Alternative Pain Medication?

Our old cat Bogey, 21 yo has severe arthritis. His current regiment is monthly Adequan injection, 1/4 baby aspirin every 3 days and 1/4 tablet Torbutrol every night. His pain is managed succesfully on this.

When I called the vet to ask them for a refill on the Torbutrol they informed me that the manufacture has a back order on this medicine and until they start production again they can't get it. They want to put him back on Buprenephrine. Which I don't want to do. The last time he was on it he became very hateful and was in a bad mood almost every day. I don't know if it just didn't help his pain enough or it just didn't sit well with him but he was not a happy kitty on it. He's an old guy, I don't want him to be in a bad mood, he's such a sweet and loving kitty I hate seeing the personality change.

That said, I don't know of any alternatives to keep his level of pain under control. Has anyone had good results with another pain med that we could try? I know Nebula had a similar thread so I'm going to see if I can find it as well.

I don't want the lack of ability to control his pain the reason we have to let him go.

Did you discuss this with the vet?  Not controlling his pain strikes me as a quite likely explaination.

My vet normally doesn't stock Torbitrol, but will give me a prescription to take to a pharmacy. They don't have to wait for the manufacturer to ship it to them. You may need to cut up the tablets, but you can get it filled.

OS - yes, my vet and I discussed it and that's why we switched to the Torbutrol. I haven't spoken to the vets office since they left me the message about the Buprenephrine. By the time I heard the message, they were already closed. I'll have to call them tomorrow to discuss in more detail.

Momofmany- I don't know why I didn't think of my pharmacy. We get his thyroid medicine there. I'll check with them today....great call out.

Thanks for the suggestions.

Called the pharmacy and they can't get the medicine either.  I will talk to the vet tomorrow and see what alternatives we have. I just can't believe there are only two pain killers this strength. 

Updating in case anyone finds this while looking for help.

Spoke to the vet and I just don't want to put him back on the Buprenephrine.....he is a sweet, loving kitty and his personality changed so dramatically on it that it just isn't how I want him to live out his final time.

So, we decided to increase his Adequan to twice a month (can go to weekly if needed) and increase his aspirin from 1/4 tablet every 3 days to 1/2 tablet every 3 days. I don't know how this will do but I'm hoping it provides the level of pain control he needs. If not, we'll go to weekly injections. And I will also get a few syringes of the Buprenephrine, just in case he needs it for quick control.

We are heading to the vet tomorrow for the shot, blood draw for thyroid medicine check and weight check.

that this will work for your guy.  Isn't this just a bandaid until the Torbutrol is back in stock?

Thank you mrsgreenjeans. We need all the vibes we can get. Unfortunately, it appears the manufacture may have discontinued Torbutrol altogether. There are mixed reports on it.

We just got back from the vet and as usual, Bogey got super-stressed, pooing and puking on the way there and on the way back which means he gets a bath on both ends of the trip. He is beside himself trying to calm down now. But, I'm sitting in his favorite chair with a blanket cuddled up around him and he seems to be relaxing finally.

Had his blood drawn to check his T4 again. This is the 4th month in a row. Can't get his thyroid levels managed. He's either too high or too low, we just can't seem to get him consistent. I told the nurse that with 4 months of data, plus all the other data from the previous adjustments that we need to determine a happy medium and go with it. The blood draws are just too much for him. Even if we move it to once a quarter or as needed, I mean, we waste no time in getting the kitties to the vet when they need to go, it's not like we just wouldn't bring him in. She said she understood and would call me later tonight once the results are in. I'm thinking he needs to go back to 7.5 mg/day...the new dose of 5 doesn't seem to be as effective. And he lost 4 oz this month, even though he's been eating really well. He actually gained 3 oz the month he was on 7.5. So, that is what's am going to push for, we'll see.

As for the pain management. We did an Adequan injection and I asked if it was something they could teach me to give as we are going to twice a month and trip to the vet is so stressful for him. They aren't comfortable teaching me the intramuscular shot but as I give sub-q fluids at home, the Adequan can be administered that way and they are fine with me doing it. So, next Adequan admin I am going to administer sub-q at the vets office and if all goes well, I'll start doing that at home. The only downside is that the injection begins working within 3-4 hours where the sub-q takes 24 hours. But, I can give a Buprenephrine treatment at the same time and that should bridge the gap.

Poor fella. I'm really worried for him. I've had too many cats not to understand what is going on. It feels like we are in the 'do anything and everything stages' that you progress through as you get to the end. Sometimes those stages take a year, sometimes months, sometimes weeks and you can only look back when it's over to know exactly where you are....does that even make sense?

