NSAID options for injured cat?

My foster diabetic, Sox, is diet-controlled. He injured his foreleg last week, and been vetted twice including xrays. The vet thinks it is maybe a sprain. But he still won't put the paw down at all. She gave him some metacam although I was very reluctant about it (remembered reading it was bad for cats) but she said the other option was pred, which would probably put him back on insulin.

I called yesterday to let her know he wasn't any better and she said it could just take a while. She wants me to give more metacam, every other day. But I read on the insert that it should not be given to cats at all. So I'm afraid to give it to him.

What other options are there?

Thanx, laur

 

My cat J.D. sprained his ankle when he jumped down from my computer desk and landed funny. I told the ER I did not want Metacam and she agreed and gave me some Buprenex to give him. I think I gave him a dose or two, and he was fine within a day.
You'll have to talk to your vet about it.

 

Hi Laur

There are no other anti-inflammatory + pain relievers for cats besides NSAIDs. Pred addresses inflammation, buprenex addresses pain only. You haven't given any Metacam? I think a cat has to be in extreme pain to not use a leg at all and I would personally would give it. I have Dillon two doses of Metacam after he had all of his cheek teeth extracted. Also, who has reviewed the x-rays? Unless a bone is broken, cats and dogs will at least 'toe touch' with the injured foot. Not using the leg at all for this long is suspicious. Can you have the x-rays reviewed by a radiologist or orthopedist?

 

Thanks Jess and Dyana. Sox had metacam the first four days in prefilled syringes. vet gave me a whole bottle on Sat. I haven't given any more. I do have two leftover buprenex prefilled syringes from May 2008, do you think it's possible they are still any good? Or should I give the metacam? I read the study on nsaids which I found unclear. On the one hand I feel like I am holding a bottle of death in my hand, but I think the study was saying most healthy cats "should" be fine. But if they are one to have a reaction, it can be really bad or fatal. then the bottle insert says it's not for cats. But then Sox is in a lot of pain from what Jess says. I will get with the vet as soon as they open but that's Tues. I don't know what to do. I have pred too, maybe I shouldn't worry about his diabetes? or I have subq's for Venture... if I gave some to Sox, does that reduce the metacam risk? Argh.

laur

 

Whenever metacam is being discussed two issues are very important:

1) dosage

2) hydration status

Any NSAID is much more toxic to the kidneys if the body is even in a low level state of dehydration so, to that end, canned food with added water or even SQF are good ideas to implement.

Dosage....I don't use metacam so the dosage is not in my brain....but the folks in Europe and Australia don't seem to have the kidney issues with metacam that we have in the US and the theory is that they use lower doses.

 

PS....I agree with Jess about non-weight bearing lame cats and would also pursue another very close look at the x-rays. Non-fractured limbs will *usually* at least toe touch.

 

Did the metacam help? He's really not putting any weight on it?

 

Gave the prescribed 0.2 ml metacam with extra-wet canned food and 100 mls ringers lactate sub-q. No improvement seen yet. He won't touch the paw to the ground at all. He holds it out in front of him, horizontal to the ground with the wrist bent. I felt along the whole arm again but no significant swelling noted. The foot seems a little tender, maybe a little bit swollen.

I'm planning to have Sox at the vet when they open tomorrow. The vet who owns the clinic, although I've only seen him once, specializes in orthopedic and soft tissue surgery, according to their website.

Thanks so much for trying to help this sweet boy.

laur

 

Update:

Sox saw the orthopedist yesterday and had more xrays. No sign of a break seen. No sign of problem when the shoulder, elbow and wrist were manipulated. The paw looks a little swollen and poor Sox was very patient with the vet, but he snarled and snapped a warning when the vet squeezed the paw more firmly. Since odds are that Sox injured his paw either jumping down or fighting with Danny through the baby gate, he has been put on oral baytril in case there is an undiscovered bite wound. Still giving the 0.2 ml metacam every 48 hours with daily sub-q's and extra wet canned food.

He will very rarely touch the paw to the ground now -- he immediately stops and lifts it again.

