title: Practical use of opioids in cats: a state-of-the-art, evidence-based review.
abstract: BACKGROUND
  Recent recognition of the need to improve pain management in cats has led to the investigation of the pharmacokinetics and efficacy of opioid analgesic drugs in this species. The results of these studies may be difficult to interpret because the effect of these drugs varies with dose, route of administration and the method used to assess them. As equipotency of different opioids is not known, it is hard to compare their effects. Animals do not verbalise the pain they feel and, in cats, it may be more difficult to recognise signs of pain in comparison with other species such as dogs.
  
  
  OBJECTIVE
  This article reviews the use of opioid analgesics in cats. It must be remembered that not all drugs are licensed for use in cats, and that marketing authorisations vary between different countries.
authors.affiliation: Department of Animal Medicine, Production and Health, University of Padua, Italy elisabortolami@hotmail.it.
authors.forename: Elisa
authors.initials: E
authors.lastname: Bortolami
authors.affiliation: School of Veterinary Sciences, University of Bristol, Langford, UK.
authors.forename: Emma J
authors.initials: EJ
authors.lastname: Love
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000493:pharmacokinetics; D000818:Animals; D002371:Cat Diseases / Q000188:drug therapy*; D002415:Cats; D004285:Dogs; D010146:Pain / Q000188:drug therapy / Q000662:veterinary*; D010147:Pain Measurement / Q000662:veterinary; D019155:Veterinary Drugs / Q000008:administration & dosage
chemical_list: D000701:Analgesics, Opioid; D019155:Veterinary Drugs
references.citation: Vet Anaesth Analg. 2003 Apr;30(2):107
references.pmid: 28404393
references.citation: Lab Anim. 2000 Jul;34(3):244-51
references.pmid: 11037117
references.citation: Am J Vet Res. 2010 Feb;71(2):150-6
references.pmid: 20113221
references.citation: Vet Anaesth Analg. 2010 May;37(3):240-9
references.pmid: 20230554
references.citation: J Feline Med Surg. 2014 Jul;16(7):572-8
references.pmid: 24966282
references.citation: J Emerg Med. 2012 May;42(5):549-52
references.pmid: 21683542
references.citation: Am J Vet Res. 2000 Jun;61(6):672-7
references.pmid: 10850844
references.citation: J Am Vet Med Assoc. 2000 Oct 1;217(7):1013-20
references.pmid: 11019707
references.citation: Pain Med. 2003 Mar;4(1):63-74
references.pmid: 12873279
references.citation: Anesthesiology. 1996 Apr;84(4):865-72
references.pmid: 8638841
references.citation: J Vet Pharmacol Ther. 2015 Oct;38(5):434-42
references.pmid: 25623082
references.citation: Am J Vet Res. 2003 Dec;64(12):1557-61
references.pmid: 14672436
references.citation: Aust Vet J. 2012 Oct;90(10):402-3
references.pmid: 23004233
references.citation: Vet Rec. 1999 Jul 24;145(4):95-9
references.pmid: 10461733
references.citation: Am J Vet Res. 2008 Aug;69(8):983-7
references.pmid: 18672960
references.citation: J Vet Pharmacol Ther. 2008 Feb;31(1):52-9
references.pmid: 18177319
references.citation: J Feline Med Surg. 2011 Aug;13(8):602-5
references.pmid: 21571562
references.citation: Vet Clin North Am Small Anim Pract. 2008 Nov;38(6):1267-90, vi
references.pmid: 18954684
references.citation: Vet Anaesth Analg. 2003 Oct;30(4):229-36
references.pmid: 12925180
references.citation: J Vet Pharmacol Ther. 2005 Oct;28(5):453-60
references.pmid: 16207308
references.citation: Vet Anaesth Analg. 2008 Jul;35(4):341-7
references.pmid: 18363580
references.citation: Vet Anaesth Analg. 2011 Jul;38(4):310-9
references.pmid: 21627756
