Dusty and the new pain meds!

As some of you know Dusty (16 1/2) has severe osteoarthritis in her left hip and both knees. There is very little approved for pain control in cats because pain meds tend to damage the liver/kidneys in cats.

We'd been doing Metacam injections about every 3 weeks (she'd already had the one time cat approved dose 2 years ago, so we are working 'off label'). The injections just didn't seem to be helping her.

I took her in to work yesterday and boss was very concerned with how bad Dusty's limping has gotten. We decided to try yet another 'off label' use for pain control, Tramadol. This drug has not been approved for or even tested in cats.

So last night I go home, have to hack this already small tablet into quarters, and Dusty was supposed to get 1/4 tablet 3 x a day. Well pilling Dusty has NEVER been easy. While the fighting her to get the pill down isn't all that bad, she usually gets herself so upset she makes herself vomit up the meds. We've been doing injectable meds only on her for years!

Amazingly enough I got the pill down her after only 2 tries, but apparently Tramadol is very bitter tasting, so Dusty proceeds to drool all over the floor for 5 full minutes!!

Pill stayed down and within 1/2 hour pill was working, but Dusty was definately 'drugged', eyes all dilated, and wobbling when she'd walk. After about 2 hours she was actually PLAYING and JOGGING without a limp, which I haven't seen her do in years!!! However the pupil dilation continued right up until her next dose. She had me worried, but that was NOTHING compared to her second dose.

I got her second dose down her at midnight on the 6th try. I was trying to hide pill in tuna flavored hairball meds, but pill kept sticking to my finger instead of going in her mouth! oops. No drooling this time but within 1/2 hour Dusty was definately 'out of it'. Her pupils were completely dilated and didn't shrink back down even in bright light, didn't respond to her name, and didn't even flick her ear when I'd tickle her ear hairs (which she HATES). She had me rather in a panic! She kept wobbling over to her water bowl and just sitting there staring off into space.

I stayed up with her until 2:30 this morning (boy am I tired today too). I finally took her into our bedroom and blocked up the door so she couldn't attempt the stairs and I would be able to hear anything if the other cats took advantage of her 'drugged' up state.

I opted NOT to give her the morning dose and took her to work with me. Boss did have her walk down the hall again today and agreed that even this many hours since her Tramadol that her gait was an improvement. Boss agreed she STILL looked 'out of it' and we decided not to give her anymore pills until we did lab work.

Dusty is notorious for being VERY difficult to get blood from, normally I can barely hold her still, she gets her front paws in the way, twists all over, and when we do manage to get a vein her blood pressure is just not enough to get a good sample. So we were NOT looking forward to doing this.

Blood draw time. I got Dusty wrapped up in a towel like a gray burrito and held her best I know how. Boss put his finger on her neck and BAM the vein popped right up there (first time), the needle went right in the vein first attempt and strangely enough her blood pressure was great and we got the best sample we've ever gotten in less than a minute!!!

Since we had a great sample we ran a bunch of lab work (it's been since 1/06 since we ran lab work last). Her tests basically came out very good for a cat her age, her kidneys were right within normal range and almost identical to last years results! YAY (big relief there). Her glucose was slightly elevated from last year but within normal range. The only minor concern was her ALT (a liver test) which was 199 (high range is like 130, last year it was normal). We figured it was probably a consequence of her high dosage of Tramadol last night (70% of Tramadol is processed through the liver). From what I've been reading a cat in distress can have ALT tests in the 700-900 range, so Dusty's 199 is a concern but not something to panic over at this point.

So for now we reduced the dose of Tramadol to 1/8 of a tablet (had to borrow the pill splitter from work to get that little tablet that small) and she only has to take it 2x a day now. Boss said we may have to 'fiddle' with the dose till we find what works for her.

My mom brought over some braunschweiger (a type of meat) to attempt to fool Dusty into taking her meds by hiding the pill in the meat. I've NEVER had luck getting any pill hidden good enough for Dusty before, and although she's never had this meat, I was doubtful it would work.

7 p.m. tonight, time for Dusty's pill in the braunschweiger. I took that teeny tiny piece of pill and rolled it up in a piece of the meat, woke Dusty up from her nap and showed the meatball to her. She instantly sat upright and was all over that piece of meat!!! She gulped it down without a second thought and wanted more!! I let her have another tiny piece of just the meat and gave her a TON of praises! No drooling and I doubt she ever even knew the pill was in there.

She's been napping on and off toinght since (it's been a stressful 24 hrs for her), but when she does walk it's with a slight limp but very good considering! Her eyes don't look all 'zoned out' and she responds to me tonight. I'm hoping this is the dose and meds that do the trick for her.

Here is a pix I took of her last night when she was 'zoned out'.

http://i92.photobucket.com/albums/l1...1/IMG_7277.jpg

I am so glad that you might have finally found a way to keep Dusty from pain. It is always scary when they "zone out". She looks great for her age. Please give her a pet from me. I just love her little ears. I wanna tickle them too!

I don't particularly appreciate feeling "zonked out," but I've been in situations where "zonked" still beat "ouch" by a mile. You're doing what can be done, and through the misty fog she feels your heart beating. That's the important part.

Love, Columbine

Just have to ask... what happened to Dusty's ears??

Glad to hear she's not reacting as badly to the tramadol... poor little thing! Hope it levels off and will be a good alternative med for her.

Theres nothing worse tahn seeing one of our Companions in pain and its wonderful that Dustys getting her medicine into her system and that its helping some.
I am terrible with pills and usually ask the Vet to put into liquid form then at least I can wipe it on thier paws.
Although Bo Bo is wiping off the gel I am putting on her sores.
We wish you and Dusty all the best, and send prayers to you both.

Aw sweet girl. Glad you were able to get her meds in her. I, like Gary, ask for liquids when possible but sometimes the meds aren't available in liquid form. So it's wrestling match time.

Dusty's ears - She showed up this way. Two different vets have assumed that either she was born this way or else had them frostbit at some point. Her tail is also missing probably about 1-2 inches, the vets have thought was from an accident and was amputated. Apparently Dusty has had a rough life even before she came to me.

Tramadol - The new dose of Tramadol seems to work much better, but pilling her is a fight. This morning I tried the meat trick again, unfortunately Dusty chewed the little meatball this time and got a taste of the bitter pill. So took me 3 tries to get the thing down her, and with her doing the whole drooling bit again. Tonight I tried the meat again, Dusty wouldn't even look at it, tried a tiny bit of yogurt, she laped that up, but as soon as I put the pill in some yogurt, forget it, she wouldn't even look at that either. So on the first try got the pill down her, with MAJOR drooling!

I feel so guilty because she had come up to me wanting to play and get pets when I gave her the pill. Now I feel bad for making her drool and be mad at me. :(

Liquid meds with Dusty are WAAAAY worse than pills. She's an EXCELLENT spitter, and liquids just end up everywhere but her mouth and have a history of making her vomit sooner. From what I've read the Tramadol is even MORE bitter in a liquid form.

Poor girl... she's so brave. I wasn't sure if it was frostbite, or genetic. It makes her look adorable actually. She's in good care with you, and she's a lucky girl.

Oh boy, you do have quite a challenge on your hands, don't ya? Best of luck to you w/pilling and, hopefully, it will get better as you go along.

I'm glad to hear that you found some pain medicine and the right doseage for Dusty.:) I also have a very hard time pilling Starr and I even use the pill syringe and I have a syringe filled with water to help wash the pill down. I have to put him in a klaw kontrol bag that I bought from Drs. Fosters & Smith with only his head sticking out. Here's a picture of it klaw kontrol bag.