Page 173 - BSAVA Guide to Pain Management in Small Animal Practice

BSAVA Guide to Pain Management in Small Animal Practice

VetBooks.ir e ex p e Cutaneous epitheliotrophic

lymphoma

HISTORY AND PRESENTATION ANALGESIC PLAN
A 1 year old male neutered ack Russell Analgesic ladder level methadone .4
errier was diagnosed with cutaneous mg kg i.v. 4–8h in hospital then speci c
epitheliotrophic lymphoma; widespread local anti neoplastic therapy including systemic
ulcerative lesions generali ed to the skin and glucocorticoids dexamethasone . mg kg
oral mucosa with nodal and hepatic i.v. 4h and asparaginase 4 IU kg s.c.
involvement igure 7. 6 . once . Reduced to level for management at
home with oral glucocorticoids prednisolone
mg kg orally 4h ; paracetamol and
codeine paracetamol 1 mg kg orally 8h ;
gabapentin 1 mg kg orally 8h ; antibiotics
cephalexin 1 mg kg orally 1 h ;
antihistamines chlorphenamine 4 mg orally
8h and topical local anaesthetic ointment
on more painful skin lesions E LA cream
lidocaine . prilocaine , topically 1 h,
avoiding ulcerated bleeding lesions and
covered with a patch to prevent oral
ingestion of cream .
Papular, pustular and nodular skin
lesions associated with epitheliotrophic
lymphoma in a terrier dog. Tips from the authors
Epitheliotrophic lymphoma is a slowly
CLINICAL SIGNS progressive form of cutaneous neoplasia
Severe pruritus, pain on touching the skin, that in advanced cases can involve nodal
hypersensitivity to stimuli including and distant sites of visceral progression. It is
subcutaneous in ections, anorexia due to associated with signi cant chronic pain
gingival pain on eating, facial oedema due to associated with the skin and mucous
lymphadenopathy, secondary pyoderma. membranes. Advanced lesions are often
widespread and ulcerated. his form of
lymphoma is poorly responsive to
TYPES OF PAIN
chemotherapy and carries a very poor
Severe and debilitating; in ammatory long term prognosis. Palliation of pain
somatic pain, visceral pain organ distension re uires consideration of the extent and
lymph nodes, liver , chronic pain leading to severity of the lesions and can be managed
central sensiti ation and allodynia on the with oral medications or in the most severe
skin surface. cases, locali ed palliative radiotherapy.

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