The phenomenon of pain is an inherent element of disease and treatment. Effective treatment of pain, prevention of its occurrence is crucial to the well-being of the animal and its owners. Particularly in oncology – chronic pain, enhanced by central sensitization, or neuropathic pain is a great challenge for the doctor. These are symptoms resulting from the cutting or crushing of nerve fibers – after amputation operations, during the destruction of bone or soft tissue by the tumor, and it is a pain caused by chronic diseases – lasting and not adequately controlled by ordinary NSAIDs. Let’s see how we can help suffering animals.
NSAIDs are most commonly used as a treatment for pain associated with joint diseases and post-operative pain. They are effective on the periphery as well as on the central level of feeling painful. Apart from unquestionable advantages, they are characterized by the possibility of causing serious side effects – from the gastrointestinal tract, kidneys, liver and not only. Therefore, more selective drugs are recommended for the Cox 2 receptor – they are safer for chronic administration. Many cancers overexpress Cox 2 receptors – therefore drugs from this group are also used in metronomic chemotherapy.
Tramadol can be a great addition for dogs who can not control pain well by NSAID drugs alone or have a tolerance. The doses are wide and selected by the physician based on the patient’s condition and response, usually 3-5 mg / kg up to 4 x daily, although there are patients who require higher doses. At high doses, we can observe sedation and constipation. In patients with impaired renal and hepatic function, dose reduction should be considered. Other opioid drugs are subject to restrictions under the Act on counteracting drug addiction, but it is worth considering oncology or surgical patients to consider the use of fentanyl in patches, or buprenorphine, which can be administered in a convenient way – to the oral mucosa. Dose 0.02 – 0.03 mg / kg. What
Gabapentin is a blocker of calcium channels. It works directly in damaged neurons and at the post-spinal corners of the spinal cord, preventing the effect of central sensitization to pain. The oral dose is from 2 to 10 mg / kg twice daily – in patients with renal insufficiency a lower dose and periodic monitoring of renal function should be considered. The drug is used before planned operations or in the course of diseases causing severe neuropathic pain – e.g. osteosarcoma, or bladder inflammation in cats. Gabapentin is deprived of interaction with other drugs, there are no expected side effects. The drug should be discontinued gradually.
Amantadine is an antiviral medicine. It also blocks NMDA receptors in the corneal atrophy of the spinal cord, blocking the effect of central sensitization to pain. This drug should be used with caution, as it may interact with tramadol and tricyclic antidepressants, leading to the so-called serotonin syndrome. At a dose of 3-5 mg / kg once a day in both dogs and cats, it can be effectively combined with NSAIDs and gabapentin.
Pamidronate is a drug that induces apoptosis of osteoclasts, reducing the pain caused by bone cancer. The drug is also used in the treatment of cancer hypercalcemia, administered intravenously at a dose of 1-2 mg / kg every 2 weeks.
The drugs listed herein may interact with each other and with other preparations used in animals. The veterinarian determines the indications and dosage of the drug for each case individually. All medicines and preparations for the treatment of pain are available only on prescription.