Acromegaly Pain control for People/Cats

One thing that worries me is headaches. I simply can't tell if Pinky has them--some people just assume that the pain is there and that makes sense but I am also afraid of some of side effects of pain medicine like constipation, lethargy, etc Pinky is already lethargic but if she is in pain something has to be given.

Anyway, been lurking on people acromegaly support forum that is open and anyone can read and learn.

Wanted to see what they have found effective and see what they say about gabapentin and other drugs in that class.

Didn't find much on that. Nor did they mention a drug that kitties can use but I am still going through the site and past posts.

I did find this about a week ago and haven't had time to run it by Pinky's doctor. It is about acromegaly pain control for people. Specifically headaches:

http://pituitary.mgh.harvard.edu/e-s-963.htm

Found it very interesting that they mention tricylic anti-depressants for headaches. That would be something like amitriptyline. I will post more links on using amitriptiline with cats that I found when I have a bit more time.

Doxepin (Sinequan) is in the class of medications called tricyclic antidepressants too. Given to dogs and cats for behaviorial issues.

The one big drawback with amitriptyline is it effects blood sugar (but I don't know to what degree). I read it can either raise or lower it --- which makes it complicated . If it did one or the other you could compensate. For a normal diabetic cat I guess they wouldn't use it but I am just toying with the idea that for the pain of acromegaly it be might worth considering IF it wouldn't play complete havoc on the BG #s. Perhaps others have already tried it.

I say this because I have already gotten gaba. powder but couldnt use it as it was formulated wrong. Next got amantadine but the liquid formulation for the diabetic cat tastes terrible. (I tasted it.)

I know that the tiniest amount of amitriptyline could be easily given and if that is what they prescribe for people's acro headaches I am wondering if it might also work for the cat.

Elaine and Pinky

 

Hi Elaine

I know I don't get to post very often these days but all these pain meds, pain issues, the human acro group, etc - we have talked about for YEARS - actually since my Merlin was first diagnosed back in 2006. I'm afraid the group here doesn't get much traffic these days - mainly because there is more "quick access and interaction" over in the FB acro group so it seems people have migrated there more for daily help. With >85 members - there is more ACRO related input and more discussion to be able to follow up on these topics.

However, headaches - YES - definitely a common problem for many acrocats. My Merlin and many others face this.

Arthralgia and spinal arthritis is another huge issue. In general I believe ALL acrocats face some pain issue! Due to the development of enlarged organs, bones, etc.

We have documents listed talking about ALL the pain meds you mentioned and have had numerous discussions regarding what works best for what pain.

Gabapentin seems to be one of the "miracle" drugs for many of our cats. Altho some do better with tramadol and some with bupe but it's best to decide which one depending on the symptoms your cat is showing and talk over with other acro owners who have had their cats experience those symptoms AND what reactions their cats have had to these drugs. Altho a drug may work well in a human - cats respond quite differently than an ADULT human being!


Amantadine is also one of the newer meds (altho it's an OLD med) that is coming back into usage. ANY MED can taste horrible BUT there are ways to give it. You can't base giving a med to your cat for their comfort level based on YOUR taste. If your cat (or a child) was having seizures - would you withhold the phenobarb because it too tastes horrible????

Also if your gaba was formulated wrong - perhaps we could help you figure out the correct dosage based on the concentration. We have ICU nurses, pharmacists and veterinarians as part of our FB group that are always on/willing to help with things like this. This is the beauty of the group.

Amitryptaline is most often used for various other things before pain control - I would be leery of trying that BEFORE using gabapentin or many of the other meds listed above. That's JMHO. Tricyclics can have many side effects and if this were my cat - I would want to give all the other meds a chance first.

FWIW - I'm a pediatric ICU RN and have had decades of experience and find that much of what I know in this field relates to the feline care. (In fact in one veterinary conference (AVCIM) it was stated "that cats are more like little people especially when it comes to heart disease". ) And I have been involved with the very formation of the feline acromegaly group and have seen what has and has not worked over the years. I don't claim to know everything but sadly or happily I have seen a lot.

If I can help you at all please let me know. I'd love to see your spreadsheet if you have one. A great way to see how any of these meds work is to see how your kitty's BG's respond to the various pain meds.

Well I've rambled on here for quite some time - I hope i have helped some. I hope to hear back from you or see you in the FB acro group where we can help you more!

wishing you all the very best

Patti - and always in my heart Merlin (acro) and Boris (diabetes)

 

Patti,

Thank you for your thoughtful reply.

I know that there is little traffic here on Acro FDMB--that's OK---I don't post much here myself as you can see. :smile:

But all the material shared on these pages was very helpful to me in the past. I think important information (non-controverial) related to any disease should be shared, searchable and available to everyone--people who join groups as well as those who don't. .

It just seems a good place to just post reference material or anything interesting as it doesn't scroll off very quickly. Whether anyone can use the info is up to them.

Your suggestion that they join FB is a good one if they want additional info. from people who have experience with these drugs.

I did already know that gaba is taken widely from posts on FDMB and this was repeated to me on FB when I asked about it.

I am just a curious sort who got to wondering if people take gaba for acromegably headaches, if not then what do they take?

I am familar with gaba, my mother took it for extreme permanent nerve damage caused by shingles on her face and head but unfortunately it didn't help at all. Nor did other drugs in that class.

Just posted the article as I found it interesting and possibly helpful but only if such a drug is safe for a cat. It sure does seem to help humans. Treatments options and favored drugs change so frequently so you never know what currently is in vogue or who has actually tried a particular drug in question. Glad you weighed in to say you prefer gaba. Thanks.

Even though I worry about headache because I read so much about it I am still not sure Pinky has them--afterall pain relief is the reason I did SRT. I may stick with the occasional bupe until I weigh in with her SRT Dr and her Int Med. Dr who has treated many pets with cancer and resultant chronic cancer pain and other major debilitating illness's but Pinky is her first acro cat . She also is currently treating 60 diabetics but acro cats are certainly in a class by themselves. She may very well not like amytriptyline as well.

Thanks again.

Elaine and Pinky

 

I use tramadol on my acrocats.

 

When I treated Merlin years ago for headaches - I used bupe for his headaches but then we didn't have quite the options then either. But I did think it worked well for him. He was able to get it tid (3x/day).

One thing that always concerns me with tricyclics - altho it's usually in higher doses - is that there can be an effect on the heart from them. Sad to say - I've seen tricyclic overdoses and it causes serious heart issues. Just something to keep in mind - especially when so many of our acrocats are already most likely dealing with enlarged hearts. Just something to keep in mind. There are much safer options to pain control to be tried before the use of this drug.

Please keep us up to date. I would love to hear how your Pinky is doing.

We do have lots of info on the gaba, tramadol, bupe, amantadine, and others in the FB group. Let me know if I can help.