A few cat caregivers have posed questions regarding their cats’ arthritis recently on some online forums. My Omaha has severe arthritis. We started acupuncture in 2004 and the results were amazing! At the time we started, he was having trouble standing up. After about three weekly sessions, he was RUNNING. We continued with the treatments for some time, but honestly it was a struggle as Omaha is NOT generally able to be handled by anyone but me. (He has to be sedated for most anything, including blood draws or x-rays. During acupuncture he’d scream and thrash, pee and poop everywhere, and once when I wasn’t sufficiently careful I was bitten very badly. We generally have to muzzle him.) We tried to keep up with maintenance treatments, but the last one we got had little to no effect, so I knew I’d either have to take him more often or give up – and I’m sorry to say I just can’t bring myself to commit to more frequent treatments. To locate a veterinary acupuncturist, I suggest consulting the AHVMA website. Keep your search broad in order to get the best results. (An acupuncturist could be listed in one discipline/area, but not another.)
http://holisticvetlist.com/
Omaha’s arthritis has worsened dramatically this year, to the point he once again was having trouble standing up. (In fact, I came home one night to find him lying in a pool of his own urine.) He’s doing MUCH better now, though, and walking well and able to stand up on his own. His current regime is:
* Adequan – 0.3 cc’s injected weekly (at home – for obvious reasons). My vet has me injecting it into the muscle (IM) – but I know others use Adequan and give it as a sub-q injection.
* Glucosamine/chondroitin: orally daily – I just use the human Now Foods brand – cheaper than Cosequin
* Gabapentin (Neurontin) – We’re now up to 2.5 mL (50 mg) twice daily. That’s the standard starting dose, but we started lower as my vet has no experience with the drug. It’s very new for use in cats – supposedly blocks the pain recepters. Only noted side effect has been drowsiness, which I have not seen in Omaha. Ours is compounded into a chicken-flavored liquid.
* Metacam (meloxicam) – We’re giving the 2 pound line of the 0.5 mg/mL suspension every other day. I think that’s 0.2 cc’s. (It comes with a special syringe that fits on the tip of the bottle and just notes “pounds”.) I know there may be risks with Metacam, but despite Omaha’s age of 18, his bloodwork looks great.
More info:
International Veterinary Academy of Pain Management – references to gabapentin
International Veterinary Academy of Pain Management – more references to gabapentin
Winn funds study on gabapentin in 2007
Hi, Lynette!
PLEASE tell me how I can get my hands on glucosamine/chondroitin compounded as a chicken-flavored liquid. Did you make some special arrangement with a veterinary pharmacy? Does your cat LIKE the flavor or do you have to use a syringe? Does it seem to be helping with stiffness and pain?
My cat is very fussy and will not touch his food after it is mixed with a crushed, bacon-flavored tablet (ProMotion). The company is sending me a complimentary bottle of the capsules containing tuna-flavored flakes that can be sprinkled on food. I am hopeful but not optimistic that he will go for that.
Hi Jane,
I’m not using a liquid for the glucosamine/chondroitin, that’s for the Gabapentin.
I just use the regular over-the-counter human version of glucosamine/chondroitin, open the capsule and empty it into the food. They don’t seem to mind the taste, if it has any.
If your cat does balk at regular unflavored glucosamine/chondroitin, you could try “Cosequin for Cats” which is capsules where the powder inside is tuna-flavored. More expensive than the human version.
I personally have found a glucosamine/chondroitin helps with *minor* arthritis, but in severe cases pain medications are needed, which is why Omaha is on all four meds/supplements.
As a side note, many pharmacies will compound various medications into flavored liquids. Omaha’s Gabapentin comes from Road Runner Pharmacy. I’ve seen advertisements at places like Osco, Walgreens, and CVS that they will flavor meds.
[…] got two options, gabapentin (Neurotin) or Metacam (meloxicam). As I noted in my recent post on arthritis, Omaha is on two supplements (Adequan and glucosamine/chondroitin) and two pain medications […]
Hi,
I found your blog while searching for arthritis help for my 17 yr old cat, Truman.
