Any Vets, Vet-Techs, or anyone with Veterinary Medicine knowledge around?

[Heddi]

Hi all!

My kitty who has cancer has recently been put on Val/Torb for pain relief. I cannot find ANYTHING online about what Val/Torb is.

For those of you who don't know (which I guess is everyone ha!), I'm a nursing student, so I know basic pharmacology (for humans, of course), and I was mostly interested in finding out the half-life of this med, what exactly it is (is it an opiate? analgesic? Something else?), how long it stays in her system, and how often I can give it to her and up to what doseage.

I've tried to ask my vet's office about this, but they're hemming and hawing about it and can't get back to me until Wednesday because the doctor is out of town and blah blah blah. All I need to know (basically at this point) is what Val/Torb stands for. I THINK that the "torb" stands for Butorph, but I'm not sure. I definitely don't know what the Val part means, and I hope that if I can find out what both of those means, I can get more info online via an online drug guide reference site.

Can anyone help me out? Oh please say yes....

[achtung_circus]

1. It's a combo

Valium and Torbugesic.

Valium as anti-anxiety/sedative. Torbugesic as painkiller.

[Heddi]

2. Thank you thank you thank you

You have just made me the happiest cancer-kitty owner in the world

[achtung_circus]

9. More here

Torbugesic-SA®

Torbugesic-SA (butorphanol tartrate) is a potent analgesic for felines that relieves pain caused by major or minor trauma and surgical procedures. Effective and long-lasting, Torbugesic-SA produces analgesic effects within 20 minutes and relieves pain for up to 8 hours. Torbugesic-SA provides analgesia with a lower incidence and/or intensity of adverse reactions than traditional opioids. Torbugesic-SA is available only by veterinary prescription. Adverse reactions: In clinical trials in cats, pain on injection, mydriasis, disorientation, swallowing/licking, and sedation were reported. Precautions: Not recommended for pregnant cats, breeding male cats, or kittens less than 4 months of age. Please consult the product labeling for complete use directions, contraindications, and warning statements. (For more detailed information, see package insert.)

<http://www.wyeth.com/products/ahp_products/ahp_torbugesic.asp>

[Heddi]

12. Thank you thank you thank you

I really appreciate all your help!

[Heddi]

4. And actually, can you tell me more about it

while I'm looking up stuff about it online? I don't know what....but anything you know. My cat weighs about 5lbs and we have been giving her 1ml every 12 hours, and when she first started taking it, 1 ml would knock her out for that entire 12 hours. But now, she's starting to 'come out of it' about 4 hours after her meds are given. So I didn't know if it would be okay to give her 1/2ml every time we feed her and then another 1/2ml when she wakes up and starts getting cranky...sorry...I should be asking my vet this and not you.

:)

[DemoTex]

3. Call Poison Control. They should have the info.

I used to work at Poison Control at Atlanta's Grady Hospital when I was at Georgia Tech. We were always happy to look up this kind of info, as long as it didn't sound like a "suicide" on the line.

[Heddi]

5. Great! Thanks alot!!!

You know, ANY TIME i have a question about anything---what to do when my cat was dx with Cancer, what to do when my car got hit, what to do when this happened or that, I can ALWAYS come to DU and I swear to God I get the answer I need within SECONDS.

DU is the absolute best. Seriously. You guys/gals/others are the best!

[DemoTex]

13. DU is much better than Google

It is a treasure chest of info.

BTW: I do hope your cat gets better. Or at least does not suffer. I have two beloved dogs, Sirius and Nick-Nick, and their health is my health.

[Heddi]

14. Thanks for your kind words

She was diganosed back in August. It's cancer of the tongue, and we were given a very grim future for her, and actually had a date with death scheduled for her quite literally b/c we had an appointment for her to be put to sleep within days of finding out her diagnosis. But the night before she was to be put down, she came out of the bedroom for the first time in days, had toys in her mouth, playing with toys, playing with us, being very active as if to say "Mom! Dad! I'm not ready yet!".

The vet told us in August that we shouldn't expect her to live more than 2 months, and that was a very very liberal life expectancy for her. Well, that was 4 months ago and she's still going strong.

Partly because of her short life expectancy, and partly because of her kind of cancer, and frankly, partly because we just couldn't afford the cost (both myself and my husband are nursing students), we opted not to go with Chemo or radiation treatment. I think that's okay, though. She's fine, and we're treating her as a hospice would treat a human. She's loaded up with pain meds, she's fed, she's warm, and she knows she's loved and we know that her future is really up to nature and time, and we just have an obligation to ensure that she's as comfortable and pain free as possible. Should things get bad for her, we have an excellent vet who will put her down humanely and with compassion and respect for her life and those that love her (great! now I'm crying). But we just take it day by day and she's doing much better than anyone ever thought she would. I cringe when I think that she could have been dead, by our hands, at the wrong time.

