Glasgow Composite Measure Pain Scale Research Articles

Pharmacokinetics and analgesic efficacy of intranasal administration of tramadol in dogs after ovariohysterectomy

ObjectiveTo assess analgesic efficacy and the pharmacokinetics of intranasal (IN) tramadol in dogs following ovariohysterectomy. Study designRandomized, blinded clinical study. AnimalsA total of 30 bitches undergoing elective ovariohysterectomy. MethodsDogs were randomly assigned to one of three experimental groups (10 dogs per group): IN tramadol 4 mg kg–1 (group T-IN), intravenous (IV) tramadol 4 mg kg–1 (group T-IV) and IV methadone 0.2 mg kg–1 (group M). Drugs were administered at extubation. At established time points (before surgery and up to 8 hours after drug administration) analgesia was assessed using the Italian version of the Glasgow Composite Measure Pain Scale Short Form and physiological variables were recorded. To determine the pharmacokinetics of IN tramadol, blood samples were collected at predetermined time points. Shapiro–Wilk test was used to assess whether data were normally distributed and consequently parametric or non parametric tests were applied. A p value < 0.05 was considered significant. ResultsNo significant intergroup differences were observed in the dogs that were administered rescue analgesia and time of its administration. Excluding dogs that were administered rescue analgesia, no significant intergroup differences emerged in pain scores and physiological variables, except for a lower rectal temperature in group M compared with the tramadol groups. After IN administration, tramadol was rapidly absorbed into the systemic circulation, reaching its maximum concentration (range 74.74–200.29 ng mL–1) within 30–60 minutes, it then decreased rapidly and was detectable in plasma for up to 2 hours after treatment in all dogs. Conclusions and clinical relevanceIN tramadol administration appears to be as effective as IV tramadol and methadone treatments in pain management of dogs after elective ovariohysterectomy. Given its low concentrations and short detection time in plasma after the IN route, systemic tramadol action appears unlikely.

Randomized controlled trial of pregabalin for analgesia after surgical treatment of intervertebral disc disease in dogs.

To assess the effect of perioperative pregabalin on pain behavior in dogs after intervertebral disc surgery. Prospective, randomized, controlled clinical trial with a blinded observer. Forty-six client-owned dogs undergoing intervertebral disc surgery. Dogs were randomly assigned to two groups, with the placebo group receiving opioids alone and the pregabalin group receiving opioids plus pregabalin. Opioid analgesia consisted of 0.6 mg/kg l-methadone given intravenously at anesthetic induction, followed by 0.2 mg/kg given at 8, 16, and 24 hours after extubation and fentanyl patches applied at the end of surgery. Pregabalin was given orally (4 mg/kg) 1 hour before anesthesia, followed by postoperative treatment three times per day (4 mg/kg) for 5 days. The outcome measures were the treatment-group differences in peri-incisional mechanical sensitivity and Glasgow Composite Measure Pain Scale (CMPS-SF) assessed during the first 5 postoperative days. Pregabalin serum concentrations were measured after 24, 72, and 120 hours. Pregabalin reduced pain levels in the treatment group by a mean of 2.5 CMPS-SF units (95% confidence interval [CI] = -3.19 to -1.83, P < .001) compared with the control group during the study period. Pregabalin increased the mechanical nociceptive threshold by a mean of 6.89 N per day (95% CI = 1.87-11.92, P < .001) and of 7.52 N per day (95% CI = 2.29-12.77, P < .001) during the study period, depending on location. Mean levels of serum pregabalin were 5.1, 4.71, and 3.68 μg/mL at 24, 72, and 120 hours postoperatively, respectively. Postoperative signs of pain after surgical treatment of intervertebral disc herniation (IVDH) were reduced when dogs received perioperative pregabalin rather than opioids alone. Perioperative pregabalin reduces postoperative pain after surgical treatment of IVDH.