Just wondering the strength of the glucosamine/ chon. capsules you get. Trummy is around 10 lbs
and also a picky eater, but I need to try something.
Just got home from the vet with 5 mg. prednisolone tabs for short term use. He says there isn’t really any meds for feline arthritis .??? I need to find something for long term.
thanks for any help!
Hi Diana,
Personally, I use the Now Foods brand, which provides 1500 mg glucosamine and 1200 mg chondroitin. (The most commonly used veterinary brand provides 125 mg glucosamine, 100 mg chondroitin.)
Generally, I recommend 1/10 to 1/2 capsule daily for cats – but since Omaha’s arthritis is so severe, I go ahead and give him a full capsule daily. A bottle of 120 capsules costs around $27.00.
Your vet is right, there aren’t really any “medications” for arthritis – you can support joints with supplements (like glucosamine/chondroitin) or relieve symptoms (steroids, pain medications)… there is some research underway regarding regenerative cell therapy – will be interesting to see where that leads.
Anyway, I do want to mention for the prednisolone – this IS a steroid. Cautions are in order:
* If feeding your cat a dry food, I would HIGHLY urge you to get him transitioned to canned or raw – steroids and dry food put a cat at serious risk for diabetes. (It’s how I got my first diabetic cat – she started on prednisolone, 1/2 of a 5 mg tablet twice daily, and was eating a dry food – a few months later, she was diagnosed with diabetes.)
* Do NOT suddenly stop giving steroids! It can cause severe withdrawal. Once you start steroids, you must wean them off the steroids gradually.
Best of luck!
Lynette
,
BACKGROUND
Patches is a 14 year old male feline with a healthy history. In mid-February, 2008 he is showing some difficulty in his movements.
On February 29, 2008, he is diagnosed by HVAH, with a chronic arthritic condition. Blood tests reveal borderline healthy kidney function. Otherwise he is in good condition.
He is given Metacam injection 0.3 mg/kg by Dr. P at HVAH. Then oral Metacam 0.8 ml is given once daily for two days followed by 0.2 ml once daily every other day for two weeks. Never mentioned to the client at any time is the possible adverse reactions from the Metacam injection nor the FDA non-approval of oral usage in felines(see below for label warning).
Patches returns to the HVAH on July 25 after some of the arthritis symptoms returned. The other veterinarian, Dr. G, gives Patches a second injection of Metacam. Owner is not told of the possible adverse effects of the injection, nor told that a second injection is contraindicated on the Metacan label. In addition no blood testing is done to properly evaluate Patches’ current condition. Owner is not told of the reason or need for a physical exam or blood test; owner is not told the name of the drug injected in either visit; and the owner is never advised of the high risks of a follow-on Metacam injection.
Patches begins losing weight in mid-August with unusual sluggishness and increased vomiting, two weeks after the second injection.. He is barely eating, and on September 4 is brought to the VB and seen by Dr. B. She exams him , gives a blood test and reports that he has serious liver and kidney deterioration. After giving antibiotics and supplements to get Patches to eat, Dr. B reports no improvement. Dr. B recommends Patches be given an ultrasound scan for a more specific diagnosis.
The scan done on September 10 shows major failure in liver, gall bladder, kidney, stomach, pancreas, peritoneum and lymph nodes. His ultrasound is done by Dr. A. at the VCAH and she states that he has chronic renal disease, pancreatitis, and cholangiohepatitis with dehydration and jaundice.. It is recommended that aggressive medical management be instituted with IV fluids, liver aspirate and e-tube.
On September 12, Patches is admitted to the VCAH. After two days of hospitalization, he is in organ failure, and is euthanized on September 15.
FROM THE METACAM LABELS AND INSERTS
“Additional doses of meloxicam in cats are contraindicated, as no safe dosage for repeated NSAID administration has been established. “. In black label, the insert states, ” Do not administer a second dose of meloxicam. Do not follow meloxicam with any other NSAID.” But, a second dose was administered, despite the warning. Also, in the Metacam Oral Suspension label, which is used exclusively for canines, there is an additional bold letter warning for felines, ” Do not use in cats.” However, the oral suspension was used and no warning given by Dr. P for the off-label use.
