Page 46 - BSAVA Guide to Pain Management in Small Animal Practice

4 | Chronic and osteoarthritic pain

VetBooks.ir CASE EXAMPLE 2 CONTINUED suggests that analgesia should be
A positive response to NSAID treatment
en yme ACE inhibitors and, therefore, such
drug combinations may still present an continued; however, longer term adjuncts
to management of feline musculoskeletal
increased risk to renal homeostasis (Sparkes pain, including omega fatty acid
et al., 1 . green lipped mussel glucosamine
ollowing a recent within 1 month
assessment of biochemistry and haema chondroitin containing feedstu s or
supplements (Lascelles et al., 1 may
tology, urinalysis, and systolic arterial blood permit a reduction in NSAID dose without a
pressure, NSAI therapy could be prescribed detrimental e ect on pain levels.
as a trial analgesic with the informed consent Environmental modi cations can further
of the owner. Client speci c outcome promote comfort and a recent review
measures (Lascelles et al., 7 and the considers a number of important areas,
feline musculoskeletal pain index (Benito et including steps and ramps to reach favoured
al., 1 could be utili ed to monitor locations, multiple feeding, drinking and
response to treatment; however, be aware appropriately accessible toileting sites, and
that there may be a signi cant placebo e ect activities to engage mental stimulation
associated with treatment (Gruen et al., 14 .
(Bennett et al., 1 .
Adjunctive analgesic drugs including
LON TE M MANA EMENT gabapentin, tramadol, amantadine and
amitriptyline may be considered for o
Reassessment, to ascertain that the cat is not licence prescription in individual cases;
su ering acute adverse e ects, is however, there is presently little evidence
recommended after 7 days of treatment regarding their e ectiveness or safety in
followed by a full re examination including feline musculoskeletal pain (Lascelles and
blood and urine analysis after 4 weeks and Robertson, 1 .
ongoing reassessment at 6 month intervals
(Sparkes et al., 1 .

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