So, more waiting and watching. Poor baby. Thanks again to everyone.

laur

 

Aw Laur your cats seem to have cornered the market on weird issues! He hadn't been declawed, right? They can get pretty bad pain from that. I'd vote for a foreign body in the paw based on his symptoms, we'll see what happens with the new meds.

Keep us posted!

 

let's just say, my cats are very considerate about giving me new opportunities to learn. :roll:

Sox is declawed -- done long ago by a previous owner. I did ask if an impact/jump injury was more likely since his poor feet might be unable to absorb shock properly without full toes. The vet examined his toes carefully both in the xray and manually. He said in a newly declawed cat, one wrong move can make the bones push through the skin. A horror to add to the already horrific practice of declawing. There can also be bone problems with the amputation, I think he said bone spurs. But he didn't see any problem like that.

laur

 

totally out of left field here but what about a torn ligament? would they have seen that in an x-ray jess & dr. lisa? i only ask because i recently caught a stray that has been hanging around my house off and on for a bit now and he showed up a couple weeks ago i think it's been, after not seeing him for a week mind you, using only 3 of his legs. he wouldn't bend it at first, then he'd do a little toe touching, to fully lifting it most of the time, and just falling over and laying sometimes. after a couple days i was able to get him confined in my garage wherein he hid from me for several days. after a few more he started coming out of hiding and eventually i got him into a carrier. got him to the vet and turns out he had "complete destruction of the cruciate ligaments" in his right rear leg. unfortunately, after a complete exam, given his whole health picture we decided to let him go peacefully saturday but i do not know though if Dr. A felt the ligament problem or it showed on x-rays, etc....?

also, fwiw, that's how we ended up with Mousie too, a torn or damaged ligament in her front leg. she appeared at work one morning with one front leg spinning to and fro and we assumed it was broken. we trapped her and got her to the vet and they said, if i remember correctly, a torn ligament. so we took her home with us to keep her off of it and she has blessed our lives ever since. ;-) i don't recall if she did toe touching or not as we were told to keep her confined so she would stay off of it and we did until i made the mistake of opening the kennel to see if she would stand on it. i do remember she stood on it long enough to turn and bolt under the bed wherein she lived for the next couple months.

just a thought i suppose

 

Soft tissue injuries such as torn ligaments do not show on x-rays.

 

so perhaps that is something that could be looked into further?

 

I like Jess's suggestion of a foreign body. Gandalf had a very small burr like seed imbedded in his paw once. There was general swelling and he acted like it hurt to walk on it. The vet had to clip some of the hair and finally found what was causing the problem! Some seeds literally work themselves deeper and can irritate the skin horribly. She and I were both surprised that something was in there because you could not feel or see anything! I thought he hurt it jumping around.

 

Hi Cindy

Ligaments in certain areas can be assessed well with a physical exam -- the hind limb cruciate ligament, like your poor stray had, have distinctive signs of rupture, even to the point where you can tell if it's a partial or total tear and get a sense of inflammation. Small ligaments like those that might be between wrist bones, for example, may not have distinctive markers. Small ligaments are also unlikely to cause a complete inability to use the leg, though.

X-rays can't show ligaments but can show some suspicious signs like effusion around an injured joint, or displacement of the bones (not dislocation, but the bones aren't sitting *quite* the way you'd expect if they were held together properly).

Laur how is your little guy doing? Any improvement. ?

 

Sorry for the slow update, but things have been crazy. I examined Sox's feet as carefully as he'd let me, but didn't see or feel anything like a seed or particular sore spot. We had discussed soft tissue injury, such as ligament, with the orthopedist but he said there was no sign of that, but that it wouldn't show on xrays. Exploratory wasn't really an option at that point, since he didn't know where in the paw to look for a problem. So it was a watch/wait situation, with baytril added in case of infection.

Sox has been gradually getting better. He will now use the foot but limps on it. I don't know if it's just time healing it, or if it was the antibiotic. Either way, Sox is finally on the mend. Thanks so much for all the ideas and suggestions.

laur