1/25 Crystal - pain relief advice needed please

[suki & crystal (GA)]

http://www.felinediabetes.com/FDMB/...-349-4-320-8-342-10-344-dose-increase.131917/
Morning everyone

Crystal is limping quite badly on her right hind leg this morning, I think the problem is in her hip area, rather than lower down the leg. I don't think it's an injury, she's had a problem with this leg at the same time she was diagnosed last March. When she sits her leg sticks out, I've mentioned it to the vet many times but there is just a lot of head scratching. I now think it might be nuropathy (have I spelt that right?) associated with her acromegaly, or perhaps arthritis but as it's causing her some pain now I think a vet visit is on the cards. Unfortunately my vet only works 3 days a week so I'm not sure when I can get her in but would like to go armed with some info regarding pain relief. I've read quite a bit on various people's posts about different medications but can't remember where but I do know that Wendy's Neko has pain relief for her arthritis. Any recommendations, good or bad, would be appreciated. I seem to remember reading that fish oil, especially omego 3 is beneficial.

Lovely morning here, sun shining so off to take the hound for a long walk. Enjoy your Sunday.

Suki & Crystal

 

[Sienne and Gabby (GA)]

Neuropathy typically isn't in the hip. Usually the cat is walking on his/her hocks and not on the toes. With neuropathy, the treatment is methylcobalamine (methyl B-12). This sounds more like arthritis.

Usually for pain relief our kitties here use buprenorphine (also called buprenex or "bupe"). Some of the acro cats have also used gabapentin which can be effective for nerve pain. Bupe is a narcotic. Some people have also use tramadol for their kitty's pain relief. It's also a narcotic.

Do NOT allow your vet to talk you into giving meloxicam or any other nonsteroidal anti-inflammatory (NSAID). In particular, meloxicam here in the US carries a "black box" warning from our Food & Drug Administration due to its causing renal failure in cats.

If this is arthritis, you may also want to ask about a glucosamine/chondroitin supplement. In the US, we can get Cosequin which is available in a formulation for cats.

 

[Wendy&Neko]

Sorry to hear that Crystal is hurting. Arthropathy is a common symptom for acromegalics. There are two approaches to treating this. The first is to improve the condition of the joints, the second is to treat the pain. Sienne described the approaches for pain. Neko is on buprenorphine. I get it compounded with chicken flavor. As soon as we started bupe, she started purring more and became a lot more interactive. She's been on bupe BID for about a year now. She tried gabapentin, but it didn't do much for her. Some people with acrocats swear by it. I think pain relief is ECID. Tramadol was Neko's vet's third choice, but we didn't go there.

For the joints itself, fish oil is an anti-inflammatory. The Omega-3 in fish oil is also good for kidneys, acrocats can get proteinuria (Neko is starting to show a bit of that). I use a fish oil that is made with anchovy and sardines. Next up is a glucosamine/chondroitin supplement. Check out pet food stores, you may be able to find one there, if the vet doesn't have Cosequin. Neko is also on Cartrophen, she now gets one injection a month. I see that there is a French distributor, so your vet may well know about it. It's designed for dogs and horses, but used off market for cats. It's quite commonly used in Canada for arthritic pets. In the US they use something called Adequan which is similar. And lastly, Neko gets Hyaflex which has hyaluronic acid in it. The company itself only sells in North America, but I have seen other pet arthritis medicines containing it (along with glucosamine).

Last summer, Neko also started acupuncture. Her acupuncture vet is also a regular vet. It does provide some relief and I give acupressure daily to supplement. Neko's acupuncture vet also discovered that she has a tight psoas muscle, and has given me a stretching exercise for it. That muscle is part of the hip. I must say that the check up that Neko got from her acupuncture vet was the most thorough she has ever gotten.

Sending vines for a good vet visit. I see lots of sunshine on Crystal's SS today.

 

[julie & punkin (ga)]

You've already gotten great advice - i've tried all of the above except fish oil - somehow we never did that one.

Bupe was the best for pain relief - punkin got it twice a day for a year or so.
Adequan also definitely helped. We used it for more than a year. In the US, if adequan isn't enough there is also another related drug called Dausequin that can be tried. We didn't try it.

