Buprenorphine is one of the most popular and reliable opioid analgesics for use in cats. It consistently provides good analgesia for cats with mild to moderate pain, but it is not the right drug for patients with severe pain.
However, since it is a partial mu-agonist, it does not cause many of the side effects of pure mu-agonists (e.g., nausea, vomiting, and dysphoria).
Duration is long, six hours or more; onset is also long, 30 minutes to an hour in dogs and cats, depending on the route of administration. It is difficult to reverse as it binds very tightly to the mu-receptor.
Can give buprenorphine transmucosally with almost 100% absorption because of the pH of the feline mouth (8-9). It is also available as a transdermal patch for humans, but so far these have not been effective for use in cats.
This is an excellent review of pain in cats: SA Robertson. Managing Pain in Feline Patients. Vet Clinics of NA: SA Practice 2008; 38: 1267–90; and acute pain assessment in cats: Steagall PV et al. Acute pain in cats: Recent advances in clinical assessment. J Fel Vet Med Surg 2018
For a thorough review of physiology and clinical use of analgesia, check out Pain Management Guidelines for Dogs & Cats from the AAHA and the AAFP’s Feline Acute Pain Scale from Colorado State Veterinary Medical Center. Additional reading about analgesia in cats is addressed in this article: Steagall PV. Analgesia. What Makes Cats Different/Challenging and What is Critical for Cats? Vet Clinics: Small Animal Practice 2020;50:749-767.
