Buprenorphine/Buprenex SR side effects

My 5 year old cat has been seen a couple of times in the past month for GI issues, which may be food-related or might be IBD (I'm actually not clear if there is a meaningful difference, but that's a whole other question).  Both times, the vet has given her Cerenia and Buprenorphine SR injections, and both times she has been super agitated for days after - not sleeping at all, chasing after me every time I move, rolling around and getting up and down repeatedly like she just can't sit still, and purring constantly, but not necessarily in a good way.  She is normally a pretty sedate cat, so this is definitely not typical behavior. I told my vet about it in detail immediately after the behavior started the first time, but he didn't seem too concerned, and he obviously decided to give it to her again.  

I'm wondering if anyone out there has experienced similar side effects in their kitties with Buprenex or Cerenia?  From what I've read online, Buprenex sounds like the more likely culprit, although the most common side effects are just the opposite - sedation, sleepiness, etc.  It's really disturbing to see her act like this for such an extended period of time, and it's hard not to be concerned that this medicine is doing something harmful to her.

My Alex was on Buprenex and it made her more sedate. I've not seen that reaction but anything is possible. I think you need to be more stern with your vet and tell him that you don't like this reaction at all! Did you happen to look up the reactions and side effects for Cerenia? Btw, I run a website for kitties with IBD and yes, there is a difference between food related problems and IBD. 

Hi finnlacey, thanks for the response and for your great website - I have spent some quality time there already!  To be clear, I didn't know that she was getting the Buprenex shot until it was already done, or I certainly would have asked more questions.  But in preparation for the next time this comes up (hopefully it won't, but that seems unrealistic based on my experience in the past month) I'm just wondering if many others have seen the same thing with Buprenex and what they have been told about it.  I'm pretty overwhelmed right now with all these issues and each new thing that comes up makes it harder to cope with.  Thanks again for taking the time to respond.    

Oh I know, this is a horrible disease and just when you think things are getting better, something else happens. I am again dealing with it with my sister's cat and it's just as hard. Even knowing the things I know. I wish I could help, maybe someone else will post soon with some other experiences. For Alex as I said it was sedating but that doesn't mean that your kitty didn't react badly to it. They're all different for sure. It's too bad because Buprenex is a better and safer pain med then some other ones. 

I have heard of the agitation response from buprenex, at least twice I have read about it, in this forum, and have seen it mentioned elsewhere also. (I have used it many times with my cats with no trouble, but the agitation IS a real response)

I would think buprenex, which can cause constipation, would not be a good drug for a cat with IBD?

It's like any other drug. It has some benefits and some side effects. It's one of the safest drugs for kitties with IBD. It gave my Alex much pain relief when she had her pancreatitis. I'm thankful for it. But I do understand it can cause side effects. Everything does. I would though choose it again over Metacam. 

OH yes, me too. NO metacam, ever. I love buprenex for pain relief for cats. It's easy to give, it's fast acting, and so effective. I just wondered how, if, it would adversely affect a cat with IBD. Glad to know mostly it doesn't.

But it does sound like this kitty will need something else, that agitation can't be a good thing. Torbugesic would be my second choice, I think. Or maybe tramadol?

That's an idea! Tramadol. And I don't know about giving injections for pain meds anymore. I'd ask for transdermals or liquids if you can. Injections last too long and then you have to wait it out when there's a reaction. 

Agree with you about injections too. Orally, transdermal, or patch, so much safer. It can be stopped, if there is a bad reaction.

finnlacey does your site address carrageenan? Cats with IBD should not have foods with this ingredient. I have two cats who cannot tolerate carrageenan. One who always seemed "fine" with it. Recently I have taken her off all foods with carrageenan too, and now that it's been a few weeks, the difference in her overall demeanor is phenomenal. In addition she is no longer having trouble with her anal glads.

A bit off topic for this thread I know, but I thought the OP might benefit from this information, carrageenan causes inflammation in the intestinal tract:

http://truthaboutpetfood2.com/carrageenan-just-dont-do-it

Yes it does, just not as extensively as your link but I think I've provided a couple of links for studies saying just that. 

