Sam Can't Walk

[weebeasties]

Grrrrr!
So Sam has been fine on his current pain med (buprinex). No nausea, no sedating effects. He was running low on it however so I contacted the vet's office about giving him a few more days worth to last him until his orthopedic appointment on Monday. The vet he has been seeing is off until next week so a different vet looked at his chart and now wants to change his meds to Gabapentin.
I'm not really happy about this because side effects of gabapentin are sedation and unsteadiness on his feet. I have been trying to encourage Sam to walk because I don't want his muscles to atrophy. He's ALREADY unsteady on his feet. I'm affraid if it gets worse he will either stop trying to walk altogether or he could injure himself more.
It's so frustrating that these docs all have differing opinions and as a parent I don't know who I am supposed to listen to.
Anyone used gabapentin for pain? How bad are the side effects?

 

[1 bruce 1]

Grrrrr!
So Sam has been fine on his current pain med (buprinex). No nausea, no sedating effects. He was running low on it however so I contacted the vet's office about giving him a few more days worth to last him until his orthopedic appointment on Monday. The vet he has been seeing is off until next week so a different vet looked at his chart and now wants to change his meds to Gabapentin.
I'm not really happy about this because side effects of gabapentin are sedation and unsteadiness on his feet. I have been trying to encourage Sam to walk because I don't want his muscles to atrophy. He's ALREADY unsteady on his feet. I'm affraid if it gets worse he will either stop trying to walk altogether or he could injure himself more.
It's so frustrating that these docs all have differing opinions and as a parent I don't know who I am supposed to listen to.
Anyone used gabapentin for pain? How bad are the side effects?

If he's handling the pain meds fine, I would be slightly firm and tell them you don't wish to change what's working.
I'm not slamming this vet or saying they're bad vets or stupid, and perhaps the new drugs would be better, but when it comes to a cat that's having some really bad pain and the meds we're using are short term and are working well with no side effects present, I tend to not want to fix what ain't broke.
I hope he had a good day, and you too.

 

[PushPurrCatPaws]

I agree. If he's doing fine on Buprenex, and you know the next appt is coming up on Monday (where you can regroup regarding pain med options, and decide where to go from that point), explain that to the vet covering for your own vet.
A lot of these meds are addictive, so perhaps that's what the vet is worried about. At this point, you'll likely need to wean Sam off the Buprenex as it is... but, I don't know -- wouldn't just switching to another drug mid-stream also cause its sort of withdrawal symptoms, yet "covered up" by the new drug's effects?
Buprenex can also cause sedation and unsteady feet if the cat is not handling it well. If he's doing ok on it, for my own cat... I'd try calling the vet back and having a good discussion of your inclinations and feelings about it.

If you feel strongly enough about the Buprenex, just try to call back and convey that as well as you can to the 'substitute' vet --

 

[weebeasties]

I called this vet back and voiced my concerns. He feels after reviewing Sam's chart that it is a neurological issue and gabapentin would be best. Also wants me to start him on baby asprin. Said I could bring Sam in tomorrow so HE could examine him in person.
I am just going to wait until Sam's ortho appt. Until then I will just have to decrease the Buprinex and try to stretch it out. If he seems to be in a lot of pain, I will use the gabapentin. I just want to make it a last resort.
Sam has had a good day today. He even jumped up on the couch by himself. His leg "locked up" when he did it but then he got it back into the right position and was ok. He has been doing a lot of walking, he just does it very cautiously. He also enjoys it when I lay in the floor with him and play with a toy. He can't chase anything right now, but he is having fun being able to lay down and still bat at things! Also Keith has been grooming him, so no hard feelings there.

 

[ArchyCat]

Aspirin for a cat? I think I would do some further checking on that before trying it.

 

[PushPurrCatPaws]

Still sending lots of hugs and healing thoughts to Sam and to you, weebeasties

 

[weebeasties]

Still sending lots of hugs and healing thoughts to Sam and to you, weebeasties

Thank you so much for thinking of Sam.
I don't know if he is improving or just getting better at dealing with pain, but he has become more mobile every day. He only had two bad episodes today when his legs gave out and he cried.
I was lying on the floor with him today and when he walked away I noticed his back legs seem very stiff and he sort of swings his right leg out. It reminded me of the John Wayne walk.
I so hope I get a definitive answer tomorrow at his appointment.

 

[tabbytom]

Great to hear that he’s getting more mobile. He’s helping himself too!

 

[weebeasties]

Sam had his appointment today. First off, he DOES have luxating patellas but they are only grade two. This vet's only concern is that he may develop arthritis from it when he is older.
As for the pain and problems Sam is currently having, the vet believes it is a spine or hip issue. They were able to take a side view xray that didn't indicate any fractures. They need to do another xray with Sam lying on his back with his legs stretched out, but this is too painful for him. So he will need to be sedated and we couldn't do that today because he had recently eaten and that makes it risky. So I will be taking him back tomorrow for that xray. He also set Sam up with 5 more days of pain meds.
All in all, a pretty good vet visit. A kind and competent doc who didn't mind explaining things.

