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Identification and management of pain in pets has advanced significantly over the past decade, leading both the World Small Animal Veterinary Association and the American Animal Hospital Association to update their guidelines on pain management. Both sets of guidelines recognise the importance of pain management in general practice for improving quality of life and patient outcomes, as well as supporting the veterinarian-client bond1,2.
With advances in preventative care, nutrition and veterinary medicine, the life expectancy of pets is increasing, and with this the incidence of osteoarthritis has also increased in both cats and dogs. Osteoarthritis and the broader category of Degenerative Joint Disease (DJD) can easily go unnoticed by pet owners or mistaken for old age, and is one of the most under-diagnosed diseases in veterinary medicine2.
Therefore, educating owners on how to identify pain in their pets is crucial for the initiation of treatment, as well as the ongoing management of the chronic pain2. In addition to the history from the client, the veterinary examination should include an assessment of the patient’s mobility, activity levels, the presence of pain and overall demeanour of the pet, which may indicate the impact of the pain on the animal2. The outcomes
of this assessment will guide the treatment choices.
Regardless of the stage of disease, or the treatments selected, veterinarians should aim to maximise the benefit and minimise the risks associated with managing this painful disease2. The mainstays of treatment involve methods to alleviate pain, and at all stages ‘nonsteroidal anti-inflammatory drugs’ (NSAID) are the most common analgesics used1.
When treating DJD in cats and dogs, all treatment angles need to be considered, to get the best outcome for your patient. Below is a broad range of treatments that can be used to help your patients manage their DJD in a multi-modal way2.
Non-surgery, non-drug treatment2
- Weight management
- Diet modulation (type, amount)
- Physical rehabilitation and physical modalities
- Environmental modification
- Nutritional supplements
- Paracetamol (acetaminophen) [not in cats]
- Corticosteroids (treating the underlying immune-mediated disease, resulting in polyarthritis)
- Adjunctive analgesics (e.g. tramadol, amantadine, gabapentin, tricyclic antidepressants)
- Postulated disease-modifying drugs (e.g. polysulfated glycosaminoglycan)
- Neuroablative procedures
- Joint replacement (hip, elbow, knee)
- Excision arthroplasty
- Joint denervation
- Stem-cell therapies
Currently, the greatest weight of evidence is behind weight management, NSAIDs, diet and exercise.
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1. Epstein, M. et al (2015) 2015 AAHA/AAFP pain management guidelines for dogs and cats. J Feline Med Surg. Mar;17(3):251-72.
2. Mathews, K. et al (2014), Guidelines for Recognition, Assessment and Treatment of Pain. J Small Anim Pract, 55: E10–E68.