references.citation: Am J Vet Res. 2011 Jun;72(6):764-71
references.pmid: 21627522
references.citation: Vet Anaesth Analg. 2013 Jan;40(1):83-95
references.pmid: 22998333
references.citation: Pharmacol Biochem Behav. 1989 Dec;34(4):847-54
references.pmid: 2623037
references.citation: Vet Anaesth Analg. 2010 Sep;37(5):417-24
references.pmid: 20712608
references.citation: Vet Anaesth Analg. 2012 Mar;39(2):137-50
references.pmid: 22356415
references.citation: J Pharmacol Exp Ther. 2001 Oct;299(1):366-71
references.pmid: 11561100
references.citation: J Vet Intern Med. 2014 May-Jun;28(3):762-70
references.pmid: 24655078
references.citation: Am J Vet Res. 2009 May;70(5):581-8
references.pmid: 19405896
references.citation: J Feline Med Surg. 2008 Feb;10(1):24-31
references.pmid: 17765590
references.citation: Am J Vet Res. 2002 Aug;63(8):1198-202
references.pmid: 12171176
references.citation: Am J Vet Res. 2014 Aug;75(8):716-21
references.pmid: 25061702
references.citation: J Vet Pharmacol Ther. 2013 Jun;36(3):222-8
references.pmid: 22607033
references.citation: J Am Vet Med Assoc. 2003 Dec 1;223(11):1608-13
references.pmid: 14664447
references.citation: J Vet Pharmacol Ther. 2004 Oct;27(5):329-36
references.pmid: 15500571
references.citation: Int J Legal Med. 2007 Mar;121(2):147-51
references.pmid: 17115172
references.citation: Am J Vet Res. 1999 Feb;60(2):194-200
references.pmid: 10048551
references.citation: Can Vet J. 1996 Sep;37(9):552-6
references.pmid: 8877041
references.citation: Am J Vet Res. 2004 Aug;65(8):1085-9
references.pmid: 15334842
references.citation: Vet Surg. 1994 Mar-Apr;23(2):149-55
references.pmid: 8191675
references.citation: J Clin Pharmacol. 2002 May;42(5):569-76
references.pmid: 12017351
references.citation: J Feline Med Surg. 2009 Jun;11(6):420-9
references.pmid: 19233698
references.citation: J Small Anim Pract. 2014 Jun;55(6):E10-68
references.pmid: 24841489
references.citation: Pain Physician. 2011 Mar-Apr;14(2):145-61
references.pmid: 21412369
references.citation: J Vet Med Sci. 2012 Feb;74(2):231-4
references.pmid: 21952398
references.citation: J Feline Med Surg. 2015 Mar;17(3):251-72
references.pmid: 25701863
references.citation: J Feline Med Surg. 2009 Feb;11(2):76-81
references.pmid: 18675572
references.citation: J Vet Pharmacol Ther. 2009 Oct;32(5):477-84
references.pmid: 19754915
references.citation: J Cardiothorac Vasc Anesth. 2006 Oct;20(5):691-5
references.pmid: 17023290
references.citation: Am J Vet Res. 2009 Dec;70(12):1465-70
references.pmid: 19951117
references.citation: Psychopharmacologia. 1974 Apr 8;36(2):185-7
references.pmid: 4407695
references.citation: Lab Anim. 1992 Jan;26(1):15-22
references.pmid: 1548841
references.citation: Am J Vet Res. 2008 Dec;69(12):1548-54
references.pmid: 19045999
references.citation: Vet Surg. 1994 Jan-Feb;23(1):67-74
references.pmid: 8140742
references.citation: Vet Anaesth Analg. 2007 Mar;34(2):132-8
references.pmid: 17316394
references.citation: J Vet Pharmacol Ther. 2006 Dec;29(6):531-7
references.pmid: 17083457
references.citation: Vet Anaesth Analg. 2011 Jan;38(1):3-14
references.pmid: 21214705
references.citation: Aust Vet J. 1996 Sep;74(3):203-10
references.pmid: 8894035
references.citation: J Am Vet Med Assoc. 2004 Mar 1;224(5):700-5
references.pmid: 15002807
references.citation: J Small Anim Pract. 2014 Dec;55(12):615-21
references.pmid: 25354833
references.citation: J Vet Med A Physiol Pathol Clin Med. 2005 May;52(4):186-98
references.pmid: 15882404
references.citation: Am J Vet Res. 2007 Jul;68(7):699-703
references.pmid: 17605603
references.citation: Am J Vet Res. 2007 Sep;68(9):932-40
