Last week, I worked with Bobby, a seven-year-old beautiful tabby. His mom Mary contacted me after Bobby had a tooth extraction. She was extremely concerned once she brought him home. Bobby was pacing constantly, only interrupted by occasional 15-minute breaks during which he would lie down, but never close his eyes. He acted hungry, but wouldn’t eat. He didn’t sleep at all. Mary suspected that he was having a reaction to Zorbium, a long-acting transdermal pain medication that provides continuous pain relief for four days.
I did three consecutive Reiki sessions for Bobby within those four days to support his system as he was clearing the drug. Mary gradually started to see improvement. “After five days, Bobby started being Bobby again,” she said.
Bobby’s story prompted me to research this drug.
What is Zorbium?
Zorbium is a transdermal form of buprenorphine, an opioid pain medication that has long been used in cats as an injectable or oral treatment. Unlike the injectable or oral forms of buprenorphine, Zorbium provides four days of continuous post-operative pain control. It was approved by the FDA in February of 2022.
On the face of it, this seems like a great idea, right? We know cats need pain control after any kind of dental or surgical procedure. We know cats can be hard to medicate. So a pain medication that can be applied between the cat’s shoulder blades once, and then controls pain for four days, should be a good thing, right? Not so fast.
While buprenorphine is well tolerated by many cats, some cats have severe adverse reactions to the drug. And since Zorbium is long acting, once a cat has a reaction, other than supportive care, there is very little that can be done to get the drug out of an affected cat’s system except waiting it out. There is a known opioid reversal agent, Naloxone (Narcan), which has been administered to cats in emergency situations. It must be started early, and repeated frequently, since Naloxone has a much shorter duration than Zorbium. While it doesn’t always work, it has shown success in about 50% of reported cases, and it may be the only chance in some critical situations.
By comparison, injectable or oral buprenorphine wears off after six to eight hours except in cats with liver or kidney problems, so if there is a reaction, it’s generally short lived, and the drug can be discontinued and replaced with a different form of pain control.
Zorbium adverse reactions and deaths
Injectable Buprenorphine has a long list of possible side effects ranging from mild to serious, including
- sleepiness (most common)
- pain at the injection site
- decreased respiratory rate
- behavior changes such as restlessness and pacing
- increased heart rate
- vomiting
The most common adverse reactions to Zorbium are hypothermia, hypotension and hypertension and sedation.
Per an FDA report from April of this year, there have been 282 confirmed fatalities (cats and dogs combined) following Zorbium administration through the 4th quarter of 2024.
ZorbiumDeaths.com is a website dedicated to informing cat parents about Zorbium. The site offers detailed information about the opioid and includes heartbreaking stories of cats who did not survive, among them a cat named Vitto, whose story has galvanized awareness efforts.
“This platform was born out of tragedy and a need for transparency,” said the site’s founder. “While the website provides important public information, a private Facebook group dives much deeper, sharing research and ongoing discussions with veterinarians, legal experts, scientists, FDA and DOJ, and grieving cat parents across the country. Too many of them were never even told the name of the drug their cat received, or potential serious side effects, which in some states is illegal.”
The group also serves as a discreet, private space for cat parents seeking answers, connection, and support.
Spooky Tooth’s death, another tragic loss following Zorbium application, inspired his mom to begin a separate journey of advocacy and research to help cat parents make informed decisions about this drug. At the recommendation of an attorney, she founded Zorbiumlawsuit.com to document cases and collect data not tracked by the FDA.
The need for informed consent
Long acting drugs have their place in veterinary medicine, especially when it comes to treating cats who are difficult to medicate. However, it is imperative that veterinarians educate their clients on the potential adverse reactions to these drugs and their long acting nature, which complicates intervention if there are complications.
My client Bobby was one of the lucky ones. Awareness is key to preventing further tragedies like Vitto, Spooky Tooth and so many others. Please spread the word about the potential hazards of Zorbium to fellow cat parents.
Image at top of post by Alexa from Pixabay, images of Vitto and Spooky Tooth used with permission by the respective copyright holders
Thank you for giving voice to this topic, Ingrid.
Another long lasting injectable antibiotic which is frequently used by veterinarians is Convenia).
Our beloved feline family member Tazmanian always struggled with the post procedure side effects of injectable buprenorphine.
Wouldn’t it be ideal if anesthesia and other drugs used for our beloved cats and dogs could be ‘vetted’ by their health care team as they are when used for us humans ?
Yes, Convenia is another long acting medication that has caused some serious issues with cats. Dr. Pierson talks about it at length on her website https://catinfo.org/convenia-worth-the-risk/
Thanks, Ingrid, for providing info on this medication. I know that I’d never try an unknown long-acting med on myself because I don’t know how I’d react and I wouldn’t want a bad reaction going on for days. I’m more diligent with my sweeties’ health care than my own. The ideal pain med (for hard to medicate animals) would appear to be an easy to apply pain med (like a gel). Getting a pain pill into any of the cats I have now or had in the past has always been extremely difficult. I’d welcome a get that would give appropriate pain relief.
Our cat got Zorbium after a dental and was a mess for weeks, finally all the way back to her normal self after a full month. We were terribly worried. I’m actually glad we didn’t know at the time that other cats had died, and I’m so incredibly grateful she pulled through now that I do know. She was 0.2 pounds above the cutoff line for a small cat versus large cat dose, so she got the large cat dose, which is much, much larger than the small cat dose. (Apparently the doses are premeasured, so there isn’t a range, just the two dose sizes.) We assumed the dose being too big for her was the main problem, along with her age. It is now in her file not to use Zorbium again.
Thank you for this important information. It’s a reminder that it’s always ok to ask our veterinarians for more information about any drugs/treatments being given to our cats, and to stay in touch with them about any side effects we observe. My cat was in a similar situation, having had an adverse reaction (that I didn’t know was a possibility) to a recently approved drug, and there was nothing we could do but wait it out. He’s fine now, but the experience has made me more cautious.
This is scary. I’m glad Bobby is ok. I feel bad for those who didn’t.