Having trouble administering oral Buprenorphine

missmindy

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Mindy is taking oral Buprenorphine to help control her pain.  She really protests at medicine time and I have a hard time dealing with a moving target.  I think she is swallowing more than she is absorbing, and I know that won't help.  The pharmacist showed me how to do it by pulling at her own cheek, but since Mindy's mouth is so much smaller and I have to contend with a squirmy mad kitty with teeth and tongue and slobber, things aren't going so well.  I don't think she is getting the full dose.  The last couple of times she doesn't seem to be geting as much relief.

Does anyone have any tips?  I wish I didn't have to "aim" this medicine!
 

scarlett 001

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I've been using oral buprenorphine. But on the cat cancer yahoo group that I am on, some people keep mentioning transdermal buprenorphine that I think is put in the ear (??). Is this a possibility where you live??
 
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missmindy

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We just got a transdermal gel for her predisilone, so it might be a possibility.  I just got the Buprenorphine filled for the next month, so I'll have to wait until after that before they are able to dispense anymore.  I'm trying so hard to get it into her cheek pouch but she is just so squirmy and hates hates hates medicine time.
 

that guy

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You need to get this in the cheek pouch where it can be absorbed through the skin in the mouth and try not to get it to go down the throat. I kneel behind my cat with him between my knees so he can't back up. I take the syringe and slip it in the side of his mouth parallel with his upper & lower teeth and slide it to the back of his cheek and then bring it a little forward and then push it out a bit so it is pointing at his cheek and then slowly release the fluid. While I am doing this I hold him under his chin and put my chin on the top of his head so he can't really move his head around and I can see what I am doing. I go through this twice a day and he gets 0.20cc each time and most of the time he doesn't try to swallow it. If it is a problem then give half first in one cheek and the half in the other or give half then wait 20 - 30 minutes then give the other half.

Try it with your own mouth and your pinky, we are not all that different. Push your finger in the side of your mouth inline with your teeth until it hits the back of your mouth then pull it back a bit and point it outwards just a bit. This is all you need to do and as you practice you will get better at it and your cat will thank you for it as the pain resides.
 

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Wow, that sounds like an unpleasant situation. You know you're trying to help your kitty, but she must not quite understand that :)

I wonder if giving the buprenorphine subcutaneously with a tiny needle and syringe would work better? I'm thinking insulin syringe size. Lots of people do it twice a day for insulin, and depending on the size of your cat, the dose would probably be pretty small. A tiny poke in the loose skin might be less stressful than wrestling to give it transmucosally! Something to consider and ask your vet about.

Tabitha
 
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missmindy

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@That Guy  thank you for that description-it really helped.  Mindy almost always swallows when I give her this so I'm betting most of it is going down the hatch instead of being absorbed.  I was aiming more for up under her lip for lack of a better description.  I never thought to put my chin on her head to keep her from moving while holding her.  Medicine time always seems to be such a struggle.
 
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missmindy

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@furbabyvetI tried giving her Adequan injections with insulin needles in the past.  It was a disaster.  As soon as I went to inject she wold take off or wriggle so much that I would waste the dose.  I must have wasted several hundred dollars worth of Adequan before I gave up and just take her to her vet every month.  She just hates being handled in any way but petting or cuddling.   I want to help her so badly and I know she is in pain.  Her struggling with me must hurt her even more.  It's horrible.

I just tried your approach @That Guy  with no luck.  She started biting at the syringe as soon as I slid it into her mouth.

I think most of the fault is with me not her.  Maybe I'm just not going to be able to medicate her.  Everyday it's such a struggle.  It might be time to throw in the towel with this disease.  Maybe we just aren't meant to win the battle.
 

that guy

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If there is a will there is a way and nature has taken care of this for you. I have three works for you and a quick search on google may just help when you search for 'chip clip cat'. When the cats mother carries them from the base of their necks they basically turn off so if the gentle approach does work then maybe this one will. You need to get these drugs into the cat some way or another so try the chip clip idea and see if that helps. My guy is very gentle and gets a sub-q every day and I give him weekly B12 shots and another one monthly for inflammation. My cat doesn't like the syringe in the mouth either but he doesn't fight too hard but not all cats are like mine.

