Wednesday, April 12, 2023

April12/2023

 


What Can You Give a Cat for Pain?
By Jennifer Coates, DVM
Published: 7/27/2022
petmd.com


Treating cat pain isn’t easy. The first hurdle is simply recognizing the signs of a cat in pain, because they’re so good at hiding it. Next, many of the medications we use to treat pain in other species don’t work well or are downright dangerous for cats.

But we can’t let cats suffer. Thankfully, with a little extra attention to detail, it is possible to help your cat feel better. Find out what you can give a cat for pain, & just as importantly, what you can’t.

Are Human Pain Meds Safe for Cats?

Never give your cat a pain medication designed for people unless your veterinarian has told you to do so. Call your veterinarian or Animal Poison Control (1‐888‐426‐4435) immediately if your cat has ingested human pain medication.

Many of the pain relievers we take are extremely dangerous for cats, even in tiny doses. In fact, one regular-strength Tylenol contains enough acetaminophen to kill some cats. Acetaminophen causes extensive damage to a cat’s red blood cells & liver & should never be used to treat cat pain.

Over-the-counter non-steroidal anti-inflammatories (NSAIDs) like Advil (ibuprofen), Aleve (naproxen), & aspirin can also be dangerous for cats. They can lead to gastrointestinal ulcers, liver, & kidney damage, & abnormal blood clotting.

There might be times when a veterinarian prescribes one of these drugs (aspirin for cats at risk for blood clots, for example), but they are only used under very specific circumstances & at extremely low dosages.


What Can You Give a Cat for Pain?

Cats need different forms of pain relief depending on the specifics of their situation. A veterinarian will take into account the type & severity of a cat’s pain & their overall health when coming up with a safe & effective pain treatment plan.

Call your veterinarian or Animal Poison Control (1‐888‐426‐4435) immediately if you’ve accidentally given your cat more cat pain medication than the prescribed dosage.

Here are some of the most common pain relievers for cats:

Prescription Nonsteroidal Anti-Inflammatories for Cats

Unlike over-the-counter NSAIDs, some prescription nonsteroidal anti-inflammatories can be used for pain relief in cats—with caution. Prescription NSAIDS for cats selectively block an enzyme that produces compounds that lead to inflammation & pain, while leaving “housekeeping” compounds alone.

Prescription NSAIDs do a better job than over-the-counter drugs in maintaining blood flow to the kidneys, helping blood clot normally, & protecting the stomach from ulcers.

Onsior (robenacoxib)

Onsior is a prescription drug labeled for short-term (up to 3 days) relief of pain & inflammation after surgery. It is sometimes prescribed off-label over longer periods for chronically painful conditions like osteoarthritis or cancer.

Possible side effects include lethargy, loss of appetite, vomiting, & diarrhea. Gastrointestinal ulceration, liver damage, kidney damage, & problems with bleeding or blood clotting can also be seen, particularly when cats are given too much Onsior.

Metacam (meloxicam)

Metacam & the other brand-name & generic products that contain meloxicam are available by prescription only.

A single dose of injectable Metacam has been approved by the FDA for treating postoperative pain in cats. However, the oral form of the medication is sometimes used off-label over longer periods for chronically painful conditions like osteoarthritis or cancer.

Kidney damage can occur with prolonged use of Metacam, although low dosages have been used safely for many years outside of the United States.

Opioids for Cats

NSAIDs may not provide enough relief for cats who are in moderate to severe pain. When this is the case, or when NSAIDs aren’t a good option for a particular cat, veterinarians often prescribe opioids.

Opioids can be natural (derived from the poppy plant) or synthetic (made in a lab). They bind to & block receptors in the nervous system that play a role in pain sensation. Opioids are controlled substances due to the potential for addiction & abuse in people.

Buprenorphine

Buprenorphine can be used for short-term pain relief—after an injury or surgery, for example—or over longer periods for chronically painful conditions like osteoarthritis or cancer.

Buprenorphine can be given by injection or absorbed through the mucous membranes in the mouth. Buprenorphine is very safe when used appropriately, but it can cause dilated or constricted pupils, euphoria or lethargy, increased body temperature, vomiting, defecation, & slow breathing.

Tramadol

Tramadol is available by prescription only. It can be used for short-term pain relief—after an injury or surgery, for example—or over longer periods for chronically painful conditions like osteoarthritis or cancer.

Tramadol is very bitter, so the tablets often need to be compounded into a liquid using cat-friendly flavors, particularly when given long-term. Tramadol can cause dilated or constricted pupils, lethargy, odd behaviors, an upset stomach, constipation, & seizures.

Duragesic (fentanyl patch)

Prescription fentanyl patches are most often used when cats need several days of relief from moderate to severe pain—such as after surgery or injury.

