Is Ketamine supposed to block pain?

[WinterTeaandCats]

Hello,

I apologize for this second post.
I went to the vet yesterday, and the experience was quite upsetting and I am considering looking for a different vet, but... I may be overreacting, because... my cat is my baby, so I am trying to be sensible.
We arrived on time, I dropped my cat and went to wait for the phone call in the parking (covid....). After 1.5 hour without a call from them (I checked in after 30 min and they said to just wait), I went back. They had not been able to examine him, as he was scared and aggressive. They suggested I hold him to see if it would help. It did not (or not enough), so they suggested sedation. I asked about risks but did not get a reply, so they injected him with ketamine. He started throwing up.
When he got more woozy, they started examining him. He was not yet fully asleep (he was still standing, though very weakly; later on, at the end, he was fully... asleep and not reacting to stuff at all). They started pressing his bladder to get everything out, which apparently caused some blood to get in the urine, and then gave him an enema (constipation was the probable issue). It lasted several minutes, and the entire time, he was howling, in what I supposed to be pain. I had to leave the room (no use for me to have a meltdown in the middle of everything and distract them), and I could still hear him yowling from the other room.

I know I can be oversensitive, so... are you able to tell me if that's normal or if I should be concerned?

 

[LTS3]

Ketamine is typically used as an anesthetic, often in combination with another drug. It doesn't really block pain. If given at the proper dosage, ketamine knocks a cat out in about 10 minutes with the effect lasting about half an hour. I would question the vet's use of ketamine as a form of sedation.

If you're not comfortable with this vet, find a new one. Some cats may need a sedative prior to vet appointments. A vet can prescribe one for your cat. Gabapetin is a common one and is given about 2 hours before an appointment so it has time to work.

Many cats yowl and such while being examined by strange people. It's not always a sign of pain. Vocalization can be an adverse reaction from the ketamine.

 

[Meowmee]

Hello,

I apologize for this second post.
I went to the vet yesterday, and the experience was quite upsetting and I am considering looking for a different vet, but... I may be overreacting, because... my cat is my baby, so I am trying to be sensible.
We arrived on time, I dropped my cat and went to wait for the phone call in the parking (covid....). After 1.5 hour without a call from them (I checked in after 30 min and they said to just wait), I went back. They had not been able to examine him, as he was scared and aggressive. They suggested I hold him to see if it would help. It did not (or not enough), so they suggested sedation. I asked about risks but did not get a reply, so they injected him with ketamine. He started throwing up.
When he got more woozy, they started examining him. He was not yet fully asleep (he was still standing, though very weakly; later on, at the end, he was fully... asleep and not reacting to stuff at all). They started pressing his bladder to get everything out, which apparently caused some blood to get in the urine, and then gave him an enema (constipation was the probable issue). It lasted several minutes, and the entire time, he was howling, in what I supposed to be pain. I had to leave the room (no use for me to have a meltdown in the middle of everything and distract them), and I could still hear him yowling from the other room.

I know I can be oversensitive, so... are you able to tell me if that's normal or if I should be concerned?

I am not sure. Has he always had to be sedated at the dvm for an exam? He could have been in pain but maybe not. It could also be the stress and or the ketamine. There was one dvm, a cat only doc, where I took Syb for a while and she went berserk there which she had never done before. They were trying to get a urine sample from her bladder with a syringe and she was screeching. They asked me to come to try to calm her but when I saw the situation I told them to just forget it because she was too upset. They had her laying on her back with all of them holding her down etc. They wanted me to bring her back for sedation etc. But I opted to just go back to our other im dvm instead where she had never had issues. I had brought her to cat only because I thought it would be less stressful without the dogs etc. But I think the cats that lived there who were very sweet and who roamed the place were part of the issue for her.

I am not sure what sedatives are usually used for an exam but ketamine seems a bit heavy duty.

 

[WinterTeaandCats]

Ketamine is typically used as an anesthetic, often in combination with another drug. It doesn't really block pain. If given at the proper dosage, ketamine knocks a cat out in about 10 minutes with the effect lasting about half an hour. I would question the vet's use of ketamine as a form of sedation.

If you're not comfortable with this vet, find a new one. Some cats may need a sedative prior to vet appointments. A vet can prescribe one for your cat. Gabapetin is a common one and is given about 2 hours before an appointment so it has time to work.

Many cats yowl and such while being examined by strange people. It's not always a sign of pain. Vocalization can be an adverse reaction from the ketamine.

Thank you for your reply. It reassures me a bit to think he was not necessarily in pain (he does not seem to be now, but... he is a cat, so who knows). I have used Gabapentin in the past, before long plane trips and it was helpful, so maybe that could be an option in the future.
I think I will probably try to look for a different vet, I am glad to hear my cat may not have been in pain, but... same, I wish we had actually discussed options for sedation, whether to come back on a different day, or anything a bit less intense. Or discussed what to do in the future to make sure that such degree of constipation does not happen again.