” When administering any NSAID, appropriate laboratory testing to establish hematological and serum biochemical baseline data is recommended prior to use in dogs and cats. All cats should undergo a thorough history and physical examination before administering meloxicam. Do not repeat dose in cats.” No blood test nor exam was administered before his second Metacam injection.
“Foreign Experience: Repeated use in cats has been associated with acute renal failure and death. ” This severe warning, stated in black label, was ignored with the second injection.
“Information for cat owners. Meloxicam, like other NSAIDs, is not free from adverse reactions. Owners should be advised of the potential for adverse reactions and be informed of the clinical signs associated with NSAID intolerance…Cat owners should be advised when their pet has received a meloxicam injection.” In fact this narrow margin of safety with oral Metacam is reflected in the FDA’s Adverse Drug Experience for June 9, 2006 where the agency reported that in 320 felines, 105 suffered kidney failure, 48 died and 35 cats had to euthanized.. Despite these statistics and warnings, neither Dr.P or Dr. G ever mentioned that Metacam was used on Patches nor the significant health risk to him.
I am outraged by the the loss of my pet! I cannot believe I lost my cat because of this incompetence. I want to save other animals from this fate.
Addendum
By Wendy C. Brooks, DVM, DipABVP
Educational Director, VeterinaryPartner.com Date Published: 11/1/2004 10:46:00 AM
Date Reviewed/Revised: 11/12/2007
Side Effects
The side effects of concern are the same with all NSAIDs: stomach ulceration, loss of kidney function, and inappropriate bleeding. These are dependent on the dose of medication used and on risk factors of the host (for example: an aged pet may not efficiently clear a dose of medication from its body leading to stronger and longer activity of the drug). There is also a particular idiosyncratic reaction for NSAIDs that has received a great deal of press. An idiosyncratic reaction is one that is neither dose-dependent nor predictable by any apparent host factor; it simply happens out of the blue. This particular idiosyncratic reaction is a liver toxicity that is rare enough that it did not show up in any of the initial 400 carprofen test subjects, nor in the U.K., and was not recognized until carprofen was used in over a million dogs in the U.S. after its release as the first NSAID. This reaction is reviewed below. While originally it was carprofen use that led to the recognition of this reaction, it is now felt that all veterinary NSAIDs have potential to cause this reaction.
The most common side effects of meloxicam are nausea, appetite loss, vomiting or diarrhea. If any of the above are noted, meloxicam should be discontinued and the pet brought in for a liver enzyme and renal parameter blood test. In most cases, the reaction is minor and resolves with symptomatic relief, but it is important to rule out whether or not the patient has more than just a routine upset stomach.
If a patient has borderline kidney function, NSAIDs should not be used as they reduce blood flow through the kidneys(my underline). It is also important that NSAIDS not be given to dehydrated patients because of this potential side effect. This is particularly true in cats.
The hepatopathy side effect (usually occurs within the first 3 weeks of use).
** Names removed by blog owner **
Mr. Stern,
I am VERY sorry for your loss. I’m of the opinion that ANY drug should be used with caution, and Metacam is certainly no exception. There have definitely been some very unfortunate cases with Metacam – and other drugs. I believe the vet and caregiver need to discuss the risks and benefits and make a decision together.
As an example, thousands of humans die from Tylenol use every year. I don’t believe that means we should never use Tylenol – for example, I have a friend who cannot use any other over-the-counter pain reliever due to allergies, for whom Tylenol works great. However, we need to exercise caution.
You wrote:
“He is given Metacam injection 0.3 mg/kg by Dr. P at HVAH. Then oral Metacam 0.8 ml is given once daily for two days followed by 0.2 ml once daily every other day for two weeks.