references.pmid: 17764406
references.citation: Am J Vet Res. 2011 Apr;72(4):461-6
references.pmid: 21453146
references.citation: J Am Vet Med Assoc. 2005 Dec 15;227(12):1937-44
references.pmid: 16379630
references.citation: Res Vet Sci. 2002 Jun;72(3):205-10
references.pmid: 12076115
references.citation: Vet Surg. 2001 Jul-Aug;30(4):351-8
references.pmid: 11443596
references.citation: Vet Anaesth Analg. 2012 Nov;39(6):653-6
references.pmid: 22789128
references.citation: Vet Anaesth Analg. 2004 Jan;31(1):40-5
references.pmid: 14756752
references.citation: J Am Vet Med Assoc. 2002 Sep 1;221(5):666-72
references.pmid: 12216906
references.citation: J Vet Intern Med. 2004 Mar-Apr;18(2):190-5
references.pmid: 15058769
references.citation: Vet Rec. 1998 Aug 15;143(7):185-9
references.pmid: 9762758
references.citation: Br J Pharmacol. 1977 Aug;60(4):537-45
references.pmid: 409448
references.citation: J Vet Pharmacol Ther. 2014 Feb;37(1):13-7
references.pmid: 23895731
references.citation: Life Sci. 2001 Jun 15;69(4):409-20
references.pmid: 11459432
references.citation: J Pharmacol Exp Ther. 1992 Jan;260(1):275-85
references.pmid: 1309873
references.citation: J Am Vet Med Assoc. 1998 Jul 15;213(2):246-50
references.pmid: 9676597
references.citation: Vet Anaesth Analg. 2006 Nov;33(6):381-9
references.pmid: 17083610
references.citation: Am J Vet Res. 2009 Sep;70(9):1065-71
references.pmid: 19719420
references.citation: Am J Vet Res. 2008 Apr;69(4):531-6
references.pmid: 18380586
references.citation: Vet Anaesth Analg. 2002 Jan;29(1):29-35
references.pmid: 28404266
references.citation: Res Vet Sci. 1996 May;60(3):243-6
references.pmid: 8735515
references.citation: Pharmacotherapy. 1984 Jan-Feb;4(1):11-9
references.pmid: 6230606
references.citation: J Feline Med Surg. 2011 Oct;13(10):738-43
references.pmid: 21873092
references.citation: Minerva Anestesiol. 2005 Jul-Aug;71(7-8):435-7
references.pmid: 16012416
references.citation: Vet J. 2009 Nov;182(2):203-9
references.pmid: 18691917
references.citation: J Am Vet Med Assoc. 2005 Jul 1;227(1):89-93
references.pmid: 16013541
references.citation: Vet Surg. 2002 Mar-Apr;31(2):99-103
references.pmid: 11884953
references.citation: Can Vet J. 2000 Feb;41(2):135-7
references.pmid: 10723604
references.citation: Am J Vet Res. 1996 Nov;57(11):1674-8
references.pmid: 8915451
references.citation: Am J Physiol. 1979 May;236(5):R292-6
references.pmid: 443408
references.citation: J Small Anim Pract. 1995 Dec;36(12):535-41
references.pmid: 8926722
references.citation: Clin Pharmacol Ther. 2008 Jan;83(1):144-52
references.pmid: 17568402
references.citation: Pharmacogenetics. 2000 Jun;10(4):355-69
references.pmid: 10862526
references.citation: J Feline Med Surg. 2012 Aug;14(8):534-9
references.pmid: 22403414
references.citation: Vet Rec. 2003 Oct 11;153(15):462-5
references.pmid: 14584576
references.citation: Vet Rec. 2007 Apr 28;160(17):578-83
references.pmid: 17468320
references.citation: J Feline Med Surg. 2010 Apr;12(4):247-55
references.pmid: 19836984
references.citation: Lab Anim. 1989 Apr;23(2):147-55
references.pmid: 2709794
references.citation: Vet Anaesth Analg. 2004 Jul;31(3):183-9
references.pmid: 15268689
references.citation: J Am Vet Med Assoc. 2002 Apr 1;220(7):1020-4
references.pmid: 12420780
references.citation: J Feline Med Surg. 2009 Jun;11(6):503-9
references.pmid: 19168382
references.citation: Vet Surg. 1994 Mar-Apr;23(2):143-8
references.pmid: 8191674
references.citation: Vet Anaesth Analg. 2010 Jan;37(1):35-43
references.pmid: 20017817
references.citation: Vet Anaesth Analg. 2007 Jan;34(1):40-7