The patch is applied to shaved skin & removed after the medication wears off, usually 5 days in cats. Fentanyl patches are very safe when used appropriately but can cause dilated or constricted pupils, euphoria or lethargy, increased body temperature, vomiting, defecation, & slow breathing.

Veterinarians can prescribe or use other types of opioids in cats depending on the specifics of the case. Possibilities include butorphanol, morphine, & hydromorphone.

Steroids for Inflammation in Cats

Corticosteroids are potent anti-inflammatories. Reducing inflammation can also decrease discomfort, but steroids like prednisolone, methylprednisolone, and dexamethasone aren’t often used solely for pain relief, especially long-term. This is due to potential side effects, like delayed healing, cartilage degeneration, & the development of diabetes.

Cats who take corticosteroids & nonsteroidal anti-inflammatories at the same time are at increased risk for side effects like gastrointestinal ulceration & kidney damage.

Other Medications for Cats in Pain

Some medications that were originally designed for other uses have also been found to provide pain relief in cats.

Neurontin (gabapentin)

Neurontin & the other products that contain gabapentin are available by prescription only. Gabapentin was originally developed to manage seizures. Now, it’s also used to treat post-operative pain & chronic pain, such as that associated with osteoarthritis, cancer, & nerve injury or disease. Side effects are minimal.

Cerenia (maropitant)

Cerenia is available by prescription only. It was developed to help control vomiting, but it can also relieve pain, often in combination with anesthetics or other pain relievers.

Side effects can include fever, dehydration, lethargy, poor appetite, blood in the urine, and drooling. Cerenia injections can be painful, so the oral form is preferred for long-term use.

Amantadine

Amantadine was created as an antiviral medication. Now it can be used in combination with other medications to treat chronic pain associated with osteoarthritis, cancer, & nerve injury or disease. Side effects can include gastrointestinal upset & unsteady movements.

Amitriptyline

Amitriptyline is a prescription antidepressant that’s sometimes used to treat chronic pain, particularly that associated with nerve injury or disease.

Side effects can include lethargy, gastrointestinal upset, constipation, increased heart rate, abnormal heart rhythms, difficulty urinating, & decreased production of saliva & tears.

Joint Supplements for Pain in Cats

The most common cause of chronic pain in cats is osteoarthritis. The best way to manage arthritis in cats is through multi-modal therapy, meaning that several types of treatment are combined to get a greater effect. Joint supplements can be safely given with pain relievers & many other forms of arthritis treatment.

Here are some common joint supplements for cats:

Glucosamine & Chondroitin

Joint supplements containing glucosamine & chondroitin are widely available without a prescription. They appear to work best when used together. Glucosamine & chondroitin limit joint cartilage breakdown, help with joint cartilage repair, increase the amount & quality of joint fluid, & decrease inflammation & pain.

Adequan (polysulfated glycosaminoglycans)

Adequan & other products containing polysulfated glycosaminoglycans are available by prescription only. They are given by injection & work in a manner similar to glucosamine & chondroitin, but seem to be more effective in some cats.

Omega-3 Fatty Acids

Nutritional supplements containing omega-3 fatty acids are widely available over the counter. Omega-3 fatty acids are thought to be beneficial in cats with osteoarthritis because they help prevent & resolve inflammation & reduce the activity of enzymes that break down cartilage.

Joint protectants often contain multiple ingredients. Other supplements that have at least some evidence behind their use include:

Turmeric

Duralactin (microlactin)

Manganese ascorbate

Avocado/soybean unsaponifiables (ASU)

Green-lipped mussels

Hyaluronic acid

How to Comfort a Cat in Pain

Sometimes the best medicine for cat pain isn’t a medicine at all. Depending on a cat’s situation, some combination of the following can be beneficial:

Weight loss limits stress on the body & reduces inflammatory hormones produced by fatty tissue.

Reorganizing your home is also important. Design the cat’s living space to make getting around as easy as possible. Keep food, water, heated beds, & low-sided litter boxes all on one level of your home & use ramps to allow cats to get to their favorite perches.

Acupuncture stimulates nerves & blood circulation, releases natural pain-killing endorphins, & relieves muscle spasms.

Therapeutic laser treatment reduces inflammation & pain & promotes healing.

Physical rehabilitation helps keep muscles & joints strong & improves coordination.

New therapies such as stem cell treatments, platelet-rich plasma, nerve growth factor inhibitors, & cannabidiol (CBD) are being investigated.

And of course, spread the love & attention! Include your cat in daily activities that they can engage in comfortably.

Talk to your veterinarian if you think your cat is in pain. After diagnosing what’s wrong, they can put together the best treatment plan based on your cat’s specific needs.

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