As some of you know Dusty (16 1/2) has severe osteoarthritis in her left hip and both knees. There is very little approved for pain control in cats because pain meds tend to damage the liver/kidneys in cats.
We'd been doing Metacam injections about every 3 weeks (she'd already had the one time cat approved dose 2 years ago, so we are working 'off label'). The injections just didn't seem to be helping her.
I took her in to work yesterday and boss was very concerned with how bad Dusty's limping has gotten. We decided to try yet another 'off label' use for pain control, Tramadol. This drug has not been approved for or even tested in cats.
So last night I go home, have to hack this already small tablet into quarters, and Dusty was supposed to get 1/4 tablet 3 x a day. Well pilling Dusty has NEVER been easy. While the fighting her to get the pill down isn't all that bad, she usually gets herself so upset she makes herself vomit up the meds. We've been doing injectable meds only on her for years!
Amazingly enough I got the pill down her after only 2 tries, but apparently Tramadol is very bitter tasting, so Dusty proceeds to drool all over the floor for 5 full minutes!!
Pill stayed down and within 1/2 hour pill was working, but Dusty was definately 'drugged', eyes all dilated, and wobbling when she'd walk. After about 2 hours she was actually PLAYING and JOGGING without a limp, which I haven't seen her do in years!!! However the pupil dilation continued right up until her next dose. She had me worried, but that was NOTHING compared to her second dose.
I got her second dose down her at midnight on the 6th try. I was trying to hide pill in tuna flavored hairball meds, but pill kept sticking to my finger instead of going in her mouth! oops. No drooling this time but within 1/2 hour Dusty was definately 'out of it'. Her pupils were completely dilated and didn't shrink back down even in bright light, didn't respond to her name, and didn't even flick her ear when I'd tickle her ear hairs (which she HATES). She had me rather in a panic! She kept wobbling over to her water bowl and just sitting there staring off into space.
I stayed up with her until 2:30 this morning (boy am I tired today too). I finally took her into our bedroom and blocked up the door so she couldn't attempt the stairs and I would be able to hear anything if the other cats took advantage of her 'drugged' up state.
I opted NOT to give her the morning dose and took her to work with me. Boss did have her walk down the hall again today and agreed that even this many hours since her Tramadol that her gait was an improvement. Boss agreed she STILL looked 'out of it' and we decided not to give her anymore pills until we did lab work.
Dusty is notorious for being VERY difficult to get blood from, normally I can barely hold her still, she gets her front paws in the way, twists all over, and when we do manage to get a vein her blood pressure is just not enough to get a good sample. So we were NOT looking forward to doing this.
Blood draw time. I got Dusty wrapped up in a towel like a gray burrito and held her best I know how. Boss put his finger on her neck and BAM the vein popped right up there (first time), the needle went right in the vein first attempt and strangely enough her blood pressure was great and we got the best sample we've ever gotten in less than a minute!!!
Since we had a great sample we ran a bunch of lab work (it's been since 1/06 since we ran lab work last). Her tests basically came out very good for a cat her age, her kidneys were right within normal range and almost identical to last years results! YAY (big relief there). Her glucose was slightly elevated from last year but within normal range. The only minor concern was her ALT (a liver test) which was 199 (high range is like 130, last year it was normal). We figured it was probably a consequence of her high dosage of Tramadol last night (70% of Tramadol is processed through the liver). From what I've been reading a cat in distress can have ALT tests in the 700-900 range, so Dusty's 199 is a concern but not something to panic over at this point.
So for now we reduced the dose of Tramadol to 1/8 of a tablet (had to borrow the pill splitter from work to get that little tablet that small) and she only has to take it 2x a day now. Boss said we may have to 'fiddle' with the dose till we find what works for her.
My mom brought over some braunschweiger (a type of meat) to attempt to fool Dusty into taking her meds by hiding the pill in the meat. I've NEVER had luck getting any pill hidden good enough for Dusty before, and although she's never had this meat, I was doubtful it would work.
7 p.m. tonight, time for Dusty's pill in the braunschweiger. I took that teeny tiny piece of pill and rolled it up in a piece of the meat, woke Dusty up from her nap and showed the meatball to her. She instantly sat upright and was all over that piece of meat!!! She gulped it down without a second thought and wanted more!! I let her have another tiny piece of just the meat and gave her a TON of praises! No drooling and I doubt she ever even knew the pill was in there.
She's been napping on and off toinght since (it's been a stressful 24 hrs for her), but when she does walk it's with a slight limp but very good considering! Her eyes don't look all 'zoned out' and she responds to me tonight. I'm hoping this is the dose and meds that do the trick for her.
Here is a pix I took of her last night when she was 'zoned out'.
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I also have a very hard time pilling Starr and I even use the pill syringe and I have a syringe filled with water to help wash the pill down. I have to put him in a klaw kontrol bag that I bought from Drs. Fosters & Smith with only his head sticking out. Here's a picture of it 
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