We tried gabapentin - didn't seem to do anything.
We tried tramadol - punkin had one dose of it and hallucinations. Didn't give that again.
We tried acupuncture - that did seem to help, but when the vet attached electrodes punkin went crazy distraught and began pulling them all out. I had to phone the front desk to get someone to come and help me. the acupuncture itself, however, seemed to provide almost immedate relief. He jumped up on a table after the first treatment. There's a link to a video of punkin getting acupuncture in my signature line.

We moved from acupuncture to cold laser therapy. That's a loaded story for me, because it made a huge difference in his comfort and mobility. We started every other day and then every 3 days, then once a week. The idea was to get to once a month. However, we could tell by how his joints reacted when moved that it didn't seem to "hold" longer than a week.

So we went once a week. Well . . . i can't know for certain, but i feel pretty certain it was a causal factor in his death. After we'd been doing it for several months, he developed very bad bloody diarrhea the Friday morning after a treatment. the vet was sure it wasn't from the laser therapy. He got metronidazole and recovered. The next week we went in as usual for his Thursday appointment, and Friday morning more bloody diarrhea. He didn't recover from that episode and died on Monday. At that point the vet acknowledged it could've caused it. What we think probably happened was that he may have had cancer. The laser treatment isn't used on an animal with cancer. We don't KNOW that he had cancer, but the cold laser was run along his spine, at the joint of each hip (pointing inward right towards his colon) and then along his hind leg joints. I think there may have been too much concentration on his colon.

So, having said that, still, he got a TON of relief from that cold laser. I would do it again, however, I would not do it that frequently or let the rays all concentrate on his colon the way they did. I don't want to completely scare people off from it because it really made a huge difference. At the same time, forewarned is forearmed - if you choose to do it, be aware of the risks. It did help him more than anything else.

I hope you can get some relief for her - you want a quality of life for Crystal, not just sitting in pain. There are lots of options for you to try, one at a time, to see what helps.

 

[Georgia and Simon (GA)]

Simon has had arthritis pain for quite awhile. We started with cosequin and for some reason, his blood sugar went up slightly on it (I'm not sure anyone else has had this happen with their cats). Dasuquin helped with less of a spike in BG, but unfortunately, it only helped for about a year. Definitely worth trying first. Simon now gets Adequan shots and it has helped, although during the winter months, he still has some pain. I am going to see if the vet will prescribe a low dose of bupe to see if that gets him through the next few months. I was going to try acupuncture, but Simon gets way to nervous at the vet to even try it.

I hope Crystal will be feeling better soon.

 

[suki & crystal (GA)]

thanks Sienne, Wendy, Julie and Georgia for all for your advice and lots of really good info, and also for your best wishes to Crystal. She's not limping so bad this morning and did manage to jump up on the counter for her breakfast, something she couldn't manage yestereday, but as I think it's an ongoing problem I will be taking her to the vet this week. She definately isn't walking on her hocks so perhaps it is arthritis. I should think the likelihood of getting acupuncture here for cats is zero but I will ask. In the meantime, I'll start her on the Omega-3.
Julie, I'm so sorry to hear of your experiences surrounding Punkin's death. It's always a balancing act, something that works can have major side effects but we can only act in good faith and as you said, he probably had other serious health issues.

I'll be making the switch to Lev tomorrow morning, I'm probably held the current dose a bit too long, but forgot this morning to increase so I'm still at 16.50.

Well I'm just off to have a routine blood test - so I will be on the other end of the needle for a change, hope they don't poke my ear!

 

[BJM]

If that hip joint was ever dislocated and not put back in place, the socket fills up and the joint functions oddly from that point on. It can have arthritis, too.
(I had a civvie growing up that this happened to.)

 

[suki & crystal (GA)]

Hi BJ, I don't think that happened (at least I certainly hope not) but it's a coincidence that I first noticed it not long after Crystal was diagnosed, along with the problems she had with her mouth and throat about the same time, which I now know are symptoms of acromegaly.

 

[rhiannon and shadow (GA)]

Shadow has severe osteoarthritis from an injury..... I give her adequan shots and she gets buprenorphine for pain management too.

The best way to test for arthritis is an x-ray.

Apparently I have a great vet for that issue because they don't feel it's necessary to sedate her for an x-ray.
She sits still for them while they quickly push the button.

An x-ray would help you to know if that's the issue.