15 April | Girlie AMPS 92 Bupe question

Condo: http://www.felinediabetes.com/FDMB/...wer-ps-numbers-on-a-drop.193816/#post-2170570

Bupe question: I've been giving her Zobaline for almost a month now, and I don't notice a dramatic change in her hind legs. I have some Bupe, which the vet gave me very grudgingly. I know her arthritis bothers her, and I'd rather try Bupe rather than Meloxicam. But she takes Phenobarbitone 2x/day, and that does make her a little groggy, though she's on a lower dose now. Any suggestions for how often to give Bupe and how much? Do you need to give it when they've eaten, or is it okay on an empty stomach? Any advice would be much appreciated!

Day 3 of trying to giver her a little food at +9 (started on 13 April). So far so good: we've had three consecutive green AMPS (although I don't know whether she's eating at +9). She does go for the AM+9, but her PMPS numbers are blue, but decent blue numbers, for sure (117 and 110).

Actually eating food seems to make a difference. She does seem to get better numbers on the day (and day after) she gets Mirtazapine. Hmmm.... I only give her 0.05 ml of the liquid compound. I might have to look at giving her that every three or four days and see if that makes a difference.

 

Cool!

I think Bupe is dosed by weight. Do you know her current weight?

 

Here ya go...

http://felinecrf.org/treatments_antibiotics_painkillers.htm#buprenorphine_dosage

 

She's 8 pounds. The bottle I was given is 0.3 mg/ml (Temgesic) and it says "give 0.1 - 0.2 mls into the mouth as required." I just have memories of when Girlie was prescribed Gabapentin: The recommendation was 1 ml 2x/day; I gave her 0.5 ml in the AM and she became a Zombie... we ditched the Gabapentin as an option.

 

the pain medicine isn't going to make her walk any better.
But i would start out with the lowest dose and work up. I actually gave just .1 of the bupe because my own girl was super sensitive to pain medications.

It can take up to 3 months for the zobaline to be effective.

 

Super! Thanks so much, Lizzie.

I guess I'll have to try it out with her when I can monitor her all day...

 

Thanks for those tips. And good to know re: the Zobaline: we'll keep at it!

As someone who's had two hip replacements myself, I know what having painful hips are like. When she gets the Meloxicam (used here in Australia; not blackboxed as in US), she's so bouncy the next day, running to the door and trotting down the stairs to go to the garden. Then there are the bad days...

I'll just have to give it a go and see how she fares.

 

Bupe is way stronger then gaba, no? Rufus was a little tired on gaba, but either a zombie or super stoned on bupe.

 

If she is arthritic, maybe you could try Adequan?

 

Agree on the Adequan, so far it is the only thing that has helped Bronx's mobility.

 

Gizmo is also. I usually give, at most, 1/2 dose what the prescription is written for.

I went back to the Torbogisic (rather than the Bupe). It just seems to work better for him, doesn't dope him up as bad and doesn't affect his appy as much but haven't given him any meds for over a week except for his Amlodipine. (YAY!)

 

Good to know! I'll have to try to microdose...

 

I don't think we can get Adequan here in Australia. We can get Pentosan as either Pentosan or what Girlie was on for years: Zydax (also Pentosan, but by another company). The Zydax had really stopped working and I found that it blew her BG numbers sky high twice after the injection; I wasn't going to try a third time, especially as it had no affect anymore.

We did go for acupuncture, but our wonderful practitioner is only available two days a week and I can't take the time off work in the morning to do this now that I'm back at work.

I might try to get some Canna. The problem with Girlie is that she's very sensitive to meds. The Phenobarbitone really knocks her out if she's over a certain dose, so I don't know how she'd go with Bupe and Phenobarbitone. Hmmm.... won't know if I don't try it, I guess. I certainly couldn't give it to her every day and then leave for work if it zonks her out...

 

Has anyone used Tramadol? I think Bron might have... I guess the problem with all of these narcotic-based or acting meds is the sedation affect. I know that well myself. The benefit of Meloxicam is the anti-inflammatory affect without the sedation, but of course the negative is the impact on kidneys. I've had a number of vets that have seen Girlie say, quite frankly, at this point and her age (19) you have to consider quality of life now and weight up the benefit of a low dose of Meloxicam vs. future complications with CKD.

I think Meloxicam is formulated differently here in Austraila; we have a brand that is formulated specifically for cats. I prepare myself for a deluge of comments re: how evil Meloxicam is! I use it very rarely - maybe once a week, if that - and at a very low dose. What is one to do?