 

[PushPurrCatPaws]

I'm so glad he's in your hands, and in the hands of an ortho doc.

​

 

[auntie]

In terms of Metacam: it definitely has risks, but for my cat it was the only thing that got her out of her pain cycle enough to eat (she had an extreme case of stomatitis. We attempted a full-mouth extraction but she had to be woken up from the anethsesia. The couple of months between extraction 1 and extraction 2 were awful). It blocks pain differently from opioids (bupronorphene, which we did try as an alternative) and just seems to give cats more of a will to live. I was very against it and argued about it with the vet. I'm so glad I gave in and used the Metacam, because without it she would have stopped eating and also lost that little spark that kept her going.

If Sam is still doing poorly physically and emotionally, Metacam might get him through this bad time like it did for my cat. Just my 2 cents...best of luck!

 

[auntie]

I also wanted to say that gabapentin did nothing for my cat (other than give her side effects), who has extensive nerve/tissue damage, and the vet actually cut us off the Bupronorphene because of regulations surrounding opioids. This was AFTER they took a photocopy of my driver's liscense for their files. Apparently 8n my state, any vet who allows a certain quantity of opioids out to patients is automatically subject to investigation by the state. This is Maine, where the opioid crisis is really roaring. So maybe that has something to do with it...after I questioned them a little my vet admitten that was their readon for substituting Bup for the gabapentin.

 

[PushPurrCatPaws]

In terms of Metacam: it definitely has risks, but for my cat it was the only thing that got her out of her pain cycle enough to eat ... and just seems to give cats more of a will to live. I was very against it and argued about it with the vet. I'm so glad I gave in and used the Metacam, because without it she would have stopped eating and also lost that little spark that kept her going.

If Sam is still doing poorly physically and emotionally, Metacam might get him through this bad time like it did for my cat. Just my 2 cents...best of luck!

For what it's worth, I personally avoid metacam for my cat.

After my cat's first knee surgery for her luxated patella in her right knee, we were given buprenex and tramadol, the latter for helping with "mood" (and both for use only once her fentanyl patch was removed, post-surgery). She definitely did NOT react well to the fentanyl patch, so we didn't even use one at all for her 2nd knee surgery.

 

[weebeasties]

Sam had his second xray at the ortho today. The good news is that his spine and hips look perfect. The downside is that we don't have a definitive answer to his pain.
The vet feels that it is a soft tissue injury in Sam's back, hip, or possibly groin area. Based on Sam's history and that he has been steadily improving, he wants to wait before doing an MRI. He is hopeful that this is just something that time will fix. We are to follow up in a week.
For Sam's part, he is sick and tired of car rides and vet visitis! I tried to make him feel better by buying him a new cat bed, but for the moment he prefers to lay on his old crinkle sack.

 

[weebeasties]

In terms of Metacam: it definitely has risks, but for my cat it was the only thing that got her out of her pain cycle enough to eat (she had an extreme case of stomatitis. We attempted a full-mouth extraction but she had to be woken up from the anethsesia. The couple of months between extraction 1 and extraction 2 were awful). It blocks pain differently from opioids (bupronorphene, which we did try as an alternative) and just seems to give cats more of a will to live. I was very against it and argued about it with the vet. I'm so glad I gave in and used the Metacam, because without it she would have stopped eating and also lost that little spark that kept her going.

If Sam is still doing poorly physically and emotionally, Metacam might get him through this bad time like it did for my cat. Just my 2 cents...best of luck!

I also wanted to say that gabapentin did nothing for my cat (other than give her side effects), who has extensive nerve/tissue damage, and the vet actually cut us off the Bupronorphene because of regulations surrounding opioids. This was AFTER they took a photocopy of my driver's liscense for their files. Apparently 8n my state, any vet who allows a certain quantity of opioids out to patients is automatically subject to investigation by the state. This is Maine, where the opioid crisis is really roaring. So maybe that has something to do with it...after I questioned them a little my vet admitten that was their readon for substituting Bup for the gabapentin.

For what it's worth, I personally avoid metacam for my cat.

After my cat's first knee surgery for her luxated patella in her right knee, we were given buprenex and tramadol, the latter for helping with "mood" (and both for use only once her fentanyl patch was removed, post-surgery). She definitely did NOT react well to the fentanyl patch, so we didn't even use one at all for her 2nd knee surgery.

I had a long discussion with the ortho about pain meds. We ultimately decided to keep Sam on Buprinex for awhile. If needed he would like to transition him to Metacam next week. I am not completely comfortable with that, but the ortho vet says it is safe. I will wait and see how Sam is doing at that point. Hopefully he won't even need pain meds by then?