It's been two weeks on the new medicines/doses and we are noticing slight changes in Bogey's behavior. He won't leave the back room and while he isn't hiding, he is sleeping on the same spot all day, every day. He's over grooming too. We brush him multiple times a week but he is CONSTANTLY bathing himself. He's begun crying out as well. He's dropped another 3 oz, which makes a total of 8oz since February 9.

Went to the vet yesterday to make sure I could administer the sub-q Adequin and tht went fine. We also did some fluids to try to increase his appetite.

So, it appears as though we are seeing some pain but not as much as I would have thought. Still keeping our eyes on him.

RAFM said:

It's been two weeks on the new medicines/doses and we are noticing slight changes in Bogey's behavior. He won't leave the back room and while he isn't hiding, he is sleeping on the same spot all day, every day. He's over grooming too. We brush him multiple times a week but he is CONSTANTLY bathing himself. He's begun crying out as well. He's dropped another 3 oz, which makes a total of 8oz since February 9.
Went to the vet yesterday to make sure I could administer the sub-q Adequin and tht went fine. We also did some fluids to try to increase his appetite.
So, it appears as though we are seeing some pain but not as much as I would have thought. Still keeping our eyes on him.

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I don't have anything helpful to add but just wanted to give you a huge huge hug. I hope your little guy gets feeling better soon so that you can enjoy whatever time you have left together. Prayers and vibes!

Called the vet today as Bogey is in a significant amount of pain. DH went to pick him up and Bogey bit him, twice. They were just warning bites and DH immediately disengaged but still, this is very out of character for Bogey. He's crying loudly, a lot. DH has some very comfy cat beds on his desk and normally Bogey lays in there with him all day while he works. Since he's been hanging out in the back and we wanted to keep an eye on him today, DH closed the door to the backroom to try to keep him out. He said Bogey sat at the door and screamed until he let him back in.

I went back home at lunch and gave more Buprenephrine. DH reports that Bogey has thrown up, has diarrhea and won't eat.

I have a call in to the vet. Gabapentin has been shown effective in pain control, however, it is very new as a pain killer in cats. Our vet does not want to prescribe it as she doesn't like to try experimental treatments. I have a call in to discuss it with her....he's 21 and without effective pain control he doesn't have much more time with us. I'm willing to try anything to get a little more time.

Oh no! I don't know how I missed this thread!

Have you called around to all the pharmacies within whatever-distance drive you're willing to make? Maybe there's one (or several) out there that still have Torbutrol in stock. If so, there is no reason the vet can't call in multiple prescriptions, and you stock up on as much as you possibly can! :cross:

you can either find Torbutrol or a solution that works!

Thanks Lorindaleigh and LDG. Spoke to the vet this afternoon and she will prescribe the gabapentin but wants us to understand that the studies of this are very new and has not been labeled for use in cats....which means there is no list of possible side effects so we won't know exactly what to look for. But, she understands what we are trying to do. If we lose him without trying it will be much sooner rather than later....if we lose him in the same amount time due to a side effect, at least we tried. And if it helps and we get more time then the risks are worth it.

Are we crazy?

I don't think so. In fact, I think one of my vets uses gabapentin in cats. We're stopping by there tomorrow to make a payment and schedule some dentals, so I'll ask. :nod: If it isn't at that vet practice, I'll just call the other two. Our holistic vet called to check in on Lazlo today anyway (we weren't here), so I have to call her back anyway. :nod:

But in the meantime, I'd sit on the phone calling pharmacies!

You are so sweet Laurie! Believe me, we've called. The last refill we got was for four months and they stopped making it at about the same time so every pharmacy around had 4 months to work through their supply before we knew. I've called and called. We get our Rx through Target and even they couldn't find it in their network.

If you remember to ask I would really appreciate it. The more I know the more comfortable I'll feel.

I'm so sorry you are going through this.

At this point, I'd try Chinese medicine, including acupuncture.  There are vets who practice acupuncture, and acupuncturist who have taken special courses to treat animals.  Given the circumstances, most acupuncturists would agree to come to your house.

Ritz said:

I'm so sorry you are going through this.
At this point, I'd try Chinese medicine, including acupuncture.  There are vets who practice acupuncture, and acupuncturist who have taken special courses to treat animals.  Given the circumstances, most acupuncturists would agree to come to your house.

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I cannot believe I didn't think of this myself. If you can find one that practices, this could be a SERIOUS help!!!!!!!!!!!!!!!!! Arthritis pain is one of the things that Acupuncture has a great history of treating really well. Our holistic vet is trained in Chinese Medicine and acupuncture, and we've discussed this. I would see if you can find someone!!!!! http://www.ahvma.org

Thanks for the acupuncture recommendation, I just placed a call to a local vet that does it and they will be calling me back. I'll keep you guys posted.