Page 171 - BSAVA Guide to Pain Management in Small Animal Practice

BSAVA Guide to Pain Management in Small Animal Practice

VetBooks.ir CASE EXAMPLE 1 CONTINUED in ammatory pain. he tumour causes

muscle damage, nerve ending compression
ANALGESIC PLAN and in ltration and visceral out ow
obstruction and distension as it occurs
Analgesic ladder level initially, meloxicam commonly in the trigone of the bladder and
.1 mg kg orally 4h and tramadol mg proximal urethra. he tumour has often been
kg orally 1 h , followed by amitriptyline present for a period of time prior to diagnosis,
1 mg kg orally 1 h; discontinuing tramadol with clinical signs fre uently assumed to be
to prevent potential serotonin syndrome ; associated with a urinary tract infection rather
antibiotic therapy co amoxiclav 1 mg kg than neoplasia.
orally 1 h ; faecal softeners lactulose, ml NSAI s improve clinical signs rapidly in a
meal up to 8h ; physical touch by the owner high percentage of patients and through
during particularly painful episodes of C inhibition may have anti cancer
straining. bene ts. he tumour may be managed with a
range of systemic chemotherapy agents with
Tips from the authors a low to moderate response rate. ther
medications that may be considered in the
ransitional cell carcinoma is a highly invasive management of this condition include
tumour; involvement of the prostate is gabapentin mg kg orally – h for
commonly seen in male dogs. etastatic chronic pain and dia epam – mg dose
sites can include lungs, liver and bone. orally – h to reduce acute urethral
Concurrent bacterial cystitis is common, spasm. Urinary retention can be a side e ect
especially in female dogs and contributes to of amitriptyline in canine patients.

e ex p e Soft tissue sarcoma with spinal
cord involvement

PRESENTATION AND HISTORY TYPES OF PAIN
A year old, female neutered Labrador Severe and complex pain; acute somatic
Retriever diagnosed with a poorly in ammatory pain; chronic pain associated
di erentiated soft tissue sarcoma a ecting with central sensiti ation; neuropathic pain.
the spinous process of with spinal canal
invasion and severe spinal cord compression CLINICAL EXAMINATION
diagnosis made following RI and surgical
biopsy with histopathology . he disease was Based on the neurological examination the
locali ed with no evidence of metastases. lesion was locali ed to the –L spinal cord
segments although a multifocal locali ation
CLINICAL SIGNS was not excluded.
Pelvic limb ataxia and vocali ation,
progressing to pelvic limb hemiparesis.

166

Ch7H Pain Management.indd 166 19/12/2018 10:46