Are chronic painkillers bad for your cat?

Hello, this is doctor said. This is the cap CA FAE podcast. It's kind of easy when doctor Susan is not here because there's no interference and we can say really really fast. But we have an amazing co host and that's doctor Kelly Sympathy. Hello Kelly, Hi, doctor churmustein. How are you doing? I'm doing well. And because you haven't been on the podcast for a while, can you reintroduce yourself? Sure I can't. Just like doctor Little, I am board certified feeline practitioners, so that I only work with cats in practice. In my other jobs, I'm also an editor of a research journal for feline medicine and a magazine for feline veterinarians. So lots of stuff going on. That's awesome. And we are here together because I know we're talking for cat owners. But the AFP and ISFM have come out with a consensus paper about guidelines for the long term use of ensays and there's lots of difficult words in here. So first explain what's AFP. Well, it's the AFP is the American Association of Feline Practitioners and their sister organization, the is FM, which is the International Society feline medicine, so they're on the other side of the pond. We work closely together on producing information for terinarians and also cat caregivers to help improve the lives of cats. And then what is an end say, so, an NSET is a medication that we as humans can take, and dogs can take and cats can take. It's called a non steroidal anti inflammatory drug, is what that stands for. But it really means something that will help control inflammation that might occur as a result of surgery or an injury, or even a chronic disease or pain issue, right right, right, and inflammation always gets together for some reason. Yeah, so you obviously felt the needs to write guidelines about this. Why so we had these guide guidelines. I think in twenty ten we had a guideline on and said use in cats. And so that's fourteen years ago, and we have a lot of really good medicine and research that's shown us a lot more information, and even since then, we have some new drugs that have come out. So it was over due for us to have a task force of experts sit down and write a guideline that helps veterinarians use these drugs. You know, well based on science to help cats with chronic pain, right right, right? How do you select these people that make those craudlines? So our task force will be selected. I mean they're invited and hopefully they have time to do it. It's a lot of work. But the people that are asked to be on the task force will be people that have expertise in the areas. So we have people that have in backgrounds in anesthesia and and analgesia. We have people that are behaviorists, we have people that have background in pain management and cats and feline specialists as well, so a number of different types of areas, but they all kind of have very roundabout expertise in these areas, that do research and they've published in the areas as well, so they're they're the smartest of the smart for the most part, right right, right right. We won't mention names. So and then obviously these guidelines are made for the air professionals. What's in it for the cat owner? Yeah, so they are geared towards the veterinary professional. But what they're going to do is help the caregiver with what they can do with their cat, so how their veterinarian can guide them how the veterinary team can guide them in terms of what drugs to use and when if their cat has pain, what chronic pain looks like. And in fact, these guidelines are really beneficial to caregivers because there's a whole section on how to help caregivers at home and for the you know those cat people listening out there. You know what when you get pills from the veterinarian and how stressful that is because you're not always sure how you're going to get the medication into your cat. There's actually a whole section in this guideline on helping caregivers medicate their cat to adjust the environment for their ca For example, if their cat has our secure arthritis, can you put up ramps and little stairs different ways to make the cat's life a little less stressful based on the condition that they have? Right? Right, So, as a cat owner, how do I recognize that my cat is in chronic pain. That's a really tough one. As we all know, cats are very independent. They have not been domesticated for very long, so they have a tendency to hide all their illness and pain. And also when they have pain for a long period of time, they will adjust their behavior and their activities very gradually, so that sometimes as the person living with that cat, we don't notice the change because it's so subtle, and so it can be very difficult. But it is really about knowing, first of all what medical conditions your cat has, talking to your veterinarian, and also monitoring your cat's behavior at home, because any change in behavior is potentially significant. So something just as simple as my cat sleep on the bed with me every night, and now they don't come to the bed at night anymore, they sleep on the couch in the living room, that can be a sign that maybe your cat's having pain getting up the stairs and doesn't go up the stairs anymore simply because they are in pain. Right, right, right, That's a very very good point. The other thing that we discussed in the podcast for Venerians and veninair technicians is the fact that a lot of disease entities go along with chronic pain in cats. So can you mention a couple of those disease entities that might that you might not think about as a cat owner that will cost so much pain? Yeah? Sure. So there's really two very big ones that are very common. When I say big I think, I mean very common. One of them is dental disease. So our cats as young as three years of age can have dental disease, and I think the statistics say that seventy percent of cats three years of age are over have some form of periadonal disease, so they're going to have oral pain. And then we also have a lot of statistics to tell us now that a lot of cats as they age develop osteoarthritis or what we also call degenerative joint disease. And the stats for that, we're talking about cats twelve years of