Dipyrone, scopolamine, and meloxicam for conventional or two-port laparoscopic-assisted ovariohysterectomy in female dogs

For ethical and organic reasons, surgical and analgesic techniques that minimize and adequately control pain should be studied. Ovariohysterectomy is the most common surgical technique in veterinary medicine and is performed in female dogs for elective or therapeutic purposes. Both conventional and minimally invasive surgical techniques are used in veterinary medicine; however, the minimally invasive laparoscopic technique is considered superior to the conventional technique because it is associated with a less painful and faster post-operative recovery. However, for various reasons, the laparoscopic technique is not yet widely used in veterinary medicine, and the conventional ovariohysterectomy is still the most common. The aim of this study, therefore, was to validate the efficacy of the combination of dipyrone, scopolamine, and meloxicam after conventional or two-port laparoscopic-assisted ovariohysterectomies in female dogs. Additionally, this study sought to assess recovery after the two surgical modalities while receiving the same analgesic protocol. Fourteen healthy adult female dogs were spayed and then evaluated using the Visual Analogue Scale, the Melbourne Scale, and the short form of the Glasgow Composite Measure Pain Scale for 72 hours after surgery. The analgesic protocol was efficient for pain control after both techniques, with minimal differences between the groups.

Metamizol and Scopolamine for Conventional or Two-Port Laparoscopic-Assisted Ovariohysterectomy in Dogs

Background: Ovariohysterectomy (OVH) is one of the most appliedtechniques in Veterinary Medicine. Although some analgesic protocols are used after this procedure in order to control post operatory pain, there is a lack of knowledge of the efficacy after conventional and two port laparoscopic-assisted techniques in dog female. Although the combined formulation of metamizol and scopolamine is used, there is no knowledge about the efficacy and collateral effects in a 6 h regimen after OVH. The aim of this research was to evaluate the efficacy of metamizol and scopolamine to analgesia after two techniques of OVH in dog female.Materials, Methods &amp; Results: Fifteen adults and healthy dog female were submitted to OVH, being eight to the conventional procedure and seven to video assisted technic with two ports. The patients received a combination of metamizol and scopolamine, 6-6 h during 48 h and were evaluated before surgery, 60 min after extubation and on 1 h interval during the first 8 h, and at 12, 18, 24, 36, 48 and 72 h after surgery. For this, the University of Melbourne Pain Scale (UMPS) and the short-form of the Glasgow Composite Measure Pain Scale (CMPS-SF) were applied by three evaluators blinded to surgical technic. Glucoses measurement was realized at 1, 6, 12, 24, 48 and 72 h after surgery. Analgesic rescue was not necessary for any animal. Punctuation of UMPS in GC decreases at 8 h and at 5 h, and to GV at 12 and 24 h. Difference between groups happened at 3 h with larger average to GV; at 48 h the punctuation in GC was lager. Considering CMPS-SF to CG, higher average was observed at 1 h and decreased at 2, 3, 8 and 18. At GV highest average points was verified at 1, 2 and 3 h and decreased at 5, 8 and 18 h. Correlation was strong and positive between each two evaluators. Animals of both groups had increased average glucose concentrations from baseline to after surgery and the values reduced to baseline after 24 h; difference between groups were observed at 1 h after surgery, with bigger average to GC. Three animals from the GC had postoperative emesis and one patient vomited after 3 h; other at 6 h and another at 36 and 48 h and owners related no vomiting or changes following hospital discharge. The time to first spontaneous food intake was earlier to GV and time to first defecation was no different between groups. Discussion: For the evaluation it was used the UMPS and CMPS-SF since it is know that pain assessment is better performed when multidimensional or composite scales are used. Considering the UMPS, 27 points is considered the most painful condition. In our study it was observed bigger average to GC at 1 h (4,5) and to GV at 2 and 3 h (5,0). According to CMPS-SF, higher punctuation to GC (7.0) was observed than GV (6,0) in a maximum of 24 points. Considering both scales, it could be suggested that the combination of metamizol and scopolamine promote good analgesic effect. The glucoses measurements and the first spontaneous food intake suggested that laparoscopic approaches results in less stress than the traditional procedures, as observed in other studies. Three animals of GC had postoperative emesis, and it signal can be associated to abdominal pain, as well nausea, vomiting, diarrhea and abdominal distention, probably because it is accepted that video surgery promotes less pain and stress than open procedures. The protocol was efficient to control pain after elective conventional and laparoscopic assisted OHV technique in dog female.

MRI-guided, transrectal, intraprostatic steam application as potential focal therapeutic modality for prostatic diseases in a large animal translational model: Afeasibility follow-up study.

