Pain Medications

I was hoping for some help. I have a cat with a rare bone disease. (Most commonly known as brittle bone disease) He has many fractures that dont heal and lately his pain medicatin isn't working. He is currently on Metcam and tramadol. He has been on torbutrol (doesn't work for him). And Fentanyl patches (They make him very out of it and I am afriad he will fall and have another fracture) I don't know what to do for him anymore. He is such a fighter and he doesn't even cry. I know his is uncomfortable because he has started pulling his hair out around the known fracture sites. Also if he has been walking for more then 10 minutes, you can tell by HOW he is walking that it's bothering him. But he just won't give up. He still eats like a horse and purrs like a mad man when you even look at him. I was just hoping someone had a suggestion for some kind of pain medication that could help him until he finally stops fighting. I dont want to give up on him because he hasn't given up on himself. PLEASE HELP

I didn't know that cats could get brittle bone disease. How sad and I'm so happy he has such a concerned and thoughtful owner. Purring happens for many reasons, one of which is pain. If you don't feel he is ready to go quite yet there are other meds to try. However, if they don't work you are faced with a sad decision. How old is he, by the way?

What dose of fentanyl patch was he on? I would recommend the 12mg patch. fentanyl is very potent and very fast acting and too high of a dose may have overwhelmed him (especially if he was opioid naive at the time)

Perhaps he is becoming opioid tolerant on the tramadol. Has the vet considered upping his dose?
other options:

Here are some opioids that you could try:
buprenorphine (has mixed agonist/antagonist action so respiratory depression difficult to reverse)
butorphanol
codeine
hydromorphone

I didn't add doses because I think you just wanted some options. The vet would also be able to deal with doses. Hope this helped!

Thanks so much.
Neville is only 2 1/2 years old. He has three fractured legs. One of his legs are pinned but the pins are slowly moving because the bone isn't healing as well as it should. We didn't even know he had fractured the one leg until we x rayed him to check the density in the front legs to see if they where as bad as the back ones.
He's such a tough little cat and I dont want to give up on him while he's still fighting to be normal. (yes he thinks he's a normal cat) It would be an easy decision if he was crying and not walking from the pain. But how can I give up on him when he wont give up on himself.
Once again thank you so much for the info. Neville and I appreciate it very much and will be talking with the vet today.