause is. I'm thinking maybe she's not pain but nauseous! Maybe next time this happens I should try give her anti-sickness medication and see if that helps..?

@KarenRamboConan , my mum used to be prescribed that but we don't have it anymore. You are saying it's a 'form of Gabapentin used for cats' so it's not a regular Gabapentin correct? I was thinking maybe mum can get it for herself again and I divide it into correct for cats dosage.

 

The dose is so small (1/4 of a 25mg tablet) that I don't think it can be divided from a human one (which is usually more than 100mg per pill). But if you're in the UK, maybe it is available - ask your vet. I just know my US friends had almost no luck in getting it formulated in doses small enough for their cats.

 

Was just searching the site for pain meds as I am thinking about a dental before starting insulin and saw this discussion

Not sure if it helps, but I got gabapentin capsules directly from vet a year ago for pain after dental. I am in the US. I just checked bottle and they are 100mg capsules, direction was to open capsule and split powder (dose prescribed was 1/3 to 1/2 capsule with food every 12-24 hours for pain). I am sure dosing would depend on cats weight. I just poured the powder from capsule on a paper plate and divided evenly into 3 piles so each dose was approximately 33 mg. Not sure capsules are available in UK and also saw mention of possible, but rare effect on BG. Worth asking vet if you are able to find it.

Sounds like Karen mention a lower dose though?

 

50 mg is a standard dose for a standard cat. My cici Moxie is about 10 pounds and has been on 50 mg gabapentin twice daily for years,

 

Good to know, thanks!

 

Thank you! I will try to get gabapentin