Page 79 - BSAVA Guide to Pain Management in Small Animal Practice

BSAVA Guide to Pain Management in Small Animal Practice

VetBooks.ir Clinical use How to use analgesic
ral administration of 1 mg kg of gabapentin
agents in special
to dogs twice a day did not a ect post
operative analgesia in dogs that underwent circumstances
thoracolumbar disc surgery (Aghighi et al., There is little information on the safety of
1 . ral administration of mg kg did not the use of analgesics in special circumstances,
a ect postoperative pain after forelimb such as for pregnant or lactating patients,
amputation agner et al., 1 . n the other for Caesarean section, for very young or
hand, administration of 1 mg kg of very old animals, and those with renal
gabapentin twice a day to dogs that disease. This can make provision of analgesia
underwent a mastectomy reduced for these patients di cult, potentially resulting
postoperative morphine requirements in inadequate analgesia and unnecessary
compared with a control group (Crociolli et al., su ering. igures .4 and . summari e
1 . Use of gabapentin has also been the available data and give the authors’
suggested to manage neuropathic pain in recommendations in such circumstances.
dogs with Chiari-like malformation (Rusbridge
and e ery, 8 . Interestingly, there is no
evidence supporting the use of gabapentin to Analgesia for patients with liver
relieve the pain associated with degenerative disease
joint disease and osteoarthritis, despite this Patients with liver dysfunction or hepatic
probably being the setting where the drug is encephalopathy can respond differently
mostly used in veterinary medicine. Clinical to drugs compared with healthy patients.
trials in humans have demonstrated that Many patients with liver disease have
gabapentin is e ective in treating neuropathic hepatocellular damage (resulting in
pain, and it is likely that this should also be the increases in alanine amino transferase
case in veterinary medicine. he side e ects and alkaline phosphatase) without liver
related to gabapentin administration in dogs dysfunction, and therefore carry no special
are relatively mild (sedation) and transient, and considerations regarding administration of
it is fair to question whether this drug is widely analgesics. To decide which patients with
used because of its limited side e ects, rather liver disease will process drugs differently
than because of evidence supporting its use in (e.g. slower metabolism resulting in longer
animals with osteoarthritis pain. duration of action), it is necessary to try
There are more publications supporting and assess the liver’s metabolic function.
the use of gabapentin in cats, particularly as Patients with low plasma concentrations of
part of a multimodal approach to analgesia in albumin, glucose, urea and clotting factors,
cats undergoing major surgical procedures or and high ammonia, may have di culty
after ma or musculoskeletal trauma 6. metabolizing drugs. Patients with increased
mg/kg two to three times a day), and bile acid concentrations may have
responding inadequately to conventional decreased metabolic function, but raised
analgesics Vettorato and Corletto, 11; bile acids can also be seen in patients
Lorenz et al., 1 ; Steagall and onteiro with biliary tract obstruction. Patients with
Steagall, 1 . Investigators failed to hepatic encephalopathy are likely to have
decreased metabolic function, in addition
demonstrate an e ect of gabapentin on they may be more sensitive to the sedative
iso urane AC and on thermal threshold in effects of drugs such as opioids. se of
cats (Pypendop et al., 1 ; Reid et al., 1 . some NSAIDs is contraindicated in patients
Single reports of successful control of orofacial with hepatic disease according to the
pain in cats have also been published datasheets (see Figure 5.3).
(Rusbridge et al., 1 .

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