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The Opiod Shortage and Pain Management
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The Rainbow Bridge

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15 March 2018 - 10:35 pm
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Just a head's up Tripawds nation. There's a big opiod shortage coming up in the vet world and it's expected to continue for at least a year. According to the University of Illinois College of Veterinary Medicine, 

In the coming months, the veterinary profession may face extreme shortages of opioids, including fentanyl, hydromorphone, morphine, and methadone, after the U.S. Drug Enforcement Administration’s 25-percent decrease in the production of Schedule II opioid medications in 2017. The DEA is currently proposing a 20-percent reduction for 2018. The quota reduction is an effort to combat the growing opioid epidemic.

The remaining available supply of opioid medications is being preferentially distributed to human hospitals, which are already facing serious drug shortages. Many human hospitals can no longer acquire morphine, for example.

Veterinarians may need to alter their typical pain management protocols in light of these drug shortages.

The good news is that veterinarians everywhere are coming together to learn the best alternatives for proper pain management. Here are some articles that discuss their findings:

Alternative analgesic options with the opioid shortage | VETgirl Veterinary Continuing Education Blogsleepy

How veterinarians can best manage the opioid shortage

An exclusive roundtable with five anesthesiologists and pain management experts

Now more than ever it is imperative that we choose veterinarians who have a good grasp on pain management. According to pain management expert Kurt Grimm, DVM, MS, Ph.D., DACVA, DACVP, an anesthesiologist with Veterinary Specialist Services in Conifer, Colorado, 

People who have been using only one protocol for years are probably going to have some bumps in the road in the coming months. Colleagues who know various protocols probably will be able to adjust to new drugs or protocols without much effort.

Whether your dog or cat is about to undergo amputation surgery or not, please take a minute to learn more about current pain management guidelines so you can have a good conversation with your vet about this important part of your pet's life. 

Is Your Vet Following Current Pain Management Guidelines?

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16 March 2018 - 7:21 am
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I saw this yesterday what a nightmare a year?oh-myugh This answers a question I had!

Thanks for the heads up and glad they have found workarounds, but we know not all will. I hope all new members see this. Maybe do a news post on it to ensure all see it?  Sorry adding more to do's. Just a thought! 

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Virginia
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16 March 2018 - 9:10 am
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The video where the Doc discusses all the "alternatives" and how he likes the multiuse/multi-infusion in some cases.........this vuy really knows his stuff!  And he explains the "whysand hows" very well!

Thanks so much Jerry!   Because of this, we may even be .ore up to date and better informed now than some of our Vets--

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

The Rainbow Bridge

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16 March 2018 - 10:42 am
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Glad you found it useful. I agree, if we go into our next vet visit being able to converse about the shortage, our vets will be thankful we are so well-informed!

Yes I plan on doing a News blog post and talking to one of our favorite pain management vets about it. Stay tuned!

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16 March 2018 - 12:22 pm
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Thanks for the update.

Casey, our Tripaw, is no longer in pain, so this is a moot point for him, but his big brother Jake, who will be fifteen in May, uses opiates for pain management.  Before we even knew about Casey's osteo, we realized Jake was experiencing chronic pain with what we now understand is lumbosacral stenosis, a spinal condition that pinches the nerves at the base of the spine, causing a multitude of complications.  We took him to the vet four months ago to ask "Is it Jake's time?"  She immediately responded "No!  He's still finding joy in life.  We can do it, but in my opinion, it's not yet his time."  She added Tramadol to the Rimadyl he'd been taking for a few years, and the chronic pain that had him pacing continuously, squeezing behind plants and furniture and in general, just unable to relax, is gone.  At fifteen, there's not a lot of joy left, but when it's time for a (very short) walk or a bye-bye in the car, Jake still gets his puppy on, his tail goes up, and he has a prance in his step that makes his ears bounce.  He's still "in hospice", and we're not going to do anything extraordinary, but as long as we can manage his pain, that alone is not going to take him out.

It's truly unfortunate that the opioid crisis has made life more challenging for those who truly need them.

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19 March 2018 - 9:13 am
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Given what may become an issue for many here in the future with pain medications availability, I wonder if Kratom might end up being more widely used for pets similar to how cannabis is being done now.  I did a quick google search and did not find much information, just one article.  

http://speciosa.....et-lovers/

Has anyone here tried this?  

-Dawna, Tuxedo, & Dazzle

The Rainbow Bridge

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19 March 2018 - 11:47 am
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Thanks for bringing this up Dawna, I look forward to hearing about others' experience with it and hope that at some point it can be incorporated into mainstream pain relief. Although I haven't heard any vets discuss it, my bet is that soon they just might if this shortage keeps up.

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19 March 2018 - 2:29 pm
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I've seen several articles in our local-ish on line paper recently.

Here is a link to several article on Kratom.

Karen

Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.

1999 to 2010

 

              Maggie's Story                  Amputation and Chemo

The Rainbow Bridge

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4 April 2018 - 11:03 am
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Thanks for the link Karen.

Meanwhile Purrkins and Holly just shared this news about Gabapentin. Sounds like this one may become harder to obtain now. UGH!

Doctors sound the alarm on "opioid alternative" gabapentin

LOUISVILLE, Ky. -- A drug that has been touted as a safe alternative to opioid painkillers is now on the radar of health officials and law enforcement officials as it is being found in more and more overdose deaths. Gabapentin is a nerve pain medication that is typically used to treat seizures and pain associated with shingles. But amid the opioid epidemic that has ripped through the country, doctors have been prescribing it for a growing number of conditions in an attempt to find new ways to offer pain relief to patients -- and more people appear to be abusing it.

In Kentucky, lawmakers have classified the drug as a controlled substance after it was found in nearly one-fourth of all overdose deaths in the state's biggest city last year.

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4 April 2018 - 7:55 pm
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Just saw this today.     Basically I think its a repeat of some of the links Karen shared.  Anything "natural"...or "herbal"...or "holistically orientated"   sure does get a lot of scrutiny from the FDA.    It's  a shame mainstream pharmaceutical companies don't get the same scrutiny. 

NPR: FDA Orders An Unprecedented Recall After Kratom Company Ignored Its Requests. http://google.c.....BIw-57ixjo

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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5 April 2018 - 3:57 am
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Yes, unfortunately here in the Meth capitol of the US (KY) they classified gaba as a controlled substance. I guess all the meth heads have found a way to play with gaba. Sad but true. Living in KY, I had to jump through hoops to get Huck his gaba after his surgery. So sad.

Jackie

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Jackie, David, Mitchell, Andy Oscar, and the coolest feral tripawd kitty Huckleberry

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