Parallel to establishment of diagnostic surveillance protocols for detection of prostatic diseases, novel treatment strategies should be developed. The aim of the present study is to evaluate the feasibility and possible side effects of transrectal, MRI-targeted intraprostatic steam application in dogs as an established large animal translational model for prostatic diseases in humans. Twelve healthy experimental, intact, male beagle dogs without evidence of prostatic pathology were recruited. An initial MRI examination was performed, and MRI-targeted steam was applied intraprostatically immediately thereafter. Serum levels of C-reactive protein (CRP), clinical and ultrasonographic examinations were performed periodically following the procedure to assess treatment effect. Four weeks after treatment, all dogs underwent follow-up MRI examinations and three needle-core biopsies were obtained from each prostatic lobe. Descriptive statistics were performed. MRI-guided intraprostatic steam application was successfully performed in the study population. The first day after steam application, 7/12 dogs had minimal signs of discomfort (grade 1/24 evaluated with the short-form Glasgow Composite Measure Pain Scale) and no dogs showed any sign of discomfort by day 6. CRP elevations were detected in 9/12 dogs during the first week post steam application. Mild to moderate T2 hyperintense intraparenchymal lesions were identified during follow-up MRI in 11/12 dogs four weeks post procedure. Ten of these lesions enhanced mild to moderately after contrast administration. Coagulative necrosis or associated chronic inflammatory response was detected in 80.6% (58/72) of the samples obtained. MRI-targeted intraprostatic steam application is a feasible technique and displays minimal side effects in healthy dogs as translational model for human prostatic diseases. This opens the possibility of minimally invasive novel treatment strategies for intraprostatic lesions.

Controlled, non-inferiority trial of bupivacaine liposome injectable suspension.

Recently, a bupivacaine liposome injectable suspension (BLIS) became commercially available in the veterinary market that may provide local analgesia for 72 h. The purpose of this study was to compare a BLIS incisional block with a control protocol in cats after ovariohysterectomy (OHE). The hypothesis was that a BLIS block would provide equivalent pain relief. This study was designed as a randomized, double-blind, non-inferiority trial. Students performed an OHE followed by a two-layer incisional and body wall block with either standard bupivacaine (control) or BLIS. Postoperatively, cats in the control group received robenacoxib, whereas the BLIS cats received saline. All cats were evaluated using the feline Glasgow Composite Measure Pain Scale (GCMPS) at multiple time points postoperatively. There were 24 control cats and 23 BLIS cats. One cat from each group required rescue medication. The mean GCMPS scores were low and the groups were equivalent at all time points (P <0.05). This study showed that BLIS was equivalent to the control group up to 42 h and pain scores remained low up to 68 h after surgery. BLIS incisional block is equivalent to a control pain protocol and reduces the need for continued postoperative drug administration.

Randomised trial of perioperative tramadol for canine sterilisation pain management.

Surgical sterilisation to manage free-roaming dog populations is widely used in many countries. However, few studies have examined optimal postoperative pain management regimens at low-resource, high-throughput veterinary clinics. The aim of this study was to examine the efficacy of two intravenous analgesic regimens, preoperative administration of meloxicam and tramadol, or meloxicam alone, in free-roaming dogs undergoing sterilisation. A total of 125 dogs were included, with 64 dogs in the meloxicam-tramadol arm and 61 dogs in the meloxicam-only arm in a non-inferiority study design. Pain levels in sterilisation surgery patients were assessed at four time points after surgery using the Colorado State University Canine Acute Pain Scale, a Visual Analogue Scale and a modified version of the Glasgow Composite Measure Pain Scale - Short Form. Non-inferiority was supported for each of the main scoring outcomes using non-inferiority margins of 0.5, 5 and 0.8, respectively. One dog from the meloxicam-tramadol group and four dogs in the meloxicam-only arm required rescue analgesia, with no difference between groups (P=0.21).The study demonstrated that meloxicam was effective in controlling postoperative pain in a high proportion of dogs. The addition of tramadol alongside meloxicam treatment was not found to be of clinical benefit.