Patches returns to the HVAH on July 25 after some of the arthritis symptoms returned. The other veterinarian, Dr. G, gives Patches a second injection of Metacam. ”
I believe Metacam injectable is approved for ONE TIME use only.
You didn’t note the strength of the oral Metacam used. It’s available in 0.5 mg/mL and 1.5 mg/mL strengths.
My cat, Omaha, is on 0.2 cc’s of 0.5 mg/mL strength every other day. That is 0.1 (or one-tenth) of a mg every other day.
Assuming your cat was around 4 kg’s in weight – and it was the 1.5 mg/mL strength (since the 0.5 mg/mL strength has only recently become available) – your cat received:
* 1.2 mg’s by injection
* 1.2 mg’s daily for two days
* 0.3 mg’s daily for two weeks
* Another injection
That’s obviously a lot more that Omaha is receiving.
However, that’s not to say Omaha’s treatment is without risk. I told my vet I was well aware of the risk to Omaha, but since *not* treating him gave me no other option that euthanasia, I had nothing to lose.
Lynette
Hi Lynette,
The Metacam oral was 0.5 solution. However, one of the major problems is giving Metacam when the cat has kidney impairment, which Patches did.
Yes, I’d be much more reluctant to give a cat with CRF Metacam.
Good to know Patches received the 0.5 mg/mL strength (though it certainly couldn’t have had a worse outcome for you).
My cat, Omaha, is on 0.1 (or one-tenth) of a mg every other day. Fortunately, though he’s older (18 years), he shows no signs of kidney disease.
Assuming your cat was around 4 kg’s in weight – and it was the 0.5 mg/mL strength – Patches received:
* 1.2 mg’s by injection
* 0.4 mg’s daily for two days
* 0.1 mg’s daily for two weeks
* Another injection
Lynette
Hi Lynette
My 18 year old cat (Chloe) does not like medication added to her food or taking oral medication such as Gabapentin. I have ordered different sized gel capsules from the Vet and I give her the medication orally. I then give her water to wash down the capsule. It works really well.
Albert,
My sincere condolences for your sweet Patches. His loss will not be in vain; I’m taking your loss to heart and getting my angel off of this med., asap.
If anything can offer you comfort, maybe that Patches will help many others (*selfishly* hoping it is not too late for my angel) and that Patches is watching over you and blowing you ruff tongue licks for being so passionate.
I wasted a year with a vet who misdiagnosed my angel and am stunned that the newest one put her on this.
If it helps some, good for them, but the pharm. companies are way too lazy these days to actually research like they could be doing. Gabapentin? This is a good example. I’m on this for seizures. Originally meant for people with bipolar.
I admit I am ignorant about just taking the doctor’s meds and advice, whether for my little one or for myself. I guess playing nice only gets you so far. On top of a vet call, I’m prowling for a grassroots organization that really advocates for companions and their lucky adult buddies.
I feel so for you, Albert.
Anne
Our 18 year old Siamese was prescribed glucosamine tablets. Several weeks later we remarked that it didn’t look as if she would live long. She had become extremely lethargic and sensitive to touch. We took her off the glucosamine. A week later she was back to her normal self and lived to be 20.
I changed our cat’s dry food for our 14 year old Siamese and within several weeks she became extremely lethargic. I looked at the contents label and discovered high percentages of glucosamine and chrondroitin. Stopped giving her that food and within 4-5 days she was back to her normal active self.
Went to small, privately owned pet store. The owner had just returned from a nutritional seminar and advised me that several brands have discontinued putting glucosamine in the food because certain states now outlaw it.
I would caution those who believe glucosamine and chondroitin are helping their cat’s arthritis that they may be mistaking arthritis pain relief when what is occurring is that the cat is “bagged out” with minimal movement or energy, and therefore experiencing minimal symptoms of pain.
Hope this helps.
Jeff
Hi Jeff,
Thanks for the comment. I did some searching and I cannot find any scientific evidence to back up the claim that glucosamine was “outlawed” or had adverse effects including lethargy.
