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 * Morphine: Pretreat with Benadryl if administering IV.
** Hydromorphone: Caution: doses of 0.1 mg/kg and higher can cause hyperthermia in some patients; severe hyperthermia is an indication to change analgesic class.
*** Meloxicam: The author and all cited studies
are referring to Metacam® throughout this article. Compounded formulations lack third party, mandated and assessed quality control (QC); there is known potency variability between compounders and even between batches from the same compounder.
**** Gabapentin: Taper dose when withdrawing drug. Do not discontinue abruptly.
Table 2: Off-label protocol for alleviating neuropathic pain from onychectomy (Gaynor)24
Administer concurrently: Amantadine 3 mg/kg PO q24h X 21 days,
+ Buprenorphine 0.01-0.02 mg/kg buccally q12h X 2-3 days,
+ Meloxicam starting at 0.05 mg/kg PO q24h X 4 days => tapering to 0.05 mg/2 kg PO q24h X 4 days => followed by 0.05 mg/cat PO q24h X 4 days and finally => 0.05 mg/ cat PO q48h X 5 days.†
†The ISFM and AAFP consensus guidelines: Long-term use of NSAIDs in cats21 recommends once daily dosing rather than other frequencies.
1. Mathews K, Kronen PW, Lascelles BDX et al. Guidelines for recognition, assessment and treatment of pain. J Small Anim Pract 2014; 55: E10-E68.
2. Robertson SA, Lascelles BDX. Long-Term Pain in Cats: How Much Do We Know about This Important Welfare Issue? J Fel Med Surg 2010; 12: 188-199
3. Bergadano A. Diagnosis of chronic pain in small animals. Europ J Companion Anim Pract. 2010, 20 (1) 55-60.
20. Gunew MN, Menrath VH, Marshall RD. Long-term safety, efficacy and palatability of oral meloxicam at 0.01-0.03 mg/kg for treatment of osteoarthritic pain in cats. J Feline Med Surg 2008; 10: 235-241.
22. Gowan RA, Baral RM, Lingard AE, et al. A retrospective analysis of the effects of meloxicam on the longevity of aged cats with and without overt chronic kidney disease. J Feline Med Surg. 2012;14(12):876-81.
23. King JN, King S, Budsberg SC et al. Clinical safety of robenacoxib in feline osteoarthritis: results of a randomized, blinded, placebo-controlled clinical trial. J Feline Med Surg 2015; 1098612X15590870.
25. Sparkes AH, Helene R, Lascelles BCX et al. ISFM and AAFP consensus guidelines: Long-term use of NSAIDs in cats. J Fel Med Surg 2010; 12: 521-538.
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