The effect of neuraxial morphine on postoperative pain in dogs after extrahepatic portosystemic shunt attenuation

ObjectiveTo investigate the analgesic effect of epidural morphine after surgical extrahepatic portosystemic shunt (EHPSS) attenuation. Study designRandomized clinical trial. AnimalsA total of 20 dogs with a congenital EHPSS. MethodsDogs were randomly allocated to be given either a single epidural dose of 0.2 mg kg–1 preservative-free morphine (group M) or not (group C) before surgery. All dogs were administered 0.3 mg kg–1 methadone intravenously (IV) as preanaesthetic medication. Pain scores were determined every 2 hours for the first 24 hours postoperatively using the short-form Glasgow Composite Measure Pain Scale (GCMPS-SF). Dogs with a GCMPS-SF pain score >4/20 or >5/24 received 0.1 mg kg–1 methadone IV as rescue analgesia and were reassessed 30 minutes later. If more than three doses of methadone were administered in a 2 hour period, alternative pain relief was provided and a treatment failure recorded. The GCMPS-SF pain scores and number of rescue analgesia injections were analysed over 24 hours. The last observation carried forward method was applied in case of treatment failure. Food consumption and time to first urination were recorded. Data were analysed using a Mann–Whitney U test and presented as median (minimum–maximum range), with significance set at p < 0.05. ResultsGroup M showed lower GCMPS-SF pain scores [15 (11–41) versus 31 (11–86); p = 0.023] and lower postoperative methadone requirements [0 (0–0.2) versus 0.25 (0–0.5) mg kg–1; p = 0.029] than group C. There were three treatment failures in group C only. Food consumption and time to first urination did not differ between groups. Conclusions and clinical relevanceEpidural morphine reduced the requirement for postoperative analgesia in this study population.

Maternal and neonatal wellbeing during elective C-section induced with a combination of propofol and dexmedetomidine: How effective is the placental barrier in dogs?

Anaesthetics administered during C-section (CS) can cross the placenta and the foetal blood-brain barrier contributing to distress up to neonatal mortality. Therefore, to prevent neonatal risks, sedatives and analgesics are not commonly administered to the bitch until all pups are delivered. This study aims to evaluate the effect of a new anaesthetic and analgesic protocol for elective CS in dogs, focused on both maternal and neonatal wellbeing. General anaesthesia was induced by a combination of propofol (PPF) and dexmedetomidine (DEX) and maintained with isoflurane. DEX was added to PPF in order to provide analgesia and to reduce PPF dose. Propofol and DEX concentrations in maternal blood, amniotic fluid, and placenta were correlated to maternal and neonatal parameters. Maternal pain score was assessed with Glasgow Composite Measure Pain Scale short-form. Nine healthy purebred dogs scheduled for elective CS delivered 54 pups. The 77.8% of pups were vigorous at birth and assigned to the highest Apgar score (AS). The lowest AS was recorded in pups from mothers receiving additional doses of PPF (p < 0.001). Apgar scores improved with the increase in time between induction and pups' extraction, starting from 30 min after induction (p < 0.01). This study could contribute to clarify the controversy about the optimal extraction's time of pups after induction i.e. the best time between PPF administration and birth. No bitch showed post-operative pain or required additional analgesic doses based on their pain score. Maternal blood PPF and DEX, as well as placental PPF concentrations, decreased over time (p < 0.01). Conversely, placental DEX was fair uniformly detected in littermate pups. Both PPF and DEX were not detectable in amniotic fluid. Placenta resulted an effective barrier against foetal DEX exposure, making this protocol safe, analgesic and advisable for elective CS in dogs.

Proximal RUMM block in dogs: preliminary results of cadaveric and clinical studies