Most glucosamine is produced from shellfish – so if the cat (or other being) taking the product was allergic to shellfish (not uncommon in people or cats) I can see where that could be a significant issue.
I’m personally not 100% convinced it helps with arthritis, at least not in every case, but the first time I used it in a cat I saw SIGNIFICANT improvement – she went from walking with a definite limp to walking/running normally. I’ve used it myself in adopted cats, and seen it used for numerous cats at the shelter, with no adverse reactions. (Not saying it couldn’t happen with your kitty – just that I have not seen it in any of the cats I’ve known on it.)
Quote:
“No study so far has found any serious side effects from either glucosamine or chondroitin. The most common side effects are increased intestinal gas and softened stools. However, animal research has raised the possibility that glucosamine may worsen insulin resistance, a major cause of diabetes. So far, studies in humans have not substantiated that risk. Nevertheless, people with diabetes should monitor their blood-sugar level particularly carefully when using that supplement. There have been no reports of allergic reactions to glucosamine. But because it is made from shellfish shells, people who are allergic to seafood should use it cautiously, watching for reactions, or avoid it entirely. As for chondroitin, it can cause bleeding in people who have a bleeding disorder or take a blood-thinning drug.”
Source:
http://www.quackwatch.org/01QuackeryRelatedTopics/DSH/glucosamine.html
Quote:
“Contrary to NSAIDs, no significant adverse clinical, hematological, hemostatic or other side effects were found in any clinical study using glucosamine and/or CS supplementation. ”
Source:
http://www.chiro.org/nutrition/ABSTRACTS/Glucosamine_and_Chondroitin_Sulfate.shtml
Quote:
“Chondroitin sulfate/Glucosamine
“These chondroprotective products (Cosequin®, Flex Free®, Xtra-Flex®, Glyco-flex®, etc.) are sold as nutritional supplements, or “nutriceuticals.” The classification of nutriceutical means that these products are not considered as “drugs” and do not have to meet the same standards of purity, efficacy, and safety that the Food and Drug Administration or Bureau of Veterinary Drugs would require of a drug for the treatment of degenerative joint disease. The nutriceuticals are promoted as oral supplements supplying the animal with the “building blocks” necessary for repair of damaged cartilage. However, the building blocks for production of joint cartilage are adequately supplied by most traditional diets. There are many anecdotal reports of improvement in clinical signs of lameness in humans and animals supplemented with nutriceuticals. Currently, there are few well-designed scientific studies proving that these products are effective. Some of the nutriceutical manufacturers are sponsoring such studies and results are pending. These products appear to be safe, may improve a lameness condition, but are somewhat expensive for long-term therapy. Because the nutriceuticals are not regulated by government agencies in the same manner as a drug would be, there is considerable variation in the composition and purity of the available products and standard doses have not been determined. Therefore, clinical results may vary considerably between different products. The chondroprotective nutriceuticals usually contain glucosamine salts and/or chondroitin sulfate.
Cartilage cells normally synthesize glucosamine from glucose and amino acids, however they can also use externally supplied, preformed glucosamine. Regardless of the source, the cartilage cells use glucosamine to synthesize glycosaminoglycans and hyaluronan. Glucosamine also regulates cartilage synthesis of proteoglycans and collagen. Chondrocytes make glucosamine from glucose. Glucosamine has mild anti-inflammatory action from scavenging free-radicals. Glucosamine is available as hydrochloride or sulfate formulations that appear equally effective. Chondroitin sulfate (CS) is long chain molecule composed of galactosamine sulfate and glucuronic acid units. It is the predominant glycosaminoglycan found in joint cartilage and is a natural component of other tissues, including tendons, bone, vertebral discs, heart, and cornea. Chondroitin sulfate stimulates glycosaminoglycan and proteoglycan synthesis in joint cartilage. It also inhibits destructive enzymes in joint fluid and cartilage and prevents thrombi formation in microvasculature.”
Source:
http://www.vin.com/VINDBPub/SearchPB/Proceedings/PR05000/PR00190.htm
Lynette
I wonder how efficacious human arthritis treatments are on cats; certainly a question for a vet. Paula Robb’s Complete Cat Training talks quite a bit about cat training but you may be able to contact her and see if she knew anything in this area.
