Alternative to metacam after spay

[franksmom]

I have read countless articles on the dangers of metacam in cats and I almost had a heart attack when I saw on the information sheet about the spay surgery from my vet that they give it after a spay surgery. My kitten will be getting spayed in about a month and I am already worried enough about the sedation. I am wondering what pain meds people have given to their cats after a spay/neuter? I give tramadol to my dog for arthritis pain and I know it is much safer than metacam- has anyone used this instead?

I am going to email the vet but wanted to get some opinions from all the amazing people on here.

 

[lcat4]

There is a newer non-steroidal anti-inflammatory that is approved for cats called Onsior.  One of the specific purposes of the drug is to be used for pain and inflammation after a spay.  The approved dose is 6 mg for three days - one pill a day. 

My cat has been taking Onsior daily since January for bladder inflammation and cancer - obviously not for its approved purpose or duration of time, but he doesn't tolerate Piroxicam and I won't do Metacam.  He has experienced no behavioral differences with the drug and not had any stomach issues.  There are signs of increasing kidney numbers, but not yet too worrying to our vet or oncologist to stop the medication.  My point being that our experience would suggest that taking Onsior for the approved three days is safe for your cat. 

Having said that, this same cat tried Tramadol a couple months ago, as an alternative to Buprenex, and he had a terrible reaction.  I guess a rare drug result caused an overdo of some neural toxin.  He was in a high anxiety, alert state for 36 hours.  Would not sit, would not sleep, he stood ram-rod straight in the dark hallway.   Scared me to death. 

So, what is tolerated by one may not be tolerated by another.  I would ask your vet about the Onsior.  It works for us. 

 

[white shadow]

First, remember that Vets use Metacam in two forms: injectible and oral suspension.

With spay surgery, the injectible is often used as a matter of course.

The oral suspension might be given as a take-home pain med.

It is even possible that both of the above protocols would be used for the same patient......despite the FDA-mandated 'Dear Doctor' letter warning about that very thing (2010-11).

So, the takeaway from all that is to have your cats' clinical files notated with "NO METACAM, NO OTHER NSAID".....that could be paper files or the computer files.......besides that, I have had "METACAM" inserted into the "ALLERGIES" alert section of the cats' files.

Instead of Metacam injection at the time of surgery, there are other safe injectible products that can be used as part of the anesthetic process.

Now, for post-surgical pain relief, I have found the most effective and simplest to be the 'pain patch' - Fenatyl. These are effective for 3-4 days. I also ask for buprenorphine, enough for 2-3 days in case the patch's effect begins to wane toward the end. That's easy to give. It will come in tiny needleless syringes, you insert it into the sides of the mouth in tiny drops so it's not swallowed (it is absorbed by the gums and oral tissue). These are the two I have used - they have been effective and giving the buprenorphine has been a piece of cake.

Tramadol is another you could request instead of buprenorphine - I have no personal experience with it.

Both buprenorphine and tramadol are opiods. My cats have certainly been a tad sedated by the bup, a side effect that I found to be helpful while they recovered. I have read of both mild sedation and the opposite, agitation, with tramadol use. Plumb's Veterinary Drug Handbook lists vocalization as a result of overdosing.

Tramadol's biggest disadvantage, as I see it, is that it comes only in tablet form - so, its effect will not be immediate. Buprenorphine, OTOH, works "instantly".

Buprenorphine and tramadol should not be given simultaneously - one will 'cancel out' the action of the other.

Hope that helps.

 

[franksmom]

Thank you both for the great info!!

 

[white shadow]

There is a newer non-steroidal anti-inflammatory that is approved for cats called Onsior....The approved dose is 6 mg for three days - one pill a day. 

My cat has been taking Onsior daily since January.............

I won't do Metacam....

There are signs of increasing kidney numbers...

My point being that our experience would suggest that taking Onsior for the approved three days is safe for your cat. 

this same cat tried Tramadol...;and he had a terrible reaction....He was in a high anxiety, alert state for 36 hours.

I would ask your vet about the Onsior.  It works for us. 

Onsior is one of the latest additions to the list of NSAIDs being used in cats............I expect to see more, unfortunately.

First, cats CANNOT METABOLIZE NSAIDs:  http://vetbook.org/wiki/cat/index.php/Glucuronidation

The drug, therefore is absorbed directly into the blood and is filtered by the kidneys. That's where the damage is done.

Kidney damage is irreversible.......kidney tissue, unlike liver tissue, is not regenerative.

Here's what happens:

A cat’s kidneys contain around 170,000 - 190,000 nephrons. This is actually many more nephrons than are needed for normal function; plus nephrons can increase their individual function to some extent when other nephrons die. This is why people can donate a kidney and still manage perfectly well with one kidney. In the case of a kidney transplant, if you remove one kidney from the donor, the donor's GFR (glomerular filtration rate, a measure of kidney function) will immediately fall to half of what it was, but will then gradually improve as the remaining nephrons increase their function to compensate for the loss of one kidney. Eventually the nephrons in the remaining kidney will reach almost the same level of function as two kidneys.

 

It works in a similar way in a cat with kidney disease, i.e. as damaged nephrons die (they are often described as "scar tissue"), other nephrons take over their work. Eventually, however, all the remaining nephrons will be working fulltime (i.e. there will be no "renal reserve" left). It is at this point, when around 66-75% of function has gone, that you will probably start to see symptoms in your cat, as the remaining nephrons start finding it harder to cope with the workload.

 

This is also why it is actually normal for CKD not to be diagnosed until at least 66% of function has been lost.

http://www.felinecrf.org/what_happens_in_ckd.htm#hard_detect_early

LCat4, I understand that when we're managing the palliative care of a terminally ill cat, our goal is to ensure the best quality of life for the cat's remaining time, and that collateral damage may not be a consideration. But, I strongly urge you not to recommend Onsior for otherwise healthy cats.

It is not a question of the safety of these NSAIDs.....it really is a question of how much kidney tissue are we willing to destroy....and, why on earth would we even consider damaging the kidneys when there are other demonstrably safe and easy to use alternatives.

 

[franksmom]

Great thanks I will not let her get any NSAIDs