If he's acting playful, then his pain - assuming he has some - probably
isn't strong enough to be interfering w/ his daily life.  It's difficult to
tell how much discomfort or pain a cat is feeling if it isn't pronounced
because they can hide it quite well.  If a cat feels really rotten, they'll
act subdued, listless, &/or will hide - either just under or behind the
furniture, or else really hide - like in a closet.

Good luck w/ Pop - there's a lot on his plate. And yours - juggling the
treatments for more than one major illness at a time is difficult - a real
juggling act.  (BTDT)

Cathy

nightstar88@hotmail.com  (Nightstar) writes

I'm sorry to hear about Pop's medical problems and wish him the best!
Sometimes it's difficult to know if a cat is in pain. They don't often show it.
They can even purr while they are in pain!  One sign is that they don't eat or
eat as much.  Another sign might be a moderate or severe change in behavior,
change in litter box habits is another.  Hope others can add to the list.

First, I'm so sorry about your cat.  

Like others have said, cats are masters at hiding mild pain although
less so with really severe pain.

It varies from cat to cat but most hide, don't want to be touched,
they assume a hunched over posture and, interestingly, their eyes
become very dilated.  If you're not sure, take a good look at their
eyes.  My cat's get hugely dilated when in pain.

I've been giving my cat pain meds for cancer. A low dose can be
effective and not make the cat all groggy.  Certainly my kitty knows
when his meds are due and starts giving me this look like "come on,
where is it?"  You can ask in alt.support.chronic-pain if you want to
talk to humans with chronic pain who can confirm that proper pain
control, even with narcotics, does not equal all spaced out and
groggy.  You might also want to go to sci.med and
sci.med.diseases.cancer and talk to human bladder cancer patients for
ideas. At least ask them if they have pain and what it's like.

Being both a nurse and a chronic pain patient I know a little bit
about good pain control.  I've also been mom to two very sick old
cats, one of whom got good pain control and one of whom didn't cause
back then I didn't know sh** and the vet didn't enlighten me.

The trick with pain meds is to first get the pain under control with a
few larger initial doses and then give smaller but REGULAR doses.
This is now the standard pain control protocol for all pain in humans.
"As needed" orders no longer exist except from stupid docs who don't
bother to read journals or learn anything outside of medical school.

The same thing applies to cats!  Try to get long acting pain meds.
This means the cat does not have to endure taking pills as often.
(I've been using Torbutrol but it only is effective for 3 hours in the
book- or about 5 hours it looks like with this particular cat. My vet
and I are about to have a discussion about this.)  

Use a higher dose the first time you give it then low doses until you
determine the minimum needed to keep the cat pain free but not groggy.
The gold standard these days is the fentanyl patch, which delivers a
continuous dose of a non-groggy but effective pain med for about 48
hours.   But TRY getting a cat to not pull off a patch....you can put
it on their head and put one of those big collars but it's a real
drag.  For that reason, most vets reserve it for hospitalized cats,
like post-surgical pain.

Also, if you're really prejudiced against narcotics,  cats can
tolerate certain non-narcotic pain meds like non-steroidal
anti-inflammatories that dogs can't.  But opiate narcotics are far
more effective when the underlying cause isn't something like
arthritis and opiates are the drug of choice for cancer pain.  They
are actually among the safest pain control drugs that exist, have been
used for thousands of years and have relatively few side effects when
used properly under medical supervision.

One other thing I've learned: don't pet your cat and get him all
relaxed before pills or IVs.  My old cat (smarter than the dickens)
decided not to trust us when we petted her ever again.  Just do it and
save petting and treats for after.

Hope this helps.    

___________________________________________________              

             Camilla Cracchiolo
              Registered Nurse
            Los Angeles, California

camilla4@mindspring.com     webpage temporarily down

Cats are stoic by nature.  They often can be in horrendous pain and
not show it.  Look for signs that he isn't enjoying life - Will hardly
move, won't play, won't eat, doesn't respond to affection.  Cats will
also purr when in pain as well, sometimes.

Good luck,
-L.

How's your cat doing?  Please keep us all informed.

I posted something in error a little earlier: I said Torbutrol was
only effective for 3 hours.  That's in dogs.  NOT true in cats.  In
cats it's good for at least 6-8 hours, sometimes 12.  Depends on the
cat.

Also, I consulted an oncology vet for my Victor, with oral cancer.
The vet said NSAIDS (non-steroidal anti-inflammatories) are good in
cancer control because a lot of the pain, at least Vic's cancer, is
from inflammation at the tumor margins where the cancer is eating away
the tissue.  

He mentioned Piroxicam as a good heavy duty aspirin-like NSAID.  Your
cat's already on it, so it sounds to me like you have a good vet.  My
old vet never even mentioned this stuff to me.

I did find that when the vet added a daily aspirin to Vic's Torbutrol
that I was able to lower the Torbutrol dosage.  Both seem to work
really well together.

Also, we discussed the possibility of palliative radiation, which is
different from 'definitive' radiation where you are trying to cure the
cancer.  The radiation is just for pain and works by killing certain
kinds of cells that respond to inflammation and which release hormones
that increase pain.  Now I don't know if this would be at all
appropriate for your kitty, since every type of cancer really should
be regarded as a whole different disease (in other words, there is no
such thing as one disease called "cancer".)  But you could ask.  

It's not cheap, though and means trips to not just the vet, but the
big people's hospital (my vet uses UCLA Medical Center, to give you an
idea.)  It also can have bad side effects, like burns and immune
suppression, even though the dosage is much lower than for regular
radiation 'curative' treatment.  It's only like 3 or 4 treatments
though, and sometimes even just one will do the trick for a long time.

___________________________________________________              

             Camilla Cracchiolo
              Registered Nurse
            Los Angeles, California

camilla4@mindspring.com     webpage temporarily down