Page 40 - BSAVA Guide to Pain Management in Small Animal Practice
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4  |  Chronic and osteoarthritic pain



        VetBooks.ir  points, an attempt to address the pain and   been shown to improve quality of life in dogs
               In cases with identi ed myofascial trigger
                                                   (German et al.,   1  , but the welfare obligation
             discomfort associated with this additional strain
             is essential with either dry needling, therapeutic   to provide pain relief remains, and the provision
                                                   of analgesia may be required to enable the
             lasers, or physical manual therapy.  he   animal to undertake more exercise and
             treatment of   rP is still in its infancy in   strengthen muscles in the  rst instance.
             veterinary medicine, but its importance in
             contributing to chronic pain is becoming more   Exercise
             widely recognized.                     he role exercise can play in the management
                                                   of the condition must be stressed to owners.
                                                   Exercise will assist with weight reduction in
             interventions                         overweight animals, the strengthening of
                                                   muscles, and go some way to reduce the
             Nutraceuticals are food supplements that are   muscle atrophy that accompanies OA.
             thought to modify the disease process of    urthermore, the emotive component that
             degenerative  oint disease.  he evidence for   exercise provides is likely to be of bene t.
             their e cacy in the maladaptive pain of  A is   Exercise is shown to have a signi cant bene t in
             limited, despite their being widely used.  he   chronic pain conditions (Bobinski et al.,   1  .
             main body of evidence shows a bene t of oral   See Chapter 6.
             supplementation with omega   fatty acids
             found in some  sh oils and green lipped
             mussel (Perna canaliculus  extracts  Bui and
             Bierer,    1; Roush et al.,   1  .  ne study    hese disease modifying agents are indicated
             recommended a dosage of       mg kg day   for use in dogs with OA and are licensed in
             of green lipped mussel extract as a loading   some countries for intramuscular administration
             dose   ielm B  rkman et al.,    9 . Some   twice weekly for 4 weeks. Concurrent NSAI s
             prescription foods include these extracts in   should be avoided and PSGAGs must not be
             their mobility-promoting diets. Other food   given to animals with bleeding disorders.
             supplements, such as glucosamine,
             chondroitin, elk velvet antlers, hydrolysed
             collagen and turmeric, have only anecdotal    his agent is available as an in ectable for a
             evidence.                             course of four injections each a week apart.
               Palmitoyl ethanolamide  PEA  is a fatty acid   Studies show con icting and inconsistent results
             amide molecule that has shown analgesic    Read et al., 1996; Sandersoln et al.,    9 .
             e ects in a blinded comparison with ibuprofen
             for the treatment of temporomandibular joint
             pain in humans (Marini et al.,   1  , but there are    his is a non sulfated glycosaminoglycan with
             presently no published studies in dogs or cats.   little evidence of a positive e ect on the
             A nutritional supplement containing PEA was   progression of osteoarthritis.
             launched in the U  in   16  Redonyl,  echra .
               More importantly, owners must address
             weight reduction in pets that are above their
             ideal bodyweight. It is worth explaining to
             owners that obesity is a chronic low level   treatment
             in ammatory state that can exacerbate  A    wo studies have recently been published
             through the adipokines released from white   demonstrating an analgesic e ect of
             adipose tissue. A moderate weight loss can   intravenous administration of a canine nerve
             reduce pain scores in animals su ering from  A   growth factor antibody to dogs   ebster et al.,
             (Marshall et al.,   1   and weight loss alone has     14; Lascelles et al.,   1  .

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