Feline Kidney Disease & Buprenex

Buprenorphine, marketed as the name brand Buprenex, is a synthetic opiate that mimics opiates such as morphine. Though only FDA-approved for use in humans, many veterinarians prescribe Buprenex as an extra-label drug for the purpose of pain management in animals. Use of Buprenex in felines with decreased kidney function could potentially worsen the condition of the cat's kidneys.

Veterinary Consultation

You should always take cats showing symptoms that resemble those of kidney failure to a veterinarian, no exceptions. Though many websites and books offer advice for home diagnosis, only a veterinarian can prescribe the medication a sick feline may need. Buprenex, like most opiate and synthetic opiate painkillers, requires a veterinarian's prescription for use. Due to the potentially harmful effects of Buprenex on an animal's kidneys, a veterinarian may prescribe a substitute painkiller.

How Buprenorphine Works

Opiates and synthetic opiates function the same way: by binding to the brain's opiate receptors and stimulating them. This stimulation of the opiate receptors dulls pain in both humans and animals. The FDA recommends Buprenex for relief of moderate to severe pain, as Buprenex is 30 times as potent as morphine. Veterinarians usually administer buprenorphine intravenously, though oral doses are available as well. A veterinarian might also inject the drug intramuscularly via a syringe. Effects of Buprenex are short-onset, which means the drug will ease pain shortly after dosage.

Legality

Though Buprenex has been marketed and approved for human use since the 1980s, the FDA has yet to approve it for veterinary use. When veterinarians prescribe Buprenex for feline pain management, they do so via an "extra-label" prescription. This means that the drug is being used in a species or for a purpose not listed on its label, though the usage remains legal. Buprenorphine requires a veterinarian's prescription due to its legal status as a Schedule III narcotic.

Interaction with Kidneys

Veterinarians should--and do--take extreme caution when prescribing Buprenex as a pain treatment for an animal with kidney problems, due to the fact that it may worsen symptoms. Once Buprenex is in the feline's blood, the kidneys and gall bladder attempt to filter it out a small amount through a process called excretion. The gall bladder excretes most of the buprenorphine into bile, however approximately 15 percent of the Buprenex present in the blood requires kidney excretion. Though chances are small, the increased burden on the feline's kidneys may increase the severity of kidney problems due to the kidney already being damaged.

Other Side Effects and Overdosage

Buprenex, as an opioid, possesses a list of minor side effects common to all drugs in its family. These side effects include mild to severe nausea, headaches, vomiting, dizziness and constipation. Buprenex presents with fewer adverse effects than other opiates such as morphine. Sedation is the most common side effect of Buprenex treatment in cats, although in rare cases, the buprenorphine can lead to slower breathing. Buprenex, due to its high safety index, carries almost no risk of overdose, though obviously a veterinarian should determine the dose.