age of overs, so we would report that seventy percent of those cats have some sorry it's ninety percent of those cats are affected by osteoarthritis. So as all that means, if you know, that's a lot of the cats that I see in today, and a lot of people have aging cats at home, and if your cat's three are over, they probably have some periodontal disease. So it's very easy for us to have cats in our home that are experiencing chronic pain and we don't even know it. Yeah, those numbers are amazing older cats for and as a prefact, seventy percent for younger cats around the age of three that have some dental disease. Yes, well, that's just you know, I think there's very few people that I only know one person in my life that brushes their cat's teeth, and so it's not like us where we rush as much as we do. In cats, they don't, So that's probably one of the reasons that cats get that much more common exactly. And I try to recommend to people that they either brush or wipe their cat's teeth that's easier than brushing, and use some of the prescription formulas that we have for dental diets now that are designed to help to reduce plaque and tarder and they do make a difference. So those two things at home alone are really good. But it's really good to have your veterinarian assess your cat's teeth before you start any of those things, because if your cat already has pain, you're going to be inflicting more pain by trying to wipe or brush their teeth, right, that makes a lot of sense. The other two major disease empathies were tumors in cats, which of course makes sense. They're often very painful, and then we talked a little bit about urinary disease. Yes, yes, And many of our cat caregivers, if they've had cats over the years, will know about lower urinary tract obstruction if their cat had an obstruction or their cat had crystals. And now we're starting to hear more and more about v line idiopathics cstitis, which is really a stress related neurological condition that affects the bladder. And so your cat may have been diagnosed with stress related cistitis and they have problems with peeing. They'll be small amounts frequently and have a lot of pain, and that is often related to stress and an inability to handle even day to day normal stressors. So that's something that we need to look at as a source of chronic pain for cats as well. Right, So if an owner recognizes that the catalyst chronic pain, why not just take a painkiller from your covert that you use for yourself. Well, like everything else with cats, they need special diets because they're obliga carnivores and they also have a very unique metabolic system and they really don't tolerate the medications that you and I would take or even that our dogs would take necessarily, so there are certain things in their body that don't work the same way, and they will potentially get really sick from some of the medications that we have at home for ourselves. So again it's really better to talk to your veterinarian because we have some nice licensed products, especially these non steroidal drugs. There's a couple of really well known ones that we have licensed and studied in cats, and we know they're safe in certain circumstances, and that's where your veterinarian can guide to and can you mention one that is absolutely not safe for cats that we use a lot. We at home will use tailotol for pain, and I know a lot of us will take it for headaches and other types of pain, and that's definitely one we don't want to give our cats ever, even in a small amount, because it is toxic. Right, So it's really important to not give any home medications do the cat because, like doctor Kelly says, we don't know what effect it has on the cat, and in some cases we do know and you can even kill the cat with So be very very careful go to your van area and for sure, if you're worried about a cat being in pain. We talked about it a little bit. There's subtle changes in the cat's behavior. Often it's not that they're screaming from pain, it's just that they're not starting to do things. And doctor Kelly were talking about a couple of things that people can check to be able to see the cats in pain. Can you give a couple of examples of that tool. So there's a lot of tools available that we have for cats, and really a lot of them have to do with mobility. If we're talking about arthritis and cats especially, and one of the things you can do at home is you can look up for in terms of your cat's mobility. There's some great websites. The companies at Us has a really good website that talks about six different types of activities your cat would do in the home that if they've changed the way they do those activities is a sign that they might have arthritis pain. But you can also make your own list of activities. So in your young cat, you can make a list of five or six things that your cat does regularly and then just over time, keep track are they still doing those things? If those things change, then that can be assigned that your cat has chronic pain, right, And you were explaining about an owner that was had a cat and even didn't think that the catactronic pain, but that cat paid back after you started on pay medication and what did the cat do? What did the cat do? Yeah? Yeah, so it was the cat that used to do something and I realized that it was not doing that anymore. We were talking about this. Yeah, So we had a cat that had really bad dental disease and we had booked the cat in to have a dental surgery. The cat obviously needed a couple of teeth out, just based on surgical removal based on me looking in the cat's mouth, but leading up to the dental surgery, I felt the cat wasn't enough pain. That I put the cat on pain medication because it was going to be a couple of weeks before the surgery. And the caregiver called me a week later to say that cat had started fetching again. So she had not noticed that the cat stopped fetching the ball that she the cat used to love fetching the ball, and she was actually almost in tears when she called me because she didn't realize she said, I didn't think that the cat was in pain, but the fact that the cat suddenly returned to fetching is a really positive sign that she