Buprenex / Buprenorphine Tips

[crystalnicole]

Hi.

My 3-year-old, Lulu, is currently dealing with a lot of mouth/dental pain. Her gums are very red and inflamed, and she thus was prescribed Buprenex (buprenorphine drops) on Friday due to the inflammation on her gums/gingivits, which she developed shortly after her first teeth cleaning about a month ago. The vet is worried she may be developing Stomatitis, most likely due to her *probable* FIV diagnosis. (see full story with additional context HERE: Possible Stomatitis...worried)

Anyway, I have been giving her the Buprenex dosage a few times per day via a syringe dropper, but I'm worried she may not be getting near the full dose. As some of you may know, this is a "sublingual" medication that is absorbed through the mucus membranes in the mouth, and the instructions are to squirt it between the lower cheek/gums (nearly impossible!) OR under the tongue (totally impossible!).

I've really tried, but it seems like she just keeps swallowing most of it. I have been kneeling down on the floor (so I'm behind her), and holding her head and trying to squirt the stuff between her cheek/gums with the syringe slowly, but she's incredibly resistant and tends to thrash around (understandably so!) and so I either end up spilling it or squirting it directly into her mouth, which obviously she immediately swallows.

Does anyone have experience with this medcation? Any tips to make it easier / more effective?? Keep in mind it's extremely difficult to get near her mouth right now because she's in so much pain.

She is about 9 lbs and her prescription calls for 0.3 mL every 8 hours or so. Is this medication AT ALL effective if it is swallowed? Would it be acceptable to ask the vet for a higher dosage if I simply cannot give it to her sublingually?

My girl is in SO much pain right now and I just want her to feel better. Any tips / advice / personal experiences with this medication would be SO appreciated!

Thanks.
-Crystal

 

[neely]

I have been kneeling down on the floor (so I'm behind her), and holding her head and trying to squirt the stuff between her cheek/gums with the syringe slowly, but she's incredibly resistant and tends to thrash around (understandably so!) and so I either end up spilling it or squirting it directly into her mouth, which obviously she immediately swallows.
Does anyone have experience with this medcation? Any tips to make it easier / more effective??

I'm so sorry to hear your Lulu is experiencing dental problems. I have had 2 cats with FORL and they were also on Buprenex. I administered it the exact same way as you described, i.e. kneeling down on the floor behind them. I would hold their mouth shut afterwards to try and avoid them spitting it out. The only advice I can offer is to wrap your girl in a towel like a burrito. But I'm sure other members with similar experience(s) will be able to help and offer their suggestions. Sending special thoughts and healing vibes your way.

 

[pushylady]

I've given this med a lot to an elderly cat, and it did seem very effective in helping with her pain. She was quite the cantankerous old lady, but still probably easier to medicate than a young, energetic ca. I used to just sit in front of her, talk to her a bit, then gently insert the syringe on a 45 degree angle in between her teeth and cheek (I'd switch sides each time) and then squirt as slowly as I could. Sometimes she'd shake her head or move around because she knew what was coming. I'd usually hold her head with my other hand, but I'd have to do it so gently as she was such a frail old cat. With your cat I think the burrito suggestion might be a good way to go. You've got to get those squirts in as they will definitely help with her mouth pain. Perhaps it is a good idea to ask the vet if you can give a higher dose two times a day instead of doing this three times a day.

 

[PushPurrCatPaws]

Hi.

My 3-year-old, Lulu, is currently dealing with a lot of mouth/dental pain. Her gums are very red and inflamed, and she thus was prescribed Buprenex (buprenorphine drops) on Friday ...
Anyway, I have been giving her the Buprenex dosage a few times per day via a syringe dropper, but I'm worried she may not be getting near the full dose. ...

Does anyone have experience with this medcation? Any tips to make it easier / more effective?? Keep in mind it's extremely difficult to get near her mouth right now because she's in so much pain.

She is about 9 lbs and her prescription calls for 0.3 mL every 8 hours or so. Is this medication AT ALL effective if it is swallowed? Would it be acceptable to ask the vet for a higher dosage if I simply cannot give it to her sublingually?

My girl is in SO much pain right now and I just want her to feel better. Any tips / advice / personal experiences with this medication would be SO appreciated!

Thanks.
-Crystal

Hi Crystal,

Some of the med does get through even if swallowed, but you really don't want to up the dosage by trying two attempts at sublingual dosing in one sitting, if the first attempt got messed up.

Have you ever had any practice in giving shots subcutaneously (sub-q)? Many times the vets give instructions to give the dosages orally, but if the syringes were of course pre-drawn in a sterile format by the vet WITH the attachment for the needle already on the syringe at the outset, the vet can give you the choice of giving the Buprenex via the sub-q injection delivery (make sure you know how to do this), or by taking off the needle attachment --which leaves just the syringe and no needle-- and by gently squirting the pain killer in the mouth for the oral delivery. You likely had to pre-arrange this with the vet beforehand, so that the syringes could have been prepped in a sterile manner for either option beforehand. I bring this up because I've had experience giving Buprenex to a cat both orally and sub-q. My current cat Milly had two knee surgeries recently, and we used Buprenex for the main pain killer. For her first surgery, we struggled with the oral route (just like you!) -- so for the 2nd surgery's recovery, the surgeon prepped the syringes sterilely for both oral or sub-q options (I gave her the Bup sub-q on her lateral abdomen). I had experience giving sub-q shots with my last dear cat, too, so I knew what I was doing with my newest cat, Milly.

The best thing is to talk to your vet again, and try to get a sense of how you both can get Lulu feeling better at the moment!


Contact the vet, explain the problems you are having about giving the sublingual, and ask their thoughts about giving the Buprenex as a sub-q shot. You could have the vet and/or his or her vet tech staff show you how to do this, if you have not done it before.


-- edit: I just want to make a small clarification to the above. If you are given syringes prepped for either a sub-q delivery or an oral delivery of the Buprenex, you need to decide before dosing which route you will take in giving the med to your cat with that particular syringe. For example, you can't start giving it orally, then, if having problems with the cat, try to put the needle attachment back on and attempt to give it via sub-q. Decide which delivery you want to use beforehand & stick with that route, in order to keep things sterile.