I don't know---I have a hard time with people who see companion animals as "just animals". This cat and her brother are 10 years old. I don't know how a person could live with such a creature for 10 years and not be emotionally involved with it. THis cat is my baby and I wish I could take her pain and put it in me, because at least I can understand it. She can't. I can't explain to her why she doesn't have a tongue, or why she can't eat, or why we have to feed her through a tube in her neck. Or maybe I can when she sits on my lap and purs and sleeps for hours, or when she cries to us for lap-time, or when I'm getting frustrated and she just looks at me and cuddles up as if it's the only way she can say "it's alright mama".

:cries:

Thanks for your words.

[DemoTex]

15. OMG Heddi. DemoTex has too many tears now.

When you said you and your husband are nursing students, the tears really welled up. I realized that you two, loaded to the max with compassion, are exactly what our health care system needs. I wish both of you the best. I love your love for your wonderful (and resilient) cat. There is a power there, eh?

[Heddi]

17. There is a power

and thanks so much for your kindness. I really do appreciate it.

people at school always ask me (and they say it so snotty-like) "Why in the hell are you keeping that cat alive? Just kill her already" and I always say "Oh gee, so I guess when granma gets a terminal diagnosis, we should just throw her on an ice flow and hope the elements kill her before the whales do, eh?" Of course, they always retort "well, a CAT is NOT my Grandma!" well a cat isn't my grandma either, but my cat is a creature that is completely dependent on my husband and I for food, shelter, and medicine. To say "oh gee. This cat is sick. That's SUCH an inconvenience. Better kill it so that I can go on vacations and such" is, imo, no different than throwing a baby against the wall because it cried too much.

When we got these animals, I knew the responsiblity I was taking on, and I don't take it lightly. Was it expensive to have her surgeries and constant medications? Sure. But we're not broke from it, it didn't put us in debt, and I never had to go hungry because of it. The cat depends on me for her care. I can't let her down, and I can't let myself down by taking the "easy way out" and euthanizing her not to end her suffering, but to give me convenience and more $$ in my pocket.

Of course, the treatment we had for her was relatively inexpensive. If the only thing that could be done tos ave her life cost $5,000 (hell, even $500!) I don't know what choice I would have made. Financial situations are always tough b/c you ask the question "how much IS her life worth" and my only answer is "as much as I can afford at the time".

Sorry for the rambling :)

[nicolemrw]

6. my husband says

its a combination valium and butorphenol. (he's not sure of the spelling, but thats how its pronounced) butorphenol is an opiate, but its an antagonist to morphine and synthetic morphines. the half life of valium is very short. he thinks the half life of butorphenol is about 2 to 3 hours. he is an oncological vetrinary technician, and he says if he has any questions you can e-mail him at my address ([e-mail]) and he'll try and answer them.

[Heddi]

7. Wow! Thanks alot! I think I will email him

My name is Heather, btw, so let him know if he gets an email from some strange girl named Heather, that he knows where I got his email from!!!

[nicolemrw]

8. worry not

thats my address, not his. he never checks his mail. i'll just read it out loud tohim and take his dictation.

[nicolemrw]

10. you'll have to wait a bit though

cause i have to go pick our daughter from girl scouts now. i'll check my mail when i get back.

[Heddi]

11. Super. No hurry

and you might want to edit your email out of your message so that freaks don't start emailing you and signing you up for RNC email web alerts :)

[sleepyhead]

16. Torbugesic (butorphanol) and VAL elixir.

VAL is a tasty supplement (B-vitamins with liver extract - that's yummy for cats) that makes a good vehicle for the pain medication torbugesic (which can sometimes taste bitter). We use it a lot and it works well, but has a very short duration of action (only 4 hours or so) so needs to be given fairly often. Ask your vet about giving buprenorphine instead. That is also a great pain medication which can be given on its own. It is absorbed sublingually (under the tongue) and lasts 8 - 12 hours. A bit more expensive, but I find it to be a much better painkiller.

[Heddi]

18. Thanks! THe only problem is that she doesn't have a tongue

and honestly, with both my husband and I unemployed and in school, I can't really afford something more expensive than ValTorb b/c that's only about $6 a week. WE had her on fentanyl patches but those only lasted 72 hours, every time a new one was put on, she had to be knocked out ($80) and the patch itself was about $30...so that was nearly $100 a week...wayyyyy too expensive for us.

Is there any other way to administer the buprenorphine besides sublingually? Because of her lack-of-tongue, she gets all food via an esophageal tube, so anything we give her has to be transdermal (not going to happen) or absorbed in the stomach. She's so frail from the cancer that I fear having her put under general anesthesia any more than she has to be because each time she's put under, it takes longer and longer for her to 'come out of it' and I just don't want to take the chance that she dies.

[sleepyhead]

19. It is absorbed transmucosally

Meaning via any mucous membrane. So I think you could drop it or rub it on her gums, or any other available oral tissue (didn't mean to imply exclusively under the tongue), if she will let you. It's not much pricier than the torbugesic and has a much longer duration of action, so you might not need to give it as often and thus it might even save you some bucks. Feel free to PM me - I can try to find some more info for you if you want.