Page 138 - BSAVA Guide to Pain Management in Small Animal Practice

7 | Neuropathic pain

VetBooks.ir Author’s perspective continued

• entanyl has a shorter half life compared with morphine and thus might be
a better choice in patients with CNS pain as it can be withdrawn more easily to assess the
patient. It seems to have fewer side e ects than morphine at higher dosages especially in
cats . owever, high doses causing side e ects such as cortical depression should be
avoided as they can mask increasing intracranial pressure assessment.
• Medetomidine or dexmedetomidine CRI. Potent alpha agonists. Can be used
individually or combined with other medications such as fentanyl.
• Lidocaine CRI. Usually given in combination with methadone or ketamine. Systemic
application of lidocaine blocks the ectopic a erent neural activity within the dorsal horn.
■ Non-pharmacological treatment options such as acupuncture, physiotherapy and other
aspects of rehabilitation can be an e ective analgesic modality see Chapter 6 .
3
■ Reassess pain and health related uality of life fre uently.
■ Check if dispensed medication, dosage and side e ect pro le is appropriate or re uires
ad ustment.

Common causes of References and further
neuropathic pain reading
Common diseases that cause neuropathic rubb 1 Chronic neuropathic pain in veterinary patients.
Topics in Companion Animal Medicine 25, 4
pain include intervertebral disc disease Loughin CA 16 Chiari like malformation. Veterinary Clinics
compressive and non compressive extrusion, of North America: Small Animal Practice 46, 1 4
protrusion , degenerative lumbo sacral stenosis, athews A 8 Neuropathic pain in dogs and cats if
meningoencephalitis of unknown origin, only they could tell us if they hurt. Veterinary Clinics of North
America: Small Animal Practice 38, 1 6 1414
steroid responsive meningitis arteritis SR A , Connor AB and workin R 9 reatment of neuropathic
infectious diseases such as discospondylitis or pain an overview of recent guidelines. American Journal of
vertebral osteo myelitis, trauma to the nervous Medicine 122, S S
system, malformation, syringomyelia, neoplasia
compressing or in ltrating the nervous system,
and vascular causes such as brocartilagenous
embolic myopathy.

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