Q: In a recent column you wrote about how hard it is to tell whether or not cats are in pain. But you didn’t mention how difficult it is to treat. My cat Bogie suffers from arthritis, and our veterinarian says there’s nothing more to be done for him short of a hip replacement, which I’ve decided against. I’m shocked that there are so many options to treat pain in dogs but none for cats. Could you write about this?
A: It’s true that there are no pain medications approved for long-term use in cats. There are, however, a couple that are approved for acute pain in the short term. These include Onsior, a tablet that can be administered three days in a row, and Metacam, which is approved as a one-time injectable (usually administered as a pain reliever for common surgical procedures).
Both of these medications are designed to be used in healthy cats only. Neither should used in cases like Bogie’s where the pain is considered chronic. Instead, what cats like Bogie need are drugs that can be given a) easily, b) every day, and c) with minimal long-term side effects.
Seeing as cats are tough to medicate and adversely sensitive to a great many of the medications we use in dogs and humans, that’s a tall order! Nonetheless, there are a few off-label options you might want to consider. Here are a few:
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Gabapentin: This medication was originally used for epilepsy but is now used more commonly for depression and pain relief. This medication, along with all but the last one listed below, can be formulated as a transdermal gel so that it can be absorbed through the skin.
Amytriptiline: This medication was originally used as an anti-anxiety medication, but we use it increasingly frequently for chronic pain in cats.
Buprenorphine: This is a opiate medication that may cause sedation and, over time, may lose its efficacy in some patients, but it’s definitely effective when cats are having especially “bad days,” pain-wise.
Prednisone: This super-common anti-inflammatory medication has lots of potential side effects, but in many cases it’s way better than pain.
Adequan: This is an injectable medication for arthritis. Many of my clients learn to give it at home.
I would be remiss if I didn’t also mention massage and acupuncture. Many cats tolerate these modalities incredibly well. They’re absolutely worth considering.
Dr. Patty Khuly has a veterinary practice at Sunset Animal Clinic in South Miami. Her website is drpattykhuly.com. Send questions to firstname.lastname@example.org.