ObjectiveTo design and assess the perioperative analgesic efficacy of an ultrasound (US)-guided radial (R), ulnar (U), median (M) and musculocutaneous (Mc) nerve blocks, performed together in the axillary space by a single, in-plane approach. Study designAnatomical research and prospective clinical study. AnimalsA group of three dog cadavers and 15 client-owned dogs undergoing orthopaedic thoracic limb surgery. MethodsPhase 1: Anatomical dissection and US study of the axillary space were performed to design the US-guided proximal RUMM block. The technique was considered successful if a total volume of 0.15 mL kg–1 new methylene blue solution completely stained the four nerves in two cadavers for ≥2 cm. Phase 2: In 15 client-owned dogs undergoing orthopaedic thoracic limb surgery, the RUMM block designed in phase 1 was performed to provide analgesia using a total volume of 0.15 mL kg–1 of ropivacaine 0.5%. The block was considered effective if the intraoperative fentanyl requirement was <1.2 mcg kg–1 hour–1 and until the postoperative pain score was [short-form Glasgow Composite Measure Pain Scale (SF-GCMPS)] ≤5/20. ResultsPhase1: Detection of the four nerves was always feasible in a single US-window. The axillary artery and Mc nerve were used as landmarks. In-plane needling approach was feasible in both cadavers. All the nerves were completely stained for >2 cm. No intrathoracic dye spread was found. Phase 2: In 14/15 anaesthetized dogs, mean intraoperative fentanyl requirement was 0.25 ± 0.05 mcg kg–1 hour–1. Postoperatively, all dogs had SF-GCMPS ≤5/20 up to 8 hours. Conclusions and clinical relevanceThe US-guided proximal RUMM block performed at the axillary level with a single, in-plane needling approach using 0.15 mL kg–1 of ropivacaine 0.5% minimized fentanyl requirement during thoracic limb surgery, contributing to postoperative analgesia up to 8 hours after execution of the peripheral nerve block.

Analgesic effect of intra-articular ropivacaine injection after arthroscopic surgery on the shoulder joint in dogs

Shoulder joint disorders are a major cause of forelimb lameness in dogs, and osteochondrosis, degenerative joint disease, and bicipital tenosynovitis are common joint disorders that have been reported in dogs. Many studies have investigated pain management after arthroscopy in human medicine, but reports from veterinary medicine are rare. Ropivacaine is a new amide local anaesthetic drug and a single isomer drug that is used more widely than bupivacaine in human medicine because it has fewer side effects. The present study was conducted to evaluate the analgesic effect of intra-articular injection of ropivacaine after arthroscopic surgery in dog shoulder joints. To accomplish this, ten dogs were randomly divided into two groups of five who underwent the same anaesthesia protocol and shoulder arthroscopic examination. After shoulder arthroscopy, ropivacaine or 0.9% NaCl was injected into the shoulder joint cavity and the dogs were evaluated at one hour, two hours, four hours, six hours, 12 hours and 24 hours after surgery. The evaluated parameters were heart rate, respiratory rate, lameness score, visual analogue scale and the short form of the Glasgow composite measure pain scale. Ropivacaine showed a higher analgesic effect than 0.9% NaCl, indicating that it may be useful for pain management following arthroscopic surgery in dogs.

CREATION AND VALIDATION OF THE ITALIAN VERSION OF THE GLASGOW COMPOSITE MEASURE PAIN SCALE-SHORT FORM (ICMPS-SF).

Objective To validate the Italian translation of the Glasgow Composite Measure Pain Scale – Short Form (ICMPS-SF) in order to assess acute pain in dogs. The original English-version of the scale (the Glasgow Composite Measure Pain Scale – Short Form - CMPS-SF) was translated into Italian according to a standard protocol to ensure linguistic and cultural validity. Nine Italian veterinary surgeons then recorded pain scores in dogs undergoing orthopaedic or soft tissue surgery using the ICMPS-SF at 2, 6, and 24 hours post-extubation. Construct validity was demonstrated using hypothesis testing. A total of 95 dogs were recruited into the study. Thirty-seven dogs underwent orthopaedic procedures and 58 dogs underwent soft tissue procedures. Twenty-three, 45, and 27 procedures were classified as mild, moderate, and severe, respectively. Statistically significant differences in the median pain scores were demonstrated between orthopaedic and soft tissue cases as well as among mild, moderate, and severe cases. Median pain scores decreased with time and changes were statistically significant. The ICMPS-SF demonstrated construct validity similar to the original English-language scale, resulting in a valid and reliable instrument for the assessment of acute pain in dogs by Italian veterinarians.