Hi Kelly,
Unfortunately, because cats metabolism (as obligate carnivores) differs so much from humans’ – they don’t tolerate non-steroidal anti-inflammatory drugs (NSAIDS) well – which eliminates most of the pain relievers commonly used by humans as options. Steroids are an option – however, if feeding a dry food diet, it could lead to diabetes in the cat. Steroids also have other risks.
Omaha saw several vets – specialists, general practice vets, holistic vets… and we landed up with the treatment regime above, which worked relatively well until I lost him to something neurological in October of 2008.
Thanks for the comment!
Lynette
Hi! I have a glucosamine question. My cat is 14 and has been on gluosamine about a year and a half. It has made such a difference for her — I am so glad I discovered it can be given to cats. Here is the situation. Because she has been an indoor/outdoor cat for most of her life, I have not known the details of her urine output. But for the past few months, we have been “couch surfing” (recession) and the cat has used a cat box. I found I was picking up as many as 12 clumps of urine per day. Worried about diabetes, I thought I would see what happened when I discontinued the glucosamine before seeing my vet. 48 hours after the last dose, we were down to 6 clumps of urine per day. Have you heard of this before? Naturally I will see my vet as soon as I can, but it could be a while before I have the money.
Thanks
Carla
Carla – glucosamine won’t impact urine output. However, if you were putting the glucosamine in wet food – more moisture in will result in more moisture out.
If you haven’t already, get your cat on an all wet diet. It is your best chance at preventing urinary, kidney, obesity and other issues – as well as preventing diabetes.
Lynette
Hi
I have followed a diet linked to blood type for over 10 years with marvelous results (Eat right 4 your type). I figured if somthing like this is valid for me, Maggie my cat could also benefit. I took her off all corn and wheat gluten which I suspect are a major culprits. She use to have eye buggers all the time and those are 99% gone. She is 15 years and doing quite well.
I’m 62 and do kick boxing, full pushup, hand stands. I wasn’t doing near so well when I started the diet
Patricia
I feel so relieved to hear about healthy cats at age 18, I have had one living to 20 but vets seem sure I had her age wrong.
My now 15 year old boy has had arthritis and I used metacam, but diluted the dose in water and a splash of milk (I dont usually give them milk but its a coercion thing) Even the diluted dose seemed to help but recently he had to go in to be put on a drip because of dehydration, we expected renal failure but tests say his kidneys are ok? Could this be due to the metacam?
The vets seem to think he is old and this is just what happens to old cats!?
He is eating well with appetite stimulants but Im having to give him water with a syringe and hope some goes down because he doesnt seem thirsty and Im scared he has to go on the drip again!
Im so sorry for those who have lost cats due to incorrect meds being administered! One of mine passed away because hyperthyroidism was diagnosed as a stomach virus!!
Hi Wendy,
In case you haven’t read any of my other posts – PLEASE get your cats on an all-wet diet. No dry food! This is the best way to ensure your cats live a long healthy life!
The oldest cat on record was in its THIRTIES. I’ve personally had a 20-year old cat. Cats can live much longer than we usually see, because we usually feed them an inappropriate DRY diet which causes disease.
https://meowmeowmom.wordpress.com/2008/01/11/six-reasons-not-to-feed-dry-cat-food/
If you’re giving the correct amount of Metacam, putting it in water or milk doesn’t change the dose. You can give sub-q fluids at home, it’s really quite easy. I have a video of me giving them to Afer…
With an older cat, especially if that cat is not on an ALL-WET diet, kidney failure is a VERY real concern. I would be sure to have bloodwork done regularly, and urinalysis to check urine specific gravity.
https://meowmeowmom.wordpress.com/2008/11/21/kidney-disease/
Best of luck,
Lynette
Thank you Lynette
the blood work came back negative for kidney issues PHEW but he seems in some pain when he lies down and cant get comfy – maybe that’s the arthritis – i hope its just that and not something internal. The doc couldnt find anything obvious.