How are you going with Bupe now with @Stacy & Asia ? I missed when you started it. Was she really dopey with it at first?

 

We discussed this yesterday here

http://www.felinediabetes.com/FDMB/...ng-out-adequan-dose-help.194089/#post-2171206

Per Wendy

 

from an old post from @Bron and Sheba

cartrophen is what they have have in Australia, the equivalent of Adequan.

 

Thanks so much, @LizzieInTexas and @rhiannon and shadow (GA) !

 

I haven't been on line for a while and just found this post tagging me.

I used tramadol for Sheba in the last couple of years of her life. It did not sedate her at all.
I found it very effective, but not as good as metacam which had the anti inflammatory effects which the tramadol doesn't. It is a painkiller only. Sheba had no side effects from the tamadol. I gave her a half a twenty mg tablet twice a day.

I used metacam for Sheba for about three years and found it wonderful. It made a huge difference to her quality of life. The Australian formula is for cats specifically unlike the US formula which was made for dogs as far as I am aware.
For metacam to be effective it needs to be given on a regular basis ie each day. I found after a few weeks at the recommended dose, I could gradually reduce the dose to about half and it was still effective, but it needs to be done slowly. If you use metacam you need to ensure that it is given with food and that the cat is drinking plenty of water. I always added water to Sheba's food to ensure adequate hydration. And never exceed the recommmended dose. If the cat isn't eating don't give the metacam.
I tend to agree with your vets that metacam would be the medication of choice at this stage. Sheba had early stage CRD and it did not effect her kidneys at all.
However it is your choice. You must do what you feel comfortable with.

 

Metacam is formulated differently in Canada too. But Neko's vet still didn't include it in her list of options for Neko's arthritis due to her kidneys. Bupe is dosed in a range, based on weight. Neko did fine on 0.22 ml of the same formulation, but she was around 14 lbs. the civie, weighing around the same, needed less. ECID.

Best to give bupe when they have a little food in their tummy.

The latest research on mirtazapine is that it only lasts 9 hours in the cat, so is recommended for daily dosing. But all the better if you don't need it that often. Transdermal mirtz is the recommended formulation.

 

Thank you so much, Bron, for all of that detailed info. Girlie loves to drink from her water fountain, so hydration is never a problem, thank goodness. When I looked at Tanya's CKD website, it looks like I should try 0.02 mg/kg/day. Does that sound something like the dose you used, if you can remember?

I hope all is well and that your new kitty is up to all sorts of amusing antics!

 

Thanks so much for that detailed info, Wendy. I might see how she reacts to the Bupe this weekend.

I've never done a transdermal med with Girlie; we've always done liquid compounds. I like the liquid because then I can easily adjust it. Max also cleans her ears when he gets near her, so I don't know how that would go. The last thing I need is a Max on Mirtazapine! I'm pretty sure he has hyperthyroidism (taking him in for blood tests tomorrow), so he's already mad for food. I think he'd go insane with Mirtazapine.

 

They prescribed her.1 mL at first and it was too much. She wasn’t really sleepy or anything, but she had huge saucer eyes so I knew it was too much. I cut it back to .075 twice a day, she’s 10 pounds and change. When she had kidney infection we went back to .1 and 3 times a day and it wasn’t too much anymore. Now she’s back down to .05 or .075 twice a day, since I added the canna, depending on the day and if it’s am or pm (it seems to take less at night for her). She is not dopey on either, at all, once I figured out what was sufficient for her. I’m also starting Adequan.

I am certain it makes it less painful for her to get around than without it, but it doesn’t address the problem and it’s not like she’s doing a lot of things she didn’t do before the bupe, she’s just doing what she did less painfully. She started FD with a bit of hind leg instability which I mistook for arthritis. I think it was the start of diabetic neuropathy which has since righted itself.

 

Hi Darrah,
The dose you mention 0.02mg/kg/day looks like it is just a bit less than half the recommended dose. Is that what you have been giving Girlie when you say she is bouncy afterward? You could try that dose and see how effective it is.
It might take longer to work at the lower dose. I would ask your vet what he thinks.
I gradually reduced Sheba to about that dose from being on the recommended dose. There are markings on the syringe they provide to dispense the metacam and I went down those markings rather than by an amount per kg.

My new kitty Harry is full of affection and cuddles and fills our house with love and laughter.