Buprenorphine Question (pain Med)

[Jem]

Hi everyone,
So I just got back from the vet with Toby, (end stage CKD and CFH). Bad news overall. Although he is stable, in a sense, we have now reached the point where we have done everything we can, there are no more treatment options for him, and his decline, whenever it will be, will be his journey to the rainbow bridge. We are going to love and cherish him, keep him comfortable, and pray he passes peacefully. And when I say peacefully, we will bring him in for euthanasia, but I just feel his time has not yet come to pass. We are watching for signs of decline, and will do what we need to before his suffering starts.
My question though, is about the pain med I just received from my vet. I asked for, and the vet was more than willing, to give me a few doses of pain medications, for when he shows signs of decline, and we need to make "the call". I'm asking here because I forgot to ask the vet, and don't want to bug them. Does anyone know how fast acting this medication is? It's called buprenorphine, and I'm to give it to him orally by syringe (it's a liquid).
Thanks a bunch!

 

[Saber_Wing]

First off, I'm so sorry to hear about your baby. I lost one of my girls a couple of years ago to a malignant brain tumor, and I still feel the loss. I feel your pain. I'll be thinking of you!

That said, one of my boys had buprenorphine when he had his bladder stones. Takes about a half hour or so to take effect.

 

[Kieka]

It starts working fairly quickly, from the times I've used it. It does make my boy sleepy and a little wobbly; but my boy reacts poorly to pain medications in general.

Have you looked into in home end of life options? I did it with my last cat and it was the best thing ever. The vet came over and he went peacefully at home without the carrier trip.

 

[Saber_Wing]

It starts working fairly quickly, from the times I've used it. It does make my boy sleepy and a little wobbly; but my boy reacts poorly to pain medications in general.

Have you looked into in home end of life options? I did it with my last cat and it was the best thing ever. The vet came over and he went peacefully at home without the carrier trip.

I second that. I did it with my girl I lost two years ago, and it was the best thing I could have done for her. I was so distressed, I probably wouldn't be able to pick the vet out of a line-up, but he was so kind, and wonderful.

 

[white shadow]

Hi jem .

What's the cause of the pain?

Buprenorphine given buccaly like this will have full effect within about 30 minutes.

Its effect/duration is actually (in my experience) ~6 hours. That's less than what is generally thought, so it's often prescribed every 8 hours, and sometimes every 12, which just won't effectively manage pain for any cat.

That's important, because you'll need to stay ahead of the pain to provide continuous pain relief, and because if the pain returns it's more difficult to regain control over it.

It needs to be absorbed by the mouth tissue - usually the gums. IF it's 'just' swallowed, it will have no effect.

To ensure it is absorbed, I will insert just 1-2 droplets at a time inside the lip, withdraw the syringe, wait a few moments and repeat...until the full dose is given. You can practice that with water in a used syringe. The cat will still seemingly swallow, but that's instinctual and those drops will still do their job. Flushing the whole syringeful at once inevitably results in some just being swallowed and wasted.

Hope that will help.
.

 

[Jem]

Thanks for the replies!

Kieka and Saber_Wing - Unfortunately there aren't any clinics that do the in home end of life where I live. I already inquired about that in preparation for my other cat, who has since passed, last month.

white shadow - At this moment Toby does not seem in any pain, although because of muscle atrophy from the CKD he is stiff and it takes him a bit to get comfy. I even had it confirmed from the vet, that he also does not believe Toby has any "pain", he's just stiff, and a bit "achy" if he's been laying down for a while. I massage him and do mobility exercises with him and he love's it. Although I have not been able to do as much since the fluid retention started. Because of the positions he's in for the exercises, he can't breath very well, so now I just massage him in the position he's most comfortable with.
I have these few doses of pain meds for when we reach his end of life. To make his travel to the clinic more comfortable, to keep him calm, and as I have read, dying from kidney failure can be painful, so I have them just to take the edge off, especially if it happens quickly. We will obviously try to take him in before he's in distress, I don't want him to suffer, but, these meds are just when I see the start of his decline, to give us time to say goodbye and get him to the vet comfortably. I just want his passing to be as peaceful as possible. He's given me almost 20 years of love and affection, so it's the least I can do for him.

Thanks for the tips on administering the medication, I will definitely make sure that it's absorbed thru the mouth, and take my time giving it to him. It says on the bottle to give it every 6 to 12 hours "as needed". So if I give it to him every 6 hours I would have enough for almost 2 days.