12/24 Ozy AMPS-291, PMPS-306

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donaleen and Ozy

donaleen and Ozy

Member Since 2013
Previous http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=110504

The vet says I shouldn't give him bupe long term because it will lose it's effectiveness. I've been trying to ease up on it but when he feels bad, I give him some. And then he wakes up and feels good (not crazy, just awake and engaged). Something must hurt him for it to be like that. The vet thinks the pancreatitis just smolders away in there.

For example, yesterday Ozy was very quiet and mostly sleeping . I think he does that when he doesn't feel well. Anyway, as usual, within an hour and a half after the bupe, he was much perkier. I want him to feel good so bupe is okay with me. However, I do wonder WHY he needs it. What hurts?

He is becoming less wary of the injections so that part of the change to Levemir is working. I sure hope it is effective at bringing his numbers down. I always hate it when we lose ground on the numbers and they are definitely higher since the switch, which started at 70% of his Lantus dose. We are at 5 units of Levemir and he was at 6.5 units of Lantus. I hate giving those antibodies the upper hand. I think they have taken on personalities and I imagine them in there laughing at me and I've named them Clydesdales (like the big horses with the big feet).

Anyway, thanks to so many of you who have taken the time to support me in my quest to be a better pancreas substitute. I especially appreciate that many of you are even busier than usual.

We aren't celebrating much this year. We are just in a quieter frame of mind. One of our guilty pleasures has been watching old Seinfeld episodes. I guess when a show is about nothing it is timeless.
 
Re: 12/24 Ozy AMPS-291

I hope the switch to Levimar really helps Ozy :-D I'm so sorry he is in pain, I hate to hear of animals not feeling well :cry: I hope you can find out what is bothering him, sending healing vines for whatever it is.

OT: I liked Seinfeld, and if it's on a rerun will usually watch it :lol: I hope you have a great Christmas Eve :-D
 
Re: 12/24 Ozy AMPS-291

He may have pain from arthritis or from the pancreatitis. Here is an email conversation I had last year with Dr. Lunn regarding pain relief for our kitties. I gave punkin bupe for months. In my opinion, keeping them comfortable outweighs any other concern. As you've said, you'd rather have quality of life for him.

On Mar 1, 2012, at 6:44 PM, Julie wrote:

Hi Dr. Lunn!

I'm wondering if you can suggest a good painkiller for Punkin. I think most of the acromegalic cats use Gabapentin or Tramadol. For some reason, our new vet seems reluctant to try either of those. The vet said Gabapentin is primarily for nerve pain so she didn't think it would be helpful for punkin's acro. She said Tramadol tastes incredibly bad and a lot of cats have trouble with the taste.

We started him on Bupe on Tuesday night and while i think it works to make him more comfortable, someone else (not a vet) raised the concern with me that a narcotic is addictive and he could develop a tolerance to it. She suggested he also could become irritable if we were, for some reason, delayed giving it to him. The way I left things with the vet is that he has a 50 day supply of Bupe, and we are giving .2ml BID during that time. If it doesn't seem like it's working, then the vet and I will talk about trying one of the others.

Someone on the Feline Diabetes.com suggested you might have experience/ideas on pain relief for the acro cats. Do you think using Bupe on him for long-term is a problem?

Thanks for the input!

Julie

From: kathylunn
Subject: Re: Punkin Update? Question on Pain Meds
Date: Fri, 2 Mar 2012 07:46:24 -0500
To: julie

Hi Julie

I think gabapentin is worth a try as the pain in acromegaly could be associated with nerve pain - all pain is transmitted by nerve fibres. Tramadol does taste bad, but there are ways around that such as putting it in a gelatin capsule or having it compounded.

Buprenorphine is a narcotic, but so is tramadol. It is really hard to know if cats get addicted to these drugs, but my feeling is that if they help the pain and keep them comfortable with no side effects, then we should use them. I have not seen tolerance develop.

Often pain is best controlled by a combination approach. That can include gabapentin, amantadine, tramadol or buprenorphine, non-steroidals, fish oil, and Cosequin or Adequan. For pain due to arthritis often the non-steroidals are best as they control the inflammation as well as the pain. However there are not a lot of good choices for cats and they are not a good idea if there is renal disease. I would certainly add on cosequin and fish oil if you are not doing those. Acupuncture can be helpful too.

If buprenorphine is the only thing that works, then I would be comfortable continuing it.

Good luck!

Kathy
Click to expand...
 
Re: 12/24 Ozy AMPS-291

Once again, thanks Julie. That is reassuring. I just hope it keeps working. And I wish I knew WHAT is keeping him from the 5Ps (no preening, purring and playing without bupe). So the bupe is pretty important.
 
Re: 12/24 Ozy AMPS-291

donaleen

I used a low maintenance dose of bupe (0.1ml bid with a 3mg/ml concentration) for Gus's arthritis for 3-4 years. It definitely helped him and I don't think he ever built up a tolerance against it; it seemed to be effective until he crossed. We were very attuned to him and would be able to tell if he was in pain and I do not believe he suffered any pain at any time that he was on the bupe.
 
Re: 12/24 Ozy AMPS-291

most people give it orally - just squirt it in the cheek pocket. it absorbs very quickly, apparently. i was worried that punkin didn't really get it absorbed before it was just swallowed, but i've been told that it really takes only moments to absorb.
 
Re: 12/24 Ozy AMPS-291

I had it compounded into a flavored liquid and gave it in the cheek pouch. Gussie was already getting subq fluids every day and I didn't want to stick him again even though he was a sweetheart.
 
Re: 12/24 Ozy AMPS-291

Thanks Julie and Marje.... I am having it compounded by DiamondBack drugs (in Phoenix I believe) and I squirt it in. He always seems to swallow some of it, which I read is not good. Thanks so much.
 
Re: 12/24 Ozy AMPS-291

It doesn't hurt if he swallows it but it will likely be less effective. They get the most benefit out of it when it is either absorbed by soft tissue in the mouth or injected. BUT....he will get some benefit if he swallows it.
 
Re: 12/24 Ozy AMPS-291

i slid the syringe up under punkin's lip so that i was squirting out onto his gum, under his lip. i'd push out about 1/2 of the dose, then move it to the other side and repeat. he probably swallowed some, but i'm sure he got some good from it.
 
Re: 12/24 Ozy AMPS-291

I'm giving the small daily dose to mine and it's making her feel much better. She even plays some now so it has to be the Bupe.
I don't always get it in the cheek... she often swallows it.

Merry Christmas.
732_christmas_cat_small.gif
 
Thanks, Marje, Julie, and Rhiannon. Ozy isn't fond of having the syringe stuck in his mouth but I will try your technique, Julie. I do try to get in his cheek but I often shoot it all quickly and then he swallows.... still, it does make him feel better.
 
Several years ago, a colleague of mine who works in the area of pain management, noted that MDs are very good at prescribing for acute pain (like post-surgical pain) but are often much less good at prescribing for people who are experiencing chronic pain. I wonder if it's the same with vets. Vets have the additional complication of their patients not being good at describing what hurts, how much it hurts, and exactly where it hurts. To make matter even more difficult, cats are the champions of compartmentalizing their discomfort. If a small dose of a narcotic like bupe makes Ozy more comfortable, it sounds like it's a good option.
 
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