If you take the cat to the vet and it fights then they simply wrap it in a towel to keep in under control which doesn't hurt so this may be another idea. I first read about the chip clip for cats by people giving them sub-q's and the cat will just sit there for as long as they are clipped. It doesn't put them under stress and giving needles or sub-q's this way should not distress them. Pain meds really help in many situations and I can see the difference in my cat with and without them so even when he fights I know it is for the best. He doesn't really like any of the stuff I have to do to him to keep him going and he avoids me at times but his overall quality of life is too good for me to put him down. Even though they don't like it a lot of the time they will figure out it helps them in a lot of cases especially with pain meds and with my cat sub-q's.

Using the method above I am able to stop the head from moving with my left hand and he can't push his head up with my chin on his head and I am usually able to get it into him. There is always a chance of them swallowing some such as mine does but his is for arthritis and I can see by how he moves, sits, lies down, and cleans whether it is working or not and even with swallowing after getting it he does get a benefit.  You can also put your hand around the mouth to keep it closed because it should be put in with the mouth closed to keep it in the cheek. There are times when he is really sick and I am not able to get his pain meds in him and I can easily see the difference. Check the dose as well, mine is once every 12 hours but the same does can actually be given up to a max of once every 8 hours if he is having issues. If you are thinking your cat is not getting enough then check with your vet to see if you can give slightly bigger does for what she swallows.

Being a care giver to an animal that doesn't really understand can be very hard but I always think of the good I am doing for my guy which helps.
 
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missmindy

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@That Guy   Thank you again for those tips.  I will try again tomorrow and see how that goes.  This is for her arthritis pain as well like your kitty.  Her pain/discomfort was well managed with Adequan injections but in the last few weeks we found out she has advanced cancer, anemia and now she appears to be in pain from her arthritis as well.  She has mostly been laying and staring into space for the past couple of days, and the Buprenorphine doesn't seem to be making much of a difference.  She went from being totally healthy to a complete wreck in a matter of a couple of weeks and needing all these medications.  Makes me feel like a complete failure to not be able to help her and now having her not really want me anywhere near her.

I will try again tomorrow though when it's time for her next dose.  She's getting .1 every 12 hours per the label, but the vet said every 8 hours, so I need to clear that up on Monday when they are open again.
 

that guy

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If she is in pain then once every 8 hours is fine, this is the same as my guy. They give a lighter dose for general use but like my vet said if he is in real discomfort then give him one does every 8 hours at the most. My cat is about 7 lbs and his dose 0.20cc.

Always keep in mind that animals are driven by hard wiring and many of the things they do is out of their control. One example is that cats that are very sick will hide where nothing can get to them which explains why she avoids you. Another part of their nature is to hide weakness at all costs which is why it is very easy to miss these kinds of illnesses. My guys sister was perfectly fine until the day after her 17th birthday when she started throwing up. With no change she went to the vet for a check and had blood tests done and the in house ones showed no issues so I had an x-ray done and she was littered with cancer. She went down very fast and later that day I had put her put under because she was just getting weaker and there was no way fix it. From what I thought was a perfectly healthy cat to a cat that is dying quickly was basically 3 days and no big signs. By the time it was showing for her it was already far too late to do anything because they hide it well.

There is no fault to you for the outcome because I am sure if you would have known before you would be doing the same thing you are trying to do now. Your cat is not feeling well so her instincts tell her to hide and avoid people so she doesn't get taken out. All you can do is what is the best for her no matter what it is. If her quality of life is very low and there is no chance of recovery then you need to decide when you will put her down for her sake. If there is a chance she can recover and be fairly healthy then I would say it is worth a chance because either option ends with the same results but only the time differs. My guy has bad times where he will stay as far away from me as possible but the good times still far out weigh the bad so I keep at it. I personally believe we have one try in life and that is it other than some kind of memory so I want to do what I can to help my guy enjoy it as much as he can. He has a number of issues but thankfully cancer is not one of them so unlike your cat he has good and bad times. The cancer cats usually have constant discomfort as the sickness progresses which is harder to deal with.