references.pmid: 17238961
references.citation: J Small Anim Pract. 1998 Apr;39(4):158-64
references.pmid: 9577756
references.citation: J Vet Pharmacol Ther. 2014 Jun;37(3):295-300
references.pmid: 24236993
references.citation: Vet Rec. 2003 May 31;152(22):675-8
references.pmid: 12803393
references.citation: Vet Anaesth Analg. 2004 Jul;31(3):175-82
references.pmid: 15268688
references.citation: J Vet Pharmacol Ther. 2005 Feb;28(1):87-93
references.pmid: 15720520
references.citation: Am J Vet Res. 1997 Nov;58(11):1274-9
references.pmid: 9361892
references.citation: J Am Anim Hosp Assoc. 2002 Nov-Dec;38(6):507-14
references.pmid: 12428880
references.citation: Vet Anaesth Analg. 2013 Mar;40(2):181-93
references.pmid: 22731882
references.citation: Vet Anaesth Analg. 2010 Jul;37(4):357-66
references.pmid: 20636568
references.citation: Vet Anaesth Analg. 2004 Jul;31(3):164-74
references.pmid: 15268687
references.citation: J Vet Pharmacol Ther. 2001 Dec;24(6):391-8
references.pmid: 11903869
references.citation: Vet Anaesth Analg. 2006 May;33(3):158-68
references.pmid: 16634941
references.citation: Neurosci Lett. 1988 Aug 15;91(1):30-5
references.pmid: 2845307
references.citation: Res Vet Sci. 2007 Feb;82(1):85-92
references.pmid: 16765390
references.citation: J S Afr Vet Assoc. 2001 Mar;72(1):57-60
references.pmid: 11563724
references.citation: Res Vet Sci. 2011 Jun;90(3):503-9
references.pmid: 20708759
references.citation: J Am Vet Med Assoc. 2008 Jun 15;232(12):1834-40
references.pmid: 18598152
references.citation: BMC Vet Res. 2013 Jul 17;9:143
references.pmid: 23867090
references.citation: Vet Clin North Am Small Anim Pract. 2000 Jul;30(4):815-37, vii
references.pmid: 10932827
references.citation: Vet Anaesth Analg. 2008 Nov;35(6):543-7
references.pmid: 18980629
references.citation: Pharmacogenomics. 2012 Nov;13(15):1719-40
references.pmid: 23171337
references.citation: J Feline Med Surg. 2012 Oct;14(10):678-85
references.pmid: 22577049
references.citation: Am J Vet Res. 1993 Oct;54(10):1721-4
references.pmid: 8250399
references.citation: Vet Anaesth Analg. 2006 Nov;33(6):390-8
references.pmid: 17083611
references.citation: Lab Anim. 2010 Jul;44(3):247-53
references.pmid: 20457825
references.citation: Arch Int Pharmacodyn Ther. 1976 Apr;220(2):231-57
references.pmid: 60089
references.citation: Br J Pharmacol. 1978 May;63(1):65-71
references.pmid: 647164
references.citation: Anesthesiology. 2003 Feb;98(2):420-7
references.pmid: 12552202
references.citation: J Am Vet Med Assoc. 2005 Mar 15;226(6):913-9
references.pmid: 15786993
references.citation: Anesth Analg. 1999 Oct;89(4 Suppl):7
references.pmid: 10511072
references.citation: Am J Vet Res. 2009 Oct;70(10):1187-92
references.pmid: 19795932
references.citation: J Med Chem. 1991 Jul;34(7):2202-8
references.pmid: 2066993
references.citation: Am J Vet Res. 1997 Nov;58(11):1267-73
references.pmid: 9361891
references.citation: J Feline Med Surg. 2009 Dec;11(12):948-53
references.pmid: 19540784
references.citation: Vet J. 2012 Jun;192(3):523-4
references.pmid: 22030474
references.citation: Res Vet Sci. 2001 Jun;70(3):243-6
references.pmid: 11676621
references.citation: J Feline Med Surg. 2012 Aug;14(8):553-9
references.pmid: 22505603
references.citation: J Pharmacol Exp Ther. 1995 Sep;274(3):1263-70
references.pmid: 7562497
references.citation: J Vet Pharmacol Ther. 2011 Dec;34(6):594-8
references.pmid: 21323677
references.citation: Am J Vet Res. 2006 Sep;67(9):1471-5
references.pmid: 16948588
references.citation: Vet Anaesth Analg. 2010 May;37(3):230-9
references.pmid: 20456112