Buprenorphine After Enucleation

[swanjun]

Hello!

My kitty, Alfie (14 years old) had to have his eye removed on Monday due to ulceration/suspected perforation.

He weighs 15 lbs and was sent home with some preloaded vials of buprenorphine. Each one has 0.5 ml of medication in it. I've been administering these at around 12-hour intervals into his cheek pouch.

Does this sound like the appropriate dosage for a kitty who weighs 15 lbs? I ask because this evening I noticed that, although I gave the meds at 7:30 this morning, his pupils are still very big and he's purring and rolling around.

If the buprenorphine is at a concentration of 0.3 mg/ml, and he's receiving 0.5 ml per dose, then that works out to .15 mg per dose. Looking at this page, which says, "The typical dose administered to dogs and cats is 0.005 to 0.01 mg per pound (0.01 to 0.02 mg/kg) intravenous or intramuscular two to four times per day. This dose can also be given orally," it seems that 0.15 would be the max range for him (at 0.01 mg per pound).

Am I interpreting that correctly? I am pondering calling the emergency vet who prescribed this to see if I can back off on the dose a bit.

 

[fionasmom]

What you are seeing Alfie doing is very typical for this medication....the rolling around, purring, and huge eyes. I am not a vet or a pharmacist, so can't tell you to alter the dosage, but I think that you should double check and describe the symptoms you are seeing and ask about cutting back on the dosage and how to do that safely.

My GSD is 15 and has kidney and liver involvement. Any opioid does not clear from his system that quickly, just to give you one example of what might be going on. Definitely check with the vet. This should only be a no charge phone call as you have provided care for Alfie already.

 

[swanjun]

Thanks for the reply! Thankfully, Alfie does not have any kidney or liver disease currently. We had "senior wellness" blood work done in July with our regular vet but also repeated some pre-surgery blood work at the emergency vet just to confirm, and no issues were noted.

I did call the vet and they said while that dosage is not too high for him, it would be alright to cut back to half as much, so that's what I'm going to try this evening and see how he does.

 

[swanjun]

Found another site with dosage guidelines.
Focus On Pharmacology | Management of Chronic Pain in Cats

According to this chart you can prescribe up to 0.1 ml per kg. Alfie weighs 7 kg, and thus a dose of 0.5 ml is not too much. I'm still going to try a half dose, though.

 

[fionasmom]

Give that a try since the vet is okay with it. Without kidney or liver issues, I think that your baby had the very standard reaction to a dose which was safe, but on the higher end.

 

[swanjun]

Give that a try since the vet is okay with it. Without kidney or liver issues, I think that your baby had the very standard reaction to a dose which was safe, but on the higher end.

Thanks for the reassurance! He got the 0.25 ml dose last night and this morning and seems to be doing fine. I also called our regular vet this morning, who confirmed that the original dose was safe, but agreed we could start tapering down now. Kitty will see regular vet tomorrow, as well, just for a quick appraisal of how he's healing up so far.

 

[silent meowlook]

Sometimes the buprenorphine is compounded into a 0.6mg/ml solution for oral use. We prescribe 0.5cc for adult cats. If it was me I would give it every 6 hours, but do what your vet says. I wouldn’t hold back any pain meds with an enucleation as it is quite painful.

 

[swanjun]

Not that anyone was clamoring for an update, but... kitty is doing great. Regular vet is happy with how he's healing up so far.

 

[silent meowlook]

I am so glad to hear that!

 

[fionasmom]

We are definitely glad to get updates and it is good to know that you are improving.