Buprenorphine for pain relief

My cat is 19 and I recently had her at the vets. He prescribed buprenorphine for her dental disease. We are awaiting blood tests to see if she is even healthy enough for a dental cleaning. But since she is so old it is also a risk. I basically just want to keep her comfortable. I have heard buprenorphine is a powerful pain killer and sedative. She won't let me squirt it into her mouth and I can barely get any on her gums since she struggles so much. Can I mix it in food? I have heard this neutralizes the medication but I don't know what else to do. Anyone have experience with this medication? Also is it administered for long term use? Thanks for any info.

Hi there 

l'm not sure about long-term use, but l was given it for one of my cats when he was a kitten for a leg injury. l can attest to the fact that it works! Both as a pain reliever and a sedative - he was pretty out of it while using it.

The instructions l was given was not to "feed" it to him via the syringe, but to put it on his gums between his gums and his cheek and that enough would be absorbed that way. The amount in the syringes was very tiny, but as l say, this stuff worked really well.

The only other time it's been used on one of mine was the 72 hour pain shot given during neutering.

Good luck, vibes for you and your kitty 

It is an opioid and it does work well. I like you have a hard time giving medicine to my cat. When my 18 year old was on it for stomatitis I asked the vet if it has to be on the gums as it instructs and she said no but that it has to be administered in the mouth not on food. I have seen post that say it must be on the gums but when that is not possible, the mouth will work according to my vet. My cat has no scruff so it wasn't easy. Since it was such a small amount I put the tip of the syringe in the corner of her mouth only, and it usually all got in with less stress. My cat was on it for a few weeks while we tried to clear up her gum flare ups. All together it may have been 6 or 8 weeks. I didn't give it to her all the time just when I saw she started to hesitate when I put a plate or bowl in front of her. You may want to clarify the usage with your vet because I don't think it is meant to be a long term medication.

I wonder if you could smear something on the end of the syringe that kitty would like and then slip it between cheek and gum? If you get it into him then your kitty will feel good. It zombies my cat out...like she was high.

You might go back to the vet and see if they can give you the Buprenex in a different form.  When my cat had a couple resorbed teeth removed, the dental specialist gave me Buprenex in a transdermal ear gel form.  That way we weren't dealing with the mouth in trying to give her pain meds.  A different vet gave us Buprenex in shot form to give to my husband's shop cat after he had most of his teeth removed to treat stomatitis. 

Thank you everyone for the replies! Very informative. I'm going to see if the vet can give me something else.

This queston is about buprenophine and kidneys. My cat is a 17-year-old sweetboy who has fairly severe arthritis. He has a genetic condition where his hind legs and rear body are withered, although he has always managed quite well. In addition to anti-inflammation drugs, the vet prescribed buphrenorphine @ 0.12 mg per day for 5 days, then, occasionally, for pain. I kept him on that for 3.5 days, and it gave him good relief; but now I'm worried. Is it true that buprenorphine can be toxic for kidneys, as I've read in drug descriptions online?. My cat has declining kidney function, which is stable, but the kidneys are probably not going to recover.

SweetandTart said:

 
This queston is about buprenophine and kidneys. My cat is a 17-year-old sweetboy who has fairly severe arthritis. He has a genetic condition where his hind legs and rear body are withered, although he has always managed quite well. In addition to anti-inflammation drugs, the vet prescribed buphrenorphine @ 0.12 mg per day for 5 days, then, occasionally, for pain. I kept him on that for 3.5 days, and it gave him good relief; but now I'm worried. Is it true that buprenorphine can be toxic for kidneys, as I've read in drug descriptions online?. My cat has declining kidney function, which is stable, but the kidneys are probably not going to recover.

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What anti-inflammatories did your vet give you?  Some can cause kidney problems in cats with just one or two doses.  I have 2 kitties with pretty severe arthritis.  This is what I am doing for them:  High levels of Fish Oil/Vit E, Microlactin, Hyaluronic Acid, Glucosamine/MSM, Adequan Injections and no grains in their diet.  I have a cat with stage 2 renal failure and give her buprenex on occasion.  It doesn't say anything about kidney problems on the Tanya's Kidney Failure Site: http://www.felinecrf.org/treatments_antibiotics_painkillers.htm#opiates

The amount and days given of the buprenorphine is not a worry at all. I've read where some had their cat on it for months! It's not addictive and is known to not harm the kidney at all. My kitty was on it after major surgery for pain relief. I have no experience with the anti-inflammation drugs so can't advise.

The pain med absorbs through the mucus membranes which is why the vet wants you to squirt it in her gums. If she just swallows/ingests it, it won't work.

thanks for the reply.

There are many sites that report no harm to kidneys. However, there are also sites that report the opposite, that buprenorphine is processed by the kidneys and is not prescribed to cats with kidney disease. For example. petplace.com. I'll be checking with my vet, but I wanted to get a variety of opinions. It might well be that my cat is healthy enough for moderate use of the drug.

SweetandTart said:

thanks for the reply.
There are many sites that report no harm to kidneys. However, there are also sites that report the opposite, that buprenorphine is processed by the kidneys and is not prescribed to cats with kidney disease. For example. petplace.com. I'll be checking with my vet, but I wanted to get a variety of opinions. It might well be that my cat is healthy enough for moderate use of the drug.

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.12 mg is not much at all. Your vet is being really conservative with this drug. My vet had me give 1 mg every 8 hrs which turned my cat into a complete zombie.

SweetandTart said:

 
There are many sites that report no harm to kidneys. However, there are also sites that report the opposite, that buprenorphine is processed by the kidneys and is not prescribed to cats with kidney disease. For example. petplace.com.

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First off, buprenorphine is metabolized (translation: processed and cleared by) the LIVER and, consequently, is one of the safe drugs of choice for cats with kidney disease.

And, as a btw, PetPlace has this to say on that matter:

Since it is metabolized by the liver, buprenorphine should be used with caution in animals with liver disease.

http://www.petplace.com/drug-library/buprenorphine-buprenex/page1.aspx

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Now, PetPlace does also state: "The drug should be avoided in animals with kidney disease, underactive thyroid gland and Addison's disease"....without any explanation. If I were to hazard a guess, it might be that the fact that "bup" does lower blood pressure might....emphasis on might....be behind that statement.

The generally recognized 'bible' of kidney disease**  has the following to say about buprenorphine:

Buprenorphine is cleared by the liver so it tends to be a good choice for CKD cats who need ongoing pain control. However, cats with CKD may eliminate it more slowly, so discuss with your vet whether to lower the dose.

http://www.felinecrf.org/treatments_antibiotics_painkillers.htm#buprenorphine

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** Tanya's Comprehensive Guide to Feline Chronic Kidney Disease (a site that I'd suggest you explore !)

Here's another reliable reference for you:

 Buprenorphine is removed from the body via the liver

http://www.marvistavet.com/html/buprenorphine.html

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Now, about something else you said - which might well be deeply concerning for any cat with kidney disease:

 In addition to anti-inflammation drugs, the vet prescribed bup......

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Exactly what are these "anti-inflammation drugs?

IF they are non-steroidal anti-inflammatories (NSAIDs).........that could be a huge problem for a CKD cat !

Vet is aware of the non-NSAID orders. We are using Cartrophen. Let me know if you know something I'm not aware of, and thanks!

Well, that's a relief!   And, Cartrophen is a completely different class of substance, not even really a drug.

So, I'd urge you to continue with the buprenorphine - or, at least, that's what I'd be doing - so long as he does better with it. And, as for the "small" dose...well, as is mentioned in the Tanya reference, because it's probably excreted more slowly, it works just fine. As well, the less the better - so that he's not overly sedated.

Just one final point for you about kidney disease. There never is recovery with kidney disease (at this point in Vet medicine, although stem cell research is ongoing). It's only going to worsen with time. Kidney cells, unlike liver cells, do not regenerate. The best we can do for now, short of a kidney transplant, is to manage the imbalances which occur and prevent any unnecessary further damage by reducing phosphorous intake and avoiding nephrotoxic drugs (like NSAIDs). There's an excellent 'How Kidneys Work' piece on Tanya's site: Why CKD Cannot Normally Be Detected at an Early Stage

Again, that site could be quite valuable for you (it's recognized by The American Association of Feline Practitioners).

White shadow is 100% correct. I have a cat in end stage crf who is currently in the hospital receiving i.v. Fluids as I type this. He is being given bupenorphrine for his rotting teeth as we speak also. He was getting the bupenorphrine administered at home, as recently as yesterday, before I had him admitted for iv treatment as a last attempt at saving his life. Good luck with everything. Tanya's site has really helped me throughout this process.

diabolik74 said:

White shadow is 100% correct. I have a cat in end stage crf who is currently in the hospital receiving i.v. Fluids as I type this. He is being given bupenorphrine for his rotting teeth as we speak also. He was getting the bupenorphrine administered at home, as recently as yesterday, before I had him admitted for iv treatment as a last attempt at saving his life. Good luck with everything. Tanya's site has really helped me throughout this process.

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Welcome to the forum, diabolik74 (oh my, does that username ever conjure up familiar images !)

NOT to derail the buprenorphine discussion-

I'm glad you found Tanya's site.......it really has been a lifesaver for many kitties,,,,,and their guardians.

You might consider joining up with her online group.....a place where people like yourself and others who are "old hands", long-time experienced caregivers to kidney cats gather and guide each other through the maze that is kidney disease.....they're especially valuable when peoples' individual Vets turn out to be less than experts (which happens most of the time, unfortunately).

Info about her group is here:http://felinecrf.org/tanyas_support_group.htm

The join-up page is here: https://www.bigtent.com/groups/tckd

(you could go in there and just be a fly-on-the-wall for a while...."size up" what's happening and then decide whether/not to participate)

Who knows?........perhaps those teeth could be attended to.......

I hope something there will help !