Used to feed them hills science diet and vets told me NEVER to give them wet food, but when he started losing weight i changed and suddenly all 6 of them started looking healthier so I reckon these expensive dry foods are a scam and wont use them exclusively again!
So sick of vets giving up and telling me ‘he IS an old cat you know…’ changed vets three time in the past year- this one at least tried everything and calls to see how he is doing – she also said I must give him fluids from home – if he doesnt improve i may just have to do that
thanks again for the advice!
Hi Lynette,
We have recently begun working with a vet who does rehabilitation work, and she has recommended 1200 mg of glucosamine per day for our cat. Of course, also with the caveat to build slowly watching for any signs of diarrhea along the way.
I’ve been trying to find any information possible about this large dose, but have so far come up short. I did, however, notice on your blog that you have posted: “Generally, I recommend 1/10 to 1/2 [1500 mg glucosamine] capsule daily for cats – but since Omaha’s arthritis is so severe, I go ahead and give him a full capsule daily.”
Have you had any adverse reactions with this dosage? Have you found any references regarding such large dosage of glucosamine or have a vet who has also advised 1200 mg is okay? We would love if this might help so we can potentially back off on the Metacam, but I’m nervous about the dosage size given it seems so unusually large.
Any thoughts you might have would be greatly appreciated. Thank you!
Hi Amy,
Glucosamine is a natural substance found in shellfish. Chondroitin is from cow or shark cartilage.
I’ve never had any of my cats experience adverse reactions. The only thing I would be leery of is a shellfish allergy, in which case a synthetic form may be preferable.
Lynette
Hi Lynette,
Do you have any more information on gabapentin and side effects or adequate dosage? My previous cat was given it 1/4 tab of a 100 mg tablet 2x a day. After two doses (perhaps only one, I’ve forgotten) we stopped as he was seriously lethargic, not just sedated, almost dead like. But, he pulled through after it worked its way out of his system.
My current cat has been prescribed it for arthritis. But, my vet told me that the tabs only come in 100 mg and I must have it compounded (note, this is the same vet who gave it to me for my last cat in the higher dose). So, somethings changed there re dosing, probably for the best. She wants to give it 10 mg 3x a day to my current cat, though I mentioned practically speaking I would only be able to give it 2x a day due to work schedule. Even though the previous bottle I had was expired, I asked if I could attempt an 1/8 pill with my cat to see how she reacts before ordering a new prescription, compounded, which is extremely expensive. Don’t want to pay that kind of money if in the end this cat won’t tolerate it either. She said yes, but mentioned that of course, if there are no side effects, we can’t really know if it’s because she can tolerate it or the ingredients are inert due to being expired. So, I cut a pill into 1/8, I gave the first dose which was probably under 12.5 mg as the pill basically shattered, and I was basically attempting to put powder into a gel cap for her. She seemed more sleepy than normal, but overall perhaps OK. That evening for her second dose, I shaved off a bit from the remaining 1/8 table (12.5 mg then) as I don’t think I was successful in cutting the 1/4 tablet in half equally (thus further evidence that her first dose was probably well under 12.5 mg), so the second dose I’m thinking was also well under 12.5 mg as I shaved off quite a bit, as I definitely didn’t want to overdose her and wanted to try to get the 10mg does. Within an hour she was well more than sedated. Here’s a cat that does not tolerate her paws being touched. I was not only touching her paws but pinching one of the pads to attempt to cause pain and she never even flinched. She was a limp noodle on the bed, though her eyes were open. When I did get her up and moving she was acting more than drunk, couldn’t walk a straight line, etc.
So definitely a bad reaction and I will not be purchasing a new prescription for her. But, I’m wondering if even at 10 mg a dose if that’s too high and perhaps I should seek out getting it compounded with the vets permission into something even smaller, considering it sounds like there is nothing out there for long term pain management for arthritic cats. I don’t believe she’s painful enough at this point to even think about Metacam with the known risks there (plus she’s 18 and has a start on the kidney disease). Right now I’m leaning toward nothing as she’s painful, but I believe it’s low grade for the time being.
