Prevention of pain and treating effectively does involve keen observation by you and involvement of your veterinary team. There are various take home pain medications like buprenorphine, tramadol, fentanyl patches, lidocaine patches and non-steroidal anti-inflammatory drugs. Buprenorphine is a commonly used pain killer in cats and dogs, which is considered approximately 30 times more potent than morphine. In cats, it is used for mild to moderate pain and is routinely used as in very small doses by applying in inside of cheek pouch and or under the tongue. In dogs, the preferred route is intravenous and or under the skin. Oral and or inside the cheek pouch administration in dogs doesn’t work as good as in cats. As the onset of analgesia is 30 minutes, so in acute pain scenario, other short acting pain killers like morphine and hydromorphone are preferred. Lower dose of buprenorphine is preferable for pain control as at higher doses, analgesia might actually decrease. Buprenorphine is also used in combination with drugs like metacam to control more severe pain. The most common side effects are respiratory depression, decrease in blood pressure and heart rate. All the opiates should be used with caution in patients with hyperthyroidism, severe renal insufficiency, Addison’s and in severely debilitated pets. Buprenorphine might increase pressure in the biliary tract, so it should be used very carefully in patients with jaundice. Most common observed clinical signs of over dosage in dogs are salivation, slow heart rate, hypothermia, agitation, dehydration and constricted pupil. Cats could show dilated pupils, behavioral changes like excessive licking, pacing, rubbing etc. Gastrointestinal side effects in cats are very minimal and it is tolerated very well. Complete physical exam and lab work should be evaluated before the long term use of this drug in debilitated pets.
