Page 154 - BSAVA Guide to Pain Management in Small Animal Practice

7 | Orthopaedic pain

VetBooks.ir Drug Dogs Cats Notes

mg kg 4h
1 4 mg kg 4h
Start at lowest dose in cats
Amantadine
Amitriptyline 1 mg kg 1 4h . 1 mg kg 4h
Buprenorphine . . mg kg 4h Oral transmucosal
Gabapentin 1 1 mg kg 8 1 h mg kg 1 h
Paracetamol 1 mg kg 8 1 h N USE Licensed dose is mg kg
Pregabalin 4 mg kg 1 h Start at mg kg then increase
ose rates of selected oral drugs used in the management of orthopaedic pain.

e ects. Indeed, several human studies have Paracetamol: Licensed in combination with
suggested that continuous use was associated codeine, paracetamol is frequently used in
with fewer and less severe osteoarthritis are dogs where NSAI use is not tolerated. At
ups. apering of NSAI s to the minimum present, there is no published evidence to
e ective dose is commonly practiced but may support its use as a sole treatment in
result in inadequate pain control and there is osteoarthritis and its analgesic e ect in dogs
no evidence for reduced side e ects. has recently been questioned. However, it is
commonly used as part of multimodal analgesia
Amantadine: Amantadine has been shown to regimes in the dog.
improve pain control in osteoarthritic dogs
when combined with an NSAI . he author has Amitriptyline: Amitriptyline, a tricyclic
had success using amantadine as a primary antidepressant, has proven e cacy in canine
treatment for osteoarthritis in dogs. neuropathic pain and the author has used it in
combination with NSAI s in the management of
Gabapentin: abapentin is a safe and e ective osteoarthritis in dogs refractory to other drugs.
drug for chronic pain in dogs and cats. It can be
used in combination with NSAI s and the Structure-modifying drugs: Pentosan
author believes it is an e ective primary polysulphate and polysulphated
treatment for chronic orthopaedic pain in dogs glycosaminoglycan are considered to have the
where NSAI use is not possible. Side e ects potential to retard cartilage degeneration.
are uncommon but may be more frequent at Clinical trials have reported mixed results but
doses above 1 mg kg. their use may provide a moderate level of
comfort in canine osteoarthritis.
Pregabalin: Pregabalin is similar to gabapentin
but has a longer half-life and a higher Nutraceuticals: Essential fatty acids of the n
bioavailability. It may provide improved group may have an anti in ammatory e ect and
analgesia where the response to gabapentin studies have shown dietary supplementation
has been unsatisfactory. with eicosapentaenoic acid and
docosahexaenoic acid improved mobility in
Tramadol: Tramadol has unpredictable dogs with osteoarthritis. Many laboratory
absorption and pharmacokinetics in dogs. studies showing potential bene ts of
his is re ected in clinical use where lack of glucosamine and chondroitin exist but data on
e cacy and side e ects are common and it is e cacy in pain relief in both human and
therefore becoming less popular as an veterinary literature are lacking. Combinations
analgesic agent. Tramadol should not be of nutraceuticals in supplements and complete
used with amitriptyline due to the serotonin diets are increasingly available. Some clinical
reuptake e ects. data showing e cacy are emerging and the

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