Thanks for any insight you might have.
Hi Marla,
Unfortunately, we can no longer access the IVAPM links directly. At the time Omaha was started on gabapentin, the standard starting dose for a cat was 50 mg twice daily, as I noted. Omaha’s gabapentin was compounded into a chicken-flavored liquid. (Yes, that’s more expensive.)
The only known side effects of gabapentin are lethargy (and possibly diarrhea) – However, there is debate among veterinarians whether the gabapentin truly CAUSES lethargy – or whether the relief from pain is simply causing the cat to “catch up” on sleep it was lacking before, from being unable to really rest due to being in pain.
“Very few analgesic drugs are approved for use in cats in the United States, and there are no FDA approved analgesic drugs labeled for long-term management of chronic pain in cats.”
Click to access 050_UPDATE%20ON%20FELINE%20DRUG%20T.pdf
If we’re to treat pain in cats (or any other species, including humans) we’re taking chances and have to weigh the risks and the benefits.
Best of luck.
Excellent website. You have got a brand-new regular reader. Please maintain the fabulous work and I look forward to more of your interesting writings.
Hi Lynette,
I have my cat on Dasequin, a glucosamine/chondroitin combo for cats. I thought to give the human form a try since it’s cheaper, but I can’t find the one you refer to in your initial post (Now Brand). Can you direct me to the type that has only these two ingredients? It seems like every glucosamine/chondroitin formula I find on Amazon.com, for instance, has other stuff in it (potassium, sodium, MSM, trace minerals). If you have a link to the specific product, I’d be really happy if you shared it 🙂 Take care! Jane
http://www.nowfoods.com/Products/ProductsbyCategory/Category/M003581.htm?cat=Joint%20Structural%20Support
It’s available online from a variety of sources
Hi Lynette,
I would appreciate your opinion on my cat’s situation. He is a large 14 yr old who has a tumour in his neck (apparently common in large cats) that has induced diabetes. He has a high protein/ low carb diet of diabetic wet food, some raw kangaroo (very lean) and diabetic dry food plus he receives insuline injections morning and night and is fairly stable. However, he has arthritis in his rear hips. After reading this site I am now concerned about giving him glucosamine. We have tried giving him glucosamine before but he will not eat any food it is added to and fights against taking pills. Given your comments about dry food, glucosamine and diabetics, would you recommend we persist with the glucosamine, as his arthritis is getting worse and affecting his quality of life? Thanks
Hi Scott,
I would definitely discontinue the dry food. I would home-test blood sugar levels (eliminating the dry food can decrease insulin needs dramatically – home-testing will help avoid the chance of an insulin overdose/hypoglycemia).
Glucosamine is a supplement and can be good for arthritis – but if he won’t take it, I wouldn’t fight him over it (quality of life is important).
The new pain medication, gabapentin, may be an option you could discuss with your veterinarian.
Lynette
Wedgewood Pet Pharmacy (online) sells a 25mg gabapentin tablet in the form of what they call Tiny Tabs. They are a very small white tablet–the size of which is perfect for cats! I have two elderly cats with osteoarthritis who get these 25mg gabapentin Tiny Tabs. The Tiny Tabs can also be easily cut in half with a pill splitter for smaller doses, especially when initially starting your cat on gabapentin. I highly recommend you start with no more than 12.5mg once daily to see how your cat reacts to it. One of my cats at 12.5 lbs does well on 25mg every 12 hrs, but the other is more sensitive to its effects and only gets 12.5mg every 12 hrs.
Google Wedgewood Pet Pharmacy for more info. Your vet will need to provide a prescription for the Tiny Tabs. They are a wonderful pharmacy providing many pet meds in doses and various administration methods (tablets, pills, transdermals, etc) that are suitable for small animals, making life much easier on the animal and their owner!
I have no connection to Wedgewood other than my purchasing various meds from them for my cats.