Abstract
This study aimed to evaluate pain scores, analgesic requirements, food intake and serum inflammatory cytokines in cats before and after clinically recommended dental treatment. Twenty-four cats were included in a prospective, blinded clinical trial. Cats were equally divided into minimal (minimal dental treatment) or severe (multiple dental extractions) oral disease groups. They were admitted (day 0) and underwent oral examination/radiographs/treatment under general anesthesia (day 1; acepromazine-hydromorphone-propofol-isoflurane-meloxicam-local anesthetic blocks). Serum inflammatory cytokines were measured on days 0 and 6. Pain was scored using the Glasgow composite measure pain scale-feline (CMPS-F). Rescue analgesia was administered with hydromorphone if CMPS-F ≥ 5/20. Dry and soft food intake (%) during 3 minutes and 2 hours, and daily soft food were calculated. The Cochran-Mantel-Haenszel and Chi-square tests, Spearman’s rank correlation and linear mixed models were used for statistical analysis (alpha = 0.05). Pain scores were significantly increased in cats with severe disease when compared with baseline (up to day 4) and minimal disease (all postoperative time points). Prevalence of rescue analgesia was significantly higher in severe (91.7%) than minimal disease (0%); analgesics were required up to day 3. Pain scores and frequency of rescue analgesia were significantly correlated with the number of tooth extractions, gingival and calculus index. Prevalence of rescue analgesia was significantly correlated with the number of missing teeth, teeth extractions and gingival index. Dry and soft food intake during 3 minutes, and dry food intake during 2 hours were significantly lower in the severe than minimal disease group throughout the study. Some cytokines differed between groups between day 0 and day 6 and were associated with the presence of tooth resorption and number of missing tooth and tooth fractures. Long-term analgesia is required after dental extractions in cats with severe oral disease. This condition reduces food intake and influences serum inflammatory cytokines.
Highlights
Pain is a serious welfare issue that produces long-term distress with significant deleterious effects affecting quality of life (QoL) in humans [1,2,3,4]
They release endotoxins that mediate the release of inflammatory cytokines [e.g. interleukin (IL)-1, IL-6, tumor necrosis factor (TNF)] which are strongly correlated with the progression of the disease in humans [11,12,13,14]
composite measure pain scale-feline (CMPS-F) scores and the frequency of rescue analgesia were significantly correlated with number of tooth extractions (r = 0.84, p = 0.0001 and r = 0.83, p = < 0.0001; respectively), gingival index (r = 0.70, p = 0.001 and r = 0.67, p = 0.003; respectively) and calculus index (r = 0.48, p = 0.02, and r = 0.47, p = 0.03; respectively)
Summary
Pain is a serious welfare issue that produces long-term distress with significant deleterious effects affecting quality of life (QoL) in humans [1,2,3,4]. Periodontal disease including gingivitis and periodontitis, is one of the most commonly reported diseases in humans and companion animals [3,5,6,7,8] In cats, it produces pain, inflammation, dysphagia, halitosis, weight loss and oral hemorrhage; aggressive full-mouth extractions are commonly required as treatment [9,10]. Pain scores and analgesic requirements have not been systematically investigated in cats with oral disease undergoing dental extractions. It is unknown how oral treatment can affect soft and dry food intake perioperatively which could significantly impact the nutritional status of these patients. The study of serum inflammatory cytokines could provide valuable insight in the pathogenesis of oral disease in cats
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