Page 140 - BSAVA Guide to Pain Management in Small Animal Practice

7 | Neuropathic pain

VetBooks.ir e ex p e Steroid-responsive meningitis

arteritis (SRMA)

n in ammatory, and suspected immune- TREATMENT
mediated, disease occurring most commonly
in young usually less than years old edical management focuses on treatment
medium- to large- reed dogs particularly of the underlying cause. Analgesia is added
eagles, o ers and ernese ountain dogs as necessary.
characterized y vasculitis of the meningeal
arteries, non-suppurative in ammation in the ■ Immunosuppressive doses of
and su clinical coronary arteritis. prednisolone in a tapering fashion over
6 1 months.
HISTORY AND PRESENTATION ■ Analgesia. A ected dogs usually
axing and waning, unchanged or worsening respond uickly to the appropriate
signs of cervical hyperaesthesia, pyrexia and therapy and are pain free within a
lethargy. few days. ogs can be very painful and
may re uire hospitali ation with opioid
e.g. methadone therapy. At home,
CLINICAL SIGNS AND SIGNS OF PAIN
analgesia may include paracetamol or
Pyrexia on physical examination. Rigid neck gabapentin in addition to
carriage, neck pain and lethargy are immunosuppressive therapy.
commonly the only neurological de cits. ■ Use a harness instead of a neck collar.

e ex p e 3 Intervertebral disc herniation

with urinary incontinence. Para tetrapareses
INTERVERTEBRAL DISC EXTRUSION or para tetraplegia is common.
(HANSEN TYPE I):
Treatment
ucleus pulposus e trusion causing spinal
cord or nerve root compression. ssociated he acute in ury and spinal pain are usually
with disc degeneration. treated. Analgesia should be given to e ect
including non steroidal anti in ammatory
History and presentation drugs NSAI s gabapentin, and, if success
ful, should not be re uired after a few weeks
ostly chondrodystrophic breeds with of management. Conservative management
usually acute or acute progressive includes restricted controlled exercise, which
presentation; commonly moderate to severe may include cautious physiotherapy for 4 6
focal spinal pain. weeks and can be elected if dogs are
ambulatory see Chapter 6b . ecompressive
Clinical signs and signs of pain spinal surgery should be discussed and
ogs commonly have focal spinal pain, considered if the dog is recumbent or if
obvious gait abnormalities or are recumbent pain is unmanaged with medical therapy.

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