Here is the thing that is REALLY making me angry. Sam had one dose of Metacam as per ER vet before regular vet switched him to Buprinex, then another vet wanted me to switch him to Gabapentin and 1 whole baby aspirin. I never gave him the Gabapentin, but did give him 1/2 of the baby aspirin once.( I just didn't think it was safe, so decided not to do it again.)
The ortho vet was VERY CONCERNED about this. He explained that there needs to be a "flush out" period between metacam and aspirin. That without the waiting period a cat can develop a perforated ulcer and DIE very quickly. He said he would never give a cat those two meds within 8 days of one another. (Preferably longer, he's not a fan of aspirin). The vet that told me to give the aspirin had looked over his chart and knew he had been given metacam!
After a quick google search I found the info about the "flush out" period. Why didn't that vet know about it? I'm angry that following a vet's directions could have put Sam in severe danger.

 

[catlover73]

I am glad you followed your instincts and you are doing a great job taking care of Sam. A couple of months ago we took my cat to the vet and the vet we saw under played how serious his condition was. I am thankful his former foster mommy still is a big part of his life and went to the vet with us. The way my vet was explaining things just did not make sense to her. She called me the next day and she paid for her vet to see my cat for a 2nd opinion. My cat had to be in intensive care for three days. Her vet was furious with my vet for not explaining things properly. My cat would have died if I had not taken him to another vet when I did. My vet's office has multiple doctors. I will not go near the last doctor I saw at that practice ever again. We were struggling financially if my friend had not questioned things and took over financially for the emergency care I would have lost my cat. I am glad you are so on top of Sam's care. I was thought I was dealing with a UTI at the time and it turned out I was dealing with a pee blockage. My friend went through this with one of her cats and that was why she questioned what my vet was saying.

 

[di and bob]

I found out how to tell the difference between blockage and UTI. Palpate the abdomen and if a blockage there will be a hard huge mass felt, the bladder. Immediate care is needed. No mass, most likely a UTI. A cat with a UTI will try to urinate very often with nothing coming out, just like a human, they think they have to go. The vet wanted to keep our Casper to make sure he didn't have a crystal and could go, but he was so scared in the vets office he went! So thankful for that.

 

[weebeasties]

I am glad you followed your instincts and you are doing a great job taking care of Sam. A couple of months ago we took my cat to the vet and the vet we saw under played how serious his condition was. I am thankful his former foster mommy still is a big part of his life and went to the vet with us. The way my vet was explaining things just did not make sense to her. She called me the next day and she paid for her vet to see my cat for a 2nd opinion. My cat had to be in intensive care for three days. Her vet was furious with my vet for not explaining things properly. My cat would have died if I had not taken him to another vet when I did. My vet's office has multiple doctors. I will not go near the last doctor I saw at that practice ever again. We were struggling financially if my friend had not questioned things and took over financially for the emergency care I would have lost my cat. I am glad you are so on top of Sam's care. I was thought I was dealing with a UTI at the time and it turned out I was dealing with a pee blockage. My friend went through this with one of her cats and that was why she questioned what my vet was saying.

It sounds as if your kitty's foster mom was a real godsend and a HERO. I am so happy your baby is ok now.
I know vets are not gods, but we rely on them to be knowledgeable, informed, and caring about the health and quality of life of our pets. Quite often I have seen a pained expression on the face of a vet when I question something they have told me because I read something different on the internet. I know where they are coming from, after all THEY are the ones with many years of medical training. But sometimes mistakes are made and a "bad call" by a vet can be a devastating loss to a pet parent. Our recent loss of Isabelle is an example of that.
I am always on the lookout for a new vet. One that is closer than an hour drive, one that isn't booked up two weeks in advance. Unfortunately my list of vets that I WILL NEVER GO TO AGAIN just gets longer. Perhaps it is because of the rural area I live in. Most vets seem to dismiss my concerns, don't want to hear my observations about how the cat is acting, and rush us out the door so they can get to the next patient. (Sort of like human doctors these days.)
Terribly sorry for this long rant. Things have been very difficult for our family lately. I just want everyone to be healthy and happy and there is nothing I can do to help. So much illness for humans and cats alike, Isabelle is gone, and I am useless. I can't fix it.

 

[di and bob]

You are NOT useless, you tried, and you tried again. Please don't blame yourself for something out of your control. Sometimes no matter what is done, or how good the vet, it still isn't enough. Don't let Isabelle's death overshadow her life and what she gave you, she would want you to remember her in happiness, not grief. You will be blessed for hurting so bad from loving so much, I am praying for you both......

 

[ArchyCat]

On aspirin for cats. I assume the 81mg baby aspirin? How about coated? In humans, that delays the pill dissolving until reaching the small intestine and avoid upset stomach and/or damage. Is that t he same for cats?