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Dr. B.
Dr. B., Board Certified Veterinarian
Category: Vet
Satisfied Customers: 22612
Experience:  General practice veterinary surgeon with extensive experience in a wide range of species.
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I am based in the UK. I have a beautiful cat who is nearly

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Hi, I am based in the UK. I have a beautiful cat who is nearly 20 years old. She has been having difficulty eating and on examination has been diagnosed with severe dental resorptive lesions. The vet advised that the teeth need to be removed under a general anaesthetic. The vet has also given her vetergesic, 0.1ml orally twice a day.
Several years back she had the same vetergesic injected. I believe 0.2ml. The outcome was terrifying. Vomiting, shaking, drooling, hiding and miserable. She refused food and water. Eventually she took some bits but it was too late and she went into kidney failure. She was admitted on a drip and eventually came out fine.
She has previously been diagnosed witness CRF.
The vet is insisting I give her 0.1ml of vetergesic twice a day for pain relief. He is also advising that Vetergesic will be administered post-op. He says it's such a small dose and ping through her digestive system too.
I am keen not to make the same mistake twice because of the frightening and dramatic reaction she had previously. So are there any other safe pain medications with limited side effect that's preferably not an opiate and will not hurt her kidneys? I did wonder about a local anaesthetic or maybe gabapentin or prednisolone.
Thank you so much for any help. She is a dear old thing and I am desperately keen to keep her with me and pain free.
Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you with your wee one today.
Actually, I have to say that I am surprised to hear about your previous experience with Vetergesic. This is because the drug itself (Buprenorphine) tends to be very kidney friendly. In fact, it is a common pain relief used in cases of human kidney failure and dialysis patients. So, it is odd to hear that she had such a reaction (especially as we'd usually think of those signs related to the non-steroidal anti-inflammatories).
In any case, if she has had such a reaction, then we'd be best to consider an alternative. As I hinted before and with her kidney related history, non-steroidal anti-inflammatories would need to be avoided here. As well, local treatments are no practical as they are short acting and often require sedation to give. Furthermore, while Gabapentin can be tried, its more effective for nerve pain and therefore likely would not really manage this for her. Therefore, with that all in mind and all our concerns, steroids like Prednisolone would be our most reasonable option for this case. They would reduce the pain and inflammation (which the opiates couldn't do) in her mouth. As well, moderate doses tend to be well tolerated in the cat and could actually boost her appetite if it has been on the wane with her sore mouth.
Overall, extraction of the affected teeth would be ideal, but keeping her comfortable is our main priority here. Therefore, considering her history and our UK based treatment options, steroids are going to be the most practical in reducing her discomfort but also reducing the inflammation here.
All the best,
Dr. B.
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