I have a 17 year old cat who has been lame on the left forefoot for three months. My vet makes house calls like you do, and she’s suggested that I x-ray my cat to see what might be causing the lameness. There is clearly no fracture and my cat seems otherwise quite happy. I am reluctant to take the cat to a local hospital for several reasons. The main reason for this is that she is extremely stressed every time she is transported, probably because she knows that it usually means that she is going to a vet. My vet gave me both gabapentin and buprenorphine to help relieve my cat’s pain, but nothing seems to work that well. What could be wrong Are there other medications I can give my cat for the pain?
My cat also has breathing problems, high blood pressure, and kidney damage. What do you suggest? The vet gave me the buprenorphine a few times at my request, but is currently losing patience with me. I need your help and thoughts on what to do next.
Given the limited information you are presented with, several things can happen to your cat’s leg. There might be a sprain that has never healed well enough, and it’s not that you can’t get the cat to stop jumping up or down, only injuring the injured animal again. There may be some level of arthritis and it may be necessary to figure out what works.
However, before doing anything else, I agree that proper diagnostic work-up should be done, even if it means the cat is stressed to have x-rays or other tests. Despite the other complicated issues you mention, knowing exactly what is going on enables a better treatment plan. In addition to the above, there are other drugs that can be used for osteoarthritis pain. NSAIDs like meloxicam can be given, and while long-term use has its risks, you may need to give it for your quality of life. Adequan is another medication that you can discuss with your veterinarian. Buprenorphine is an opiate and should only be used with restrictions for legal and other reasons. Opiates should be used in limited quantities and very sparingly. Tramadol is another drug that can be given, but the bitter taste poses a challenge.
There are also several supplements that can promote better joint health. Gabapentin and NSAIDs like meloxicam might be your best choices, but start diagnosing and go from there. Finally, I learned that gabapentin doses can be increased more than most people realize, and that might be worth a try. Much luck!
Dr. John de Jong owns and operates the Boston Mobile Veterinary Clinic. He can be reached at 781-899-9994.