I wouldn't feel guilty about anything because there was nothing you could do to change the outcome and you are trying to deal with it as best you can and that says a lot. Cat are very good at hiding any weaknesses and even my guys sister I can remember a few signs that in hindsight I may have pointed to the cancer but they were so few and never persisted. As much as I would have loved to fix any problems she had early on by their own nature they make it hard to identify problems. She was a cat that ate well, had no issues in the litter box, and showed no signs of issues even after blood tests until the x-ray. How are we to know, there are times when you have to deal with the end result and do the best you can for your pet.

Keep at the meds and find something that works for you because once you get the method down it only gets easier. I would try another dose of pain meds 8 hours after your last hit and see if that works any better. Remember though it goes between the cheek and the teeth so try hard to keep her jaws together. Make sure to be calm and talk to her in a soothing matter and take your time. I stroke my guy and take my time while  I talk to him and usually it is okay.
 

Tarnacki93

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I've been using oral buprenorphine. But on the cat cancer yahoo group that I am on, some people keep mentioning transdermal buprenorphine that I think is put in the ear (??). Is this a possibility where you live??
Yes buprenorphine does permeate through the skin how ever it’s still not as effective. The bioavailability of cheeks are usually 40% but can get up to 70% and transdermal is like 15-20% however I’m not sure if it will absorb well with liquid because transdermal meds work by sticking with gel. Lastly the best spot for transdermal application would be the ear or a spot with very little hair so under belly may even be more effective
 

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I am having problems getting it in her cheek pocket. It always seems she turns her head at the last minute even though my husband and I do it together. She’s used to oral meds twice daily so it isn’t as though she’s afraid. I’d love to be able to do transdermal. My cat who is gone now received Elavil on her ear (yes, I had an overly anxious cat) and it worked well. I wouldn’t risk it with her pain meds though. We have success about 50% of the time so we buy a lot. I think the vet believes I have an opioid problem. If it gets the job done, I don’t care.
 

lalagimp

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I hate to hear people struggle with this because it's such a necessary medication when it's at the point they are actually being prescribed narcotics. I show it to my cat, slip it in his cheek pocket in the back and drag it forward to the front of his mouth while I do the plunger, and then just remove it from his mouth like nothing happened. He's had to do this at least a half a dozen times or more while we were recovering from urinary blockages and then surgery.
 

DelilahKate

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I hate to hear people struggle with this because it's such a necessary medication when it's at the point they are actually being prescribed narcotics. I show it to my cat, slip it in his cheek pocket in the back and drag it forward to the front of his mouth while I do the plunger, and then just remove it from his mouth like nothing happened. He's had to do this at least a half a dozen times or more while we were recovering from urinary blockages and then surgery.
Thank you! We hadn’t considered this. She gets pills twice daily plus an asthma inhaler, so you’d think she would be more accepting. We’ll try this tonight.
 

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I've never been able to get the hang of liquid meds. So I always end up asking the vet for pills. It may mean using a different med, but at least I know I can get it into the little beasties.

I also usually ask the vet not to use injections. The reason being that once a med is injected it sometimes stays in the system for days, so it's more difficult to manage an adverse reaction (this happened with Bupren with one of our cats). With pills, the medication can be stopped relatively quickly if there is an adverse reaction.

Also, I never let a vet give my cat Rimadyl. I am very adamant about that, as it is made for dogs and the info paperwork on it specifically says not to give it to cats.
 

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I had two kittens spayed and neutered and they gave them buprenorphrine liquid. Does it have to be given on empty or full stomach?
 

kathy1

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I forgot to ask vet and there is nothing online saying whether to give on empty or full stomach
 

kathy1

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I forgot to ask vet and there is nothing online saying whether to give on empty or full stomach
 
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