knew that she was doing the right thing to do that dental surgery. The cat needed it, so it was quite it was quite dramatic change. She hadn't noticed, really that the cat had stopped doing it. And it's at these changes are often so subtle, so you shouldn't blame yourself that you don't see the changes. But Venerians are trained to see these things. So go to you Vanarian, and if you worried about it, certain behavior changes are happening, checked out. I think that's really really important. Never apologize sometimes that people bring their cats in for like the what they think is the weirdest behavior change, and they say, I shouldn't have brought the cat, and I feel so embarrassed for coming in just for this, And I always say, that's not not a cat. If something's changed, you know your cat best, then then you need to look into it because it potentially could be something important. So you were talking about the fact that chronic therapies like these ensays in this case leads to a chronic period of time that you have to give this, and as a cat owner, I would be really, really worried, So I probably would not really jump on this opportunity to have to pill my cat for the next six months or maybe for the next life, because depending on the cat's behavior, it might not be my friend anymore. So the guidelines are specifically talking about it. So give us some tips for owners that are hesitant to do this. Yeah, I mean so, first of all, if you have concerns with how the medicating is going to go, you do need to let your veterinarian. No, don't just you know, buy the whatever they're telling you you need to take home and use for your cat and walk out. Ask questions like I'm not sure how to give this, or the last time I gave pills to the cat it was a disaster. What can I do? Because a lot of veterinarians will be able to guide you to a website or they may have a handout or something to help you, and then they can also get technicians or nurses to support you through phone calls and emails if you're having trouble. So don't be afraid to ask questions. Don't you know if it seems like they're assuming you know how to do it. Don't be afraid to say I don't. And then really, when you're at home with your cat, you're going to need to figure out how these things are going to go. And sometimes we can use medical treats to try and get medications in like chu Rus. We see a lot of these liquid treats now, and also pill pockets and pill assists. A lot of those things will help us to get medications into our cat. But some cats won't take those medications when they're not feeling well because it's it's something new, right. So one of the things I actually recommend now to everybody who has a healthy cat is why are we not using these things as treats periodically? So a pill pocket that we would normally hide a pill in, let's give our cat that a couple times a week so the cat really gets used to that as a treat, and then they're not as suspicious and they're more willing to eat it when they actually are unwell. So that's a really good kind of heads up before your cat gets sick or it needs medication, start doing that as well. I love that. I love that idea so let's switch topics a little bit afe. So this organization has also a lot of information for cat owners. Yeah, where shoot find that information. The AFP has one of the best sites for catcaregivers and it's at catfriendly dot com. And that website is, as you'll mention, put together by the AFP by a lot of feline specialists, and it is updated on a regular basis, and it's designed for people who live with cats. It explores health problems, it explores what your cat needs in their environment to feel safe and healthy. It explores scratching and also giving medication. Like, there's just so much there introducing cats to each other. It's a very very broad website. It's easy to navigate and it's very helpful. Right right, And is there anything new? What has been developed lately? We have? You did we actually now with this isfm AFP and said guideline, We developed a toolkit again for veterinarians on chronic pain. But we also have brochures available for caregivers and you can get those at kept friendly dot com as well that talk about how will I know if my cat's in pain? What if my cat has arthreat is pain, what if my cat has chronic pain, and there's tips and tricks again on medicating as well. Right, last question, So, now I have a cat on this chronic pain medication, these insets, what should I look for if we talk about side effects? Yeah, and this is a really important question. You'll and I'm glad you brought this up. If your cat has prescribed any of these non steroidal anti inflammatory drugs or end sets, you want to make sure that your cat's still eating well the normal amounts your cat's drinking, and if that's not happening at home, then you don't want to give that inset, and your veterinarian will likely tell you this when they prescribe the medication. But if any of those things are happening, then you want to stop the medication and let them know. And then if they are taking the medication and you start to see signs like a loss of appetite, vomiting, diarrhea, anything really associated with their gastro intestinal tracks of their stomach and their intestines, those are also reasons to stop the medication in case the medication is causing those signs and to let your veterinarian know that that's happening. Great, Great, ending of the show, so thank you so much, doctor Kelly, and I to stop us and you know where. We're talking about the new guidelines that the AFP and I s at them produced about chronic painkillers in cats or chronic medication in cats. It's really really important, but as caregivers, as people that have cats, it's also important to know that there are possibilities to treat chronic pain. Go to your veterinarian to get more information. And this was the cafe podcasts. You can find far more, much more information on cat Cafe podcasts dot net or on social media att fake podcast. So doctor Kelly, thank you so much for being with us, thank you for having me. Sorry, thank you for having me of course yes and uh and we will talk to our audience the next time, so see you later.