How To Handle Pain Control For Cats

I recently interacted with a client who asked about pain control for her cat who had oral cancer. Whether it is oral pain, arthritis pain, post-operative pain or other discomfort, cats can be tricky to treat. Recognizing that your cat is in discomfort is one thing. How to get a medication into a cat is another! There are a variety of pharmaceutical and therapeutic options. Today we will look mostly at medications that we can use for pain control for cats.

NSAIDs

Veterinarians often use non-steroidal anti-inflammatory drugs (NSAIDs) for dogs with pain. Humans pop both prescription and over the counter NSAIDs at an alarming rate in my opinion. NSAIDs are often the first line in pain control because inflammation is a significant cause of pain. NSAIDs are fantastic, but like all meds they can have potentially harmful side effects. We do use NSAIDs in cats, but cats are unique. Cats have a different set of liver enzymes compared to dogs and humans, and they don’t metabolize NSAIDs very well. We have to be very careful using NSAIDs in our feline friends.

Few NSAID drugs have FDA approval for cats. Meloxicam (aka Metacam or Ostilox) and Carprofen (aka Rimadyl) are FDA approved for one dose in cats. Robenacoxib (aka Onsior) has FDA approval for 3 consecutive days in cats. Sometimes veterinarians will use a NSAID in an “extra label” fashion and use it longer than the approved FDA labeling. In these situations the veterinarian will discuss the risks with the client and together the client and doctor can decide if it is worth the risks.

What are the risks? NSAIDS are potentially damaging to the stomach and GI tract (manifesting as vomiting, diarrhea and possibly even stomach ulcers), the kidneys and the liver. Cats seem especially sensitive to kidney damage from NSAIDs. It’s very important that the patient is well hydrated when administering an NSAID. Even we humans should be careful about our hydration status when we take an NSAID made for humans. I personally won’t take an NSAID unless I am very well hydrated and even then I also drink a huge glass of water at the same time.

So if we are limited in how long we can give an NSAID to a cat, what are our alternatives for pain control?

Narcotics

Oral buprenorphine is a mixed agonist/antagonist that tends to work nicely in cats. It doesn’t cause increased body temperature as some narcotics can cause in felines. And due to its pH it can be absorbed across the gums so it is convenient! It can last for up to 8 hours. It’s great for an acute situation as most cat owners can squirt a bit of liquid into their cats’ mouths. Vets often use this in short term situations, but occasionally we use it for longer term situations.

Vets, myself included, also like Fentanyl patches for short term pain. The risk here is the cat pawing the patch off or the cat chewing the patch off and swallowing it, thereby risking overdose from to the accidental ingestion.

Tramadol usually tastes awful, but it is an effective narcotic in cats. We can get compounding pharmacies to compound it into small tablets or liquid, but even so many folks have trouble getting it into a cat.

Adequan

Adequan (off label use in cats) is approved for dogs and horses to decrease inflammation in joints and to improve the viscosity of joint fluid. It is not FDA approved for cats, but I give monthly injections of Adequan to my own arthritic cat. I’ve read that some cats have lethargy for a day after the injection. I can’t say that I’ve noticed any lethargy with my own darling cat, Twinkle, after her injection.

Cerenia

You heard me right. Cerenia, the anti-nausea medication, can also be used for pain. It works on “substance p” (p is for pain), and it provides potent analgesia to the GI tract.

Gabapentin

Gabapentin helps pets with chronic pain, particularly arthritis pain or neuropathic pain (chronic nerve pain). Its main side effect is that it can make pets sleepy. I’ve made more than one pet sleepy and have learned to start at a low dose and then gradually increase the dose as needed with weekly assessments. We need to be cautious using it if there is kidney insufficiency. Gabapentin comes in a commercially prepared liquid for humans, but I find it easiest to sprinkle the capsule (or part of a capsule) onto a bit of canned cat food. I have my own cat on Gabapentin for her arthritis. Admittedly she is a highly food motivated pet, but she doesn’t seem to mind it at all. I’ve even tasted the Gabapentin powder (the stuff in the capsules) and found it to have minimal taste.

Therapeutic Laser

I love my class 4 therapeutic laser. I use it for arthritic pets, post-surgically for most of the surgeries I perform, and for many inflammatory and/or painful conditions. It utilizes light energy to decrease pain and inflammation. Veterinarians and chiropractors often utilize class 4 lasers to promote healing and for painful conditions. I use my class 4 laser repeatedly throughout the work day.

Acupuncture

This is on my bucket list to learn. Somehow running my own vet clinic and being the staff veterinarian for ADW Diabetes, I’ve not quite gotten around to acupuncture training, but I believe it works. There are more and more holistic veterinarians that provide this service.

Have a question or comment? Post below or email me at [email protected]. I always enjoy hearing from my readers!

NOTE: Consult your veterinarian first to make sure my recommendations fit your pets special health needs.