I am not sure. Has he always had to be sedated at the dvm for an exam? He could have been in pain but maybe not. It could also be the stress and or the ketamine. There was one dvm, a cat only doc, where I took Syb for a while and she went berserk there which she had never done before. They were trying to get a urine sample from her bladder with a syringe and she was screeching. They asked me to come to try to calm her but when I saw the situation I told them to just forget it because she was too upset. They had her laying on her back with all of them holding her down etc. They wanted me to bring her back for sedation etc. But I opted to just go back to our other im dvm instead where she had never issues. I had brought her to cat only because I thought it would be less stressful without the dogs etc. But I think the cats that lived there who were very sweet and who roamed the place were part of the issue for her.

I am not sure what sedatives are usually used for an exam but ketamine seems a bit heavy duty.

Thanks for taking the time to reply.
No, it has not always been the case that he needed to be sedated. For his first 5 years, we went to a vet (female), and while he was not necessarily super fond of her and may have hissed once or twice, she was always able to examine him. Then one year ago, I moved and he had an emergency (due to the same-ish issue... probably), so I brought him to the current vet. They did not sedate him the first time, though they did later on, but they had to put a muzzle (covering mouth and eyes) on him, which made him more terrified (even in his carrier he is less anxious when he can see what is happening around him). He had to stay there for several days (coming back home at night as they did not have overnight staff due to covid), and he is significantly more anxious/jumpy, especially around strangers since then. I am kinda upset at myself for bringing him back there (after trying 3 other vets who did not have appointments available for weeks). They did cure him the first time, and they had an appointment available relatively rapidly.
I guess it may be for the best if I look for someone else, even if just to avoid the negative associations he has with this doctor, and I think he may do better with a woman. I would also feel better with someone who takes the time to discuss his health, issues, and possible solutions, rather than just telling me "so do you want to do this or that", without telling me any of the possible consequences of either options and then just sending me on my way with a prescription.

Thank you for taking the time to share your thoughts and experiences.

 

[Meowmee]

Thank you for your reply. It reassures me a bit to think he was not necessarily in pain (he does not seem to be now, but... he is a cat, so who knows). I have used Gabapentin in the past, before long plane trips and it was helpful, so maybe that could be an option in the future.
I think I will probably try to look for a different vet, I am glad to hear my cat may not have been in pain, but... same, I wish we had actually discussed options for sedation, whether to come back on a different day, or anything a bit less intense. Or discussed what to do in the future to make sure that such degree of constipation does not happen again.


Thanks for taking the time to reply.
No, it has not always been the case that he needed to be sedated. For his first 5 years, we went to a vet (female), and while he was not necessarily super fond of her and may have hissed once or twice, she was always able to examine him. Then one year ago, I moved and he had an emergency (due to the same-ish issue... probably), so I brought him to the current vet. They did not sedate him the first time, though they did later on, but they had to put a muzzle (covering mouth and eyes) on him, which made him more terrified (even in his carrier he is less anxious when he can see what is happening around him). He had to stay there for several days (coming back home at night as they did not have overnight staff due to covid), and he is significantly more anxious/jumpy, especially around strangers since then. I am kinda upset at myself for bringing him back there (after trying 3 other vets who did not have appointments available for weeks). They did cure him the first time, and they had an appointment available relatively rapidly.
I guess it may be for the best if I look for someone else, even if just to avoid the negative associations he has with this doctor, and I think he may do better with a woman. I would also feel better with someone who takes the time to discuss his health, issues, and possible solutions, rather than just telling me "so do you want to do this or that", without telling me any of the possible consequences of either options and then just sending me on my way with a prescription.

Thank you for taking the time to share your thoughts and experiences.

I would def find a woman dvm and one who will discuss the actual possible conditions going on here and how to prevent this from happening again hopefully. Avoiding neg associations is a good idea too.

 

[BlackCatOp]

Just for reference ketamine does provide pain control and it why it is used in combination with other anesthetic to provide multi-modal anesthesia. Though probably using ketamine as a sole drug the pain control is limited. (Ketamine blocks NMDA receptors - thus providing good visceral pain control)

 

[silent meowlook]

Find another vet. Try to find a feline only veterinarian. Ketamine shouldn't be used as a sole anesthetic agent. We don't use it at all where I work.
Once the cat was upset there was no point to continue. They should have sent you home with gabapentin to give before the next visit.

 

[fionasmom]

I am sure that you felt as if you needed a little something when that was over as well. Your baby was ill and you made the best choice you could in getting help for him. Any of us would have done that.

Definitely get another vet. IMO, ketamine was not the most appropriate choice for sedation, the eye/mouth muzzle seems extreme, and the question to you about what you wanted done would not instill confidence. I do suspect that as an NMDA blocker, there was some pain control. My dog was once put on amantadine which is in the same class specifically for pain relief.