Thanks everyone for the thoughts and ideas!  Just as a followup, I spoke with my vet, and it was a mistake by a tech that resulted in her being given Buprenex at all.  They have now put notes all over her chart that she reacts poorly to it as an extra precaution to prevent this sort of mistake from happening again.  We're now almost exactly 4 days out from the injection, and she's finally starting to settle down this evening (it's supposed to last 3 days, but with her slow metabolism I'm guessing it just takes longer to flush out than with most cats).

In terms of the IBD, I started her on a different food, and she's more or less inhaling it at every meal and hasn't vomited for a week and a half.  She has also already gained back some of the weight she lost while she wasn't interested in eating with the old food.  I know how quickly that all can change, but I'm hoping beyond hope that her problems can be narrowed down to a food allergy or intolerance and nothing more serious than that.  

Thanks again to everyone.  

I had just sent out a link to people about pharmacies mixing up pet's medications. I wonder what med she was supposed to get instead?

Mistakes With Pet Prescriptions Can Prove Deadly

http://newyork.cbslocal.com/2012/12/11/mistakes-with-pet-prescriptions-can-be-deadly/

I'm so glad to hear she's eating again and gaining some weight back, that's terrific! 

Hello,

Yesterday I gave my pancreatitis kitty an oral injection of buprenorphine, and she did not sleep a wink from 8am to 10pm when I went to bed.  As you know, this is abnormal for an ailing & elderly kitty.  Today I gave her no injection and she is sleeping some.   She looked pretty unhappy too yesterday and seemed not quite herself, like she wasn't there....so that must have been the strong drug effect.  Today she seems much more herself.  And yes, she was restless and jumpy too.  So I guess I don't want to give her buprenorphine unless strong evidence it is needed.  I'll talk to the vet about it.

My cat also takes predisone daily and an antibiotic and anti-emetic.

I know that some human beings have paradoxical reactions to meds, where they get just the opposite effect.  I guess that can happen to kitties too.

bluesmom said:

Hello,

Yesterday I gave my pancreatitis kitty an oral injection of buprenorphine, and she did not sleep a wink from 8am to 10pm when I went to bed.  As you know, this is abnormal for an ailing & elderly kitty.  Today I gave her no injection and she is sleeping some.   She looked pretty unhappy too yesterday and seemed not quite herself, like she wasn't there....so that must have been the strong drug effect.  Today she seems much more herself.  And yes, she was restless and jumpy too.  So I guess I don't want to give her buprenorphine unless strong evidence it is needed.  I'll talk to the vet about it.

My cat also takes predisone daily and an antibiotic and anti-emetic.

I know that some human beings have paradoxical reactions to meds, where they get just the opposite effect.  I guess that can happen to kitties too.

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I would also talk to your vet about adjusting the dosage of the buprenorphine. Most vets prescribe way too high a dose.

Good advice, Vball.  I will do that.

Buprenex is an opiate, so it is an extremely strong pain killer. In fact, it is more powerful than morphine! You should ask your vet about dosage, my cat only received 1 mm per 12 hours, taken orally. But she was still acting strange, she is completely unlike herself. She has become skittish and has developed a habit of growling. 

I believe my cat developed Serotonin syndrome from his pain medications.  You might want to look that up and see what you think about the symptoms.  Im pretty darn sure thats what happened in Smiths case, but when I called the vet, she pooh poohed it and said it was perfectly normal.   I dont think so.  He has been on pain meds for a while now, and slowly these symptoms have been creeping in, and I interpreted them as breakthrough pain, so, his vet was dosing him higher and the weird distressed behavior just kept getting worse. 

I have him on nothing to day, and he acts less in pain on NO pain meds than he did on the best stuff around.  Which makes me pretty darn certain he was having a bad reaction to the meds. 

Both of my elderly cats with kidney disease were recently given one dose of 3MG/ML buprenorphine for pain (unrelated to kidney disease) and both had the same adverse reaction of  NO sleep, dilated pupils for 3 days.  One meowed all night the first night.  Just wanted to share my experience...

PMFan said:

Both of my elderly cats with kidney disease were recently given one dose of 3MG/ML buprenorphine for pain (unrelated to kidney disease) and both had the same adverse reaction of  NO sleep, dilated pupils for 3 days.  One meowed all night the first night.  Just wanted to share my experience...

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Hopefully you mean .3 (point three) but even that is a very high dose. .1 (point one) ml is the normal dose for a cat. No wonder your cats were so affected.