Page 139 - BSAVA Guide to Pain Management in Small Animal Practice

BSAVA Guide to Pain Management in Small Animal Practice

VetBooks.ir e ex p e Chiari-like malformation and

syringomyelia

This disease is characterized y a mismatch TREATMENT
etween the caudal fossa volume and its
contents the cere ellum and caudal rain edical management focuses on analgesia
stem leading to an o struction of the normal and reduction of CS production but is not
cere rospinal uid ow through the proven to prevent disease progression.
foramen magnum resulting in syringomyelia
uid- lled cavitation and dilatation of the ■ Anti in ammatory drugs combined with
central canal within the spinal cord. analgesic action
• Non steroidal anti in ammatory
HISTORY AND PRESENTATION drugs as rst choice, or anti
in ammatory dose of corticosteroids
ccurs most commonly in young to middle less preferred .
aged Cavalier ing Charles Spaniels, Analgesia
presenting with allodynia or dysaesthesia. ■
hey may scratch at usually one side of the • abapentin. In some dogs pregabalin
neck at rest and while walking and often appears to be more e ective.
without making skin contact, yelp for no • ther types of analgesia such as
reason or on light touch, dislike being touched amantadine or amitriptyline can be
or groomed, with a worsening of signs when a added if necessary.
collar is used; they may be less energetic and ■ rugs that may have an e ect on CS
sleep more than usual, with the head in an production and CS pulse pressure, but
elevated position. Signs can be intermittent. for which a clear conclusion of e cacy
has not yet been made
• mepra ole. Newer studies suggest
CLINICAL SIGNS AND SIGNS OF PAIN
that omepra ole may not have the
he dog may exhibit a large variety of signs desired e ect
from normal to severely abnormal. Abnormal • urosemide. ecreases intracranial
mentation may only be evident from the pressure by diuresis and reduced
history. ait can be normal, ataxic, paretic or blood volume, but it may not have the
lame. Cervical pain is often only evident on desired e ect on CS pressure
palpation and not on movement of the neck. • Corticosteroids. ay decrease CS
Postural reactions may be normal or abnormal. pulse pressure.
Cranial nerve examination is unremarkable. ■ Use a harness instead of a neck collar.

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