Evaluation and comparison of postoperative analgesic effects of dexketoprofen and methadone in dogs

ObjectiveTo evaluate and compare the analgesic efficacy and adverse effects of dexketoprofen and methadone using a noninferiority trial, during the first 24 postoperative hours in dogs undergoing orthopaedic surgery. Study designRandomized, blinded clinical study. AnimalsA total of 38 healthy dogs undergoing orthopaedic surgery. MethodsDogs were premedicated with dexmedetomidine [1 μg kg–1 intravenously (IV)] followed by dexketoprofen (1 mg kg–1 IV; group DK) or methadone (0.2 mg kg–1 IV; group M). Anaesthesia was induced with propofol and maintained with isoflurane in 60% oxygen. Postoperatively, dexketoprofen was administered every 8 hours (group DK) and methadone every 4 hours (group M). Analgesia was assessed at baseline and at 1, 2, 4, 6, 18 and 24 hours after extubation using a dynamic and interactive visual analogue scale (DIVAS), the short form of the Glasgow Composite Measure Pain Scale (CMPS-SF), mechanical wound thresholds (MWTs) and plasma cortisol levels. If CMPS-SF score was ≥5, rescue analgesia was administered. Data were analysed using a general linear mixed model, Mann–Whitney U test and chi-squared test as appropriate; a p value <0.05 was considered significant. ResultsThe CMPS-SF and DIVAS scores were significantly higher in group M compared with group DK and remained higher for a longer period in group M, although the differences were not clinically significant. No significant differences were found in MWT assessment between groups. Plasma cortisol level significantly increased 2 hours after extubation, without significant differences between treatments. Rescue analgesia was administered to three animals (one in group DK; two in group M). Conclusion and clinical relevanceWe conclude that 1 mg kg–1 IV dexketoprofen administered every 8 hours during the first 24 hours postoperatively is noninferior to methadone in controlling pain after orthopaedic surgery in dog, although frequent pain assessments are recommended to adjust the analgesia plan.

Efficacy of white rice-based diets in nursery pigs

The objective of this study was to evaluate the efficiency of PU in male cats. The perineal urethrostomy (PU) was performed in 10 home-breed male cats, in which 9 cats were healthy and 1 cat had cystolith (2.5 ± 0.5 kg BW), from May 2017 to April 2018 at the Department of Clinical Veterinary Science of Nong Lam University, Ho Chi Minh City. The criteria for evaluating the experiment included the successful rate, wound healing time, post-operative pain assessment, time of return to normal urination and defecation and post-operative short-term complications. The results showed that 9 out of 10 cats completely recovered their urinating ability in approximately 14 days post-operation, in which 2 cats experienced wound infection and required a surgical intervention. One cat died due to unknown causes at the 10th day post operation. The average pain scores based on the Feline Glasgow Composite Measure Pain Scale (CMPS - Feline) in the first 5 days were relatively high (scored as 11) and gradually decreased; until 14 days post-operation, 100% of cats recovered had no sign of pain (scored as 1). It was recorded that all cats experienced pain and difficulty in urination and defecation for a few days after the surgery. After removing the urinary catheter, the cats needed 3 to 5 days to get used to the new urethral stoma and normally self-urinated ability. In general, the successful rate of this surgical method was 90% (9 out of 10 fully recovered cats) in which most of the cats were healthy and returned to normal urination after 14 days post-operation

Preliminary appraisal of the reliability and validity of the Colorado State University Feline Acute Pain Scale.

The objective of this study was to determine the inter-rater reliability and convergent validity of the Colorado State University Feline Acute Pain Scale (CSU-FAPS) in a preliminary appraisal of its performance in a clinical teaching setting. Sixty-eight female cats were assessed for pain after ovariohysterectomy. A cohort of 21 cats was examined independently by four raters (two board-certified anesthesiologists and two anesthesia residents) with the CSU-FAPS, and intra-class correlation coefficient (ICC) was used to determine inter-rater reliability. Weighted Cohen's kappa was used to determine inter-rater reliability centered on the 'need to reassess analgesic plan' (dichotomous scale). A separate cohort of 47 cats was evaluated independently by two raters (one board-certified anesthesiologist and one veterinary small animal rotating intern) using the CSU-FAPS and the Glasgow Composite Measure Pain Scale (CMPS-Feline), and Spearman rank-order correlation was determined to assess convergent validity. Reliability was interpreted using Altman's classification as very good, good, moderate, fair and poor. Validity was considered adequate if correlation coefficients were between 0.4 and 0.8. The ICC was 0.61 for anesthesiologists and 0.67 for residents, indicating good reliability. Weighted Cohen's kappa was 0.79 for anesthesiologists and 0.44 for residents, indicating moderate to good reliability. The Spearman rank correlation indicated a statistically significant ( P = 0.0003) positive correlation (0.31; 95% confidence interval 0.14-0.46) between the CSU-FAPS and the CMPS-Feline. The CSU-FAPS showed moderate-to-good inter-rater reliability when used by veterinarians to assess pain level or need to reassess analgesic plan after ovariohysterectomy in cats. The validity fell short of current guidelines for correlation coefficients and further refinement and testing are warranted to improve its performance.

A retrospective comparison of two analgesic strategies after uncomplicated tibial plateau levelling osteotomy in dogs

ObjectiveTo compare the efficacy and side effects of postoperative methadone administered according to pain score (PS) or every 4 hours (Q4), after unilateral uncomplicated tibial plateau levelling osteotomy (TPLO) in dogs in which a peripheral nerve block (PNB) was administered. Study designRetrospective, case-control study. AnimalsClinical records of dogs that underwent a TPLO in 2015 were retrieved; 136 out of 174 dogs were included: 52 assigned to group PS, 84 to group Q4. MethodsIn group PS, methadone was administered according to the short form of the Glasgow Composite Measure Pain Scale (CMPS-SF), whereas in group Q4 methadone was administered at 4 hour intervals. Demographic data, anaesthetic technique, surgery time, American Society of Anesthesiologists classification, PNB performed, local anaesthetic used and dose, anti-inflammatory drugs administered, end-expiratory fraction of isoflurane, perioperative opioid consumption, time to first postoperative methadone administration, pain scores, time to first pain score, food intake, number of postoperative observations, presence/absence of specific keywords representing the general state and behaviour of the animal, use of the operated limb and reaction to wound palpation were retrieved. Fisher's exact test, chi-square test, Student t test or Mann–Whitney U test were used, considering p<0.05 significant. Odds ratios and 95% confidence intervals were calculated, when indicated. ResultsFour times more methadone was administered to dogs in group Q4, and whilst not having lower pain scores or better short-term outcome (e.g. toe-touching and weight bearing), were 23.42 times (1.37 to 400.40) more likely to vomit, 3.76 (1.50 to 9.49) more likely to vocalize, and their food intake was 38% less than dogs in group PS. No dogs in group PS vomited postoperatively. Conclusions and clinical relevanceAdministration of methadone Q4 caused more side effects than administration guided by CMPS-SF. This should be considered when planning postoperative analgesia in dogs undergoing uncomplicated TPLO and in which a PNB has been performed.

A preliminary investigation into personality and pain in dogs

Abstract Adherence to basic animal welfare standards involves effective monitoring and control of pain, especially in a veterinary setting. Assessment relies on behavioral and physiological indicators. However, individual differences in physiology mediate consistent individual differences in behavior, referred to as personality. Therefore, personality may confound measurements of pain. The current work is a preliminary investigation into whether extraversion and neuroticism are associated with differences in individual behavioral and physiological responses to pain. Twenty dogs were observed during recovery from routine castration in a clinical setting. Core temperature was recorded using infrared thermography on admission, 15 minutes after extubation and every 30 minutes thereafter, until the subject was collected by their owner. Behavior during recovery was scored using Short-Form Glasgow Composite Measure Pain Scale at the same intervals as infrared thermography readings. Personality was measured using Monash Canine Personality Questionnaire–Revised, and owners rated their dog's tolerance to pain on a 5-point Likert scale. Pain score did not have an association with eye temperature discrepancy or core temperature changes from control, indicating it may not predict affective response to pain. More highly extravert subjects had significantly higher pain scores ( P = 0.031), despite experiencing similar tissue damage. More extravert subjects showed significantly greater right eye temperature ( P = 0.035), suggesting hemispheric dominance. Neuroticism had no association with physiological or behavioral responses to pain. Finally, owners were not able to predict their dog's behavioral or physiological response to pain. These results indicate that personality may be a useful clinical tool for assessing individual differences in response to pain, whereas owners' ratings of their dog's response are not reliable.

Preemptive Analgesic Effects of Tramadol for Ovariohysterectomy in Bitches

An experimental study was conducted on 12 healthy bitches presented to University of Gondar Veterinary Clinic for Ovariohysterectomy to evaluate the preemptive analgesic efficacy of tramadol to relieve postoperative pain. The bitches were randomly assigned to experimental group I and II. Anesthesia was achieved by administration of atropine (0.04 mg/kg BW, SC) and immediately followