Arthritis Pain Management Options?

Hello All, 

My 12 year old female cat will be getting a visit from the vet on Monday to start the process of pain management for Arthritis and Stiffness. I was wondering if anyone had any advice or suggestions I could ask my vet or if you have knowledge of the pros/cons of some treatments? 

I always prefer to go holistic where I can but I think she and I have hit a wall with home remedies - she's currently on Cosequin, one pill twice a day and has been on it for years, it has little effect anymore. I also ordered Green-Lipped Mussel Powder from Hare Today but she doesn't like it and 1 tsp of that powder per meal is a HUGE amount, especially if it's only supposed to be used as a topper, I mixed it in her food and she was still hesitant. I didn't see any difference with the GLMP but obviously because she wasn't getting the full amount. I still have the majority of the bag but I essentially gave up on it. 

Her diet is all raw food, chicken for breakfast, rabbit for dinner and I use the recipe from Feline Nutrition. 

I'm concerned with constipation as well, she was given Buprenorphine (.1ml) and a day or so later she had trouble passing a stool, basically it didn't come out all the way and it was larger around than normal, I gave her some Miralax. Should she be on Miralax if she gets put on pain medication? She has never had issues with urine or stool so the Buprenorphine is most likely the culprit. 

Lastly, the vet I'm seeing is not Holistic so I'm not counting on anything other than prescribed medication when we see him. 

Thank you! 

I know Metacam has a bad reputation for kitties, I used to be in the no Metacam camp myself.  It can with precautions be given to kitties  I would want to make sure that the vet knew everything about safe dosages and monitoring kidney function though.  Metacam is used in Europe but it is just beginning to be used safely here in the U.S.  It really is all about a safe dosage.

alexiso said:

 
Hello All, 
 
Thank you! 

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Tramadol is well tolerated in cats and is probably better for long term use the Buprenorphine which is a strong opiate.  Holistic medicine is great when it works, but pain relief is important regardless of what gives it.

you could try warm compresses to the affected joints and add SAM-e to her supplements, and maybe MSM. 

Denice said:

 
I know Metacam has a bad reputation for kitties, I used to be in the no Metacam camp myself.  It can with precautions be given to kitties  I would want to make sure that the vet knew everything about safe dosages and monitoring kidney function though.  Metacam is used in Europe but it is just beginning to be used safely here in the U.S.  It really is all about a safe dosage.

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Thanks! I'll check it out. I'm compiling a list of questions. She's never had kidney issues before, she's a pretty hearty cat - she just has the arthritis issues. 

StephenQ said:

 
Tramadol is well tolerated in cats and is probably better for long term use the Buprenorphine which is a strong opiate.  Holistic medicine is great when it works, but pain relief is important regardless of what gives it.

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I read a little bit about Tramadol, is that something you have to administer with another medication?

 opioid pain medicine tends to be constipating -- buprenorphine, tramadol, etc. 

detmut said:

 
you could try warm compresses to the affected joints and add SAM-e to her supplements, and maybe MSM. 

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Thanks! We have a heating pad I've been utilizing and she seems comforted by it but she doesn't seem to want to use it consistently. I'll check out those Supplements, I've never heard of them. 

detmut said:

 
 opioid pain medicine tends to be constipating -- buprenorphine, tramadol, etc. 

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Would you think she needs to be on some sort of non-constipating supplement/medicine if she is prescribed the opioids? I could tell the Buprenorphine was the issue when it came to her hard stool that wouldn't come out all the way because she's never had any issues going to the bathroom in her 12 years on earth prior to that. Like Miralax or other stool softener? I have Psyllium Husk powder but I'm getting mixed information on whether or not that softens or hardens stool. I used the Psyllium Husk when I first put my cats on Raw but it was making one of the cats have bloody hard stool so I stopped the PHP and haven't had issues since. All three cats are fine without the Psyllium. 

you may need something with the narcotic pain meds -- Miralax, Lactulose, Colace. 

that would be one advantage of using Metacam -- it's non-constipating plus it's anti-inflammatory. but you have to balance the risks and benefits. 

alexiso said:

 
I read a little bit about Tramadol, is that something you have to administer with another medication?

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Tramadol is fine on its own unless there is some constipation, then you would want to add some sort of laxative.  I would just suggest that pain is worse than constipation.

StephenQ said:

 
Tramadol is fine on its own unless there is some constipation, then you would want to add some sort of laxative.  I would just suggest that pain is worse than constipation.

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Cool. Now that you mention it, last time we saw the vet he did mention Tramadol but we didn't go into detail. 

alexiso said:

 
Cool. Now that you mention it, last time we saw the vet he did mention Tramadol but we didn't go into detail. 

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Tramadol is one of the better options for arthritis pain in cats.  Pain relief in creatures with limited lifespans and no decision making ability is primary, everything else is secondary.  In nature, they would have died of other causes before getting arthritis, but since we can keep them alive longer through domestication, we owe them the flip side to that, relief due to living longer at our hands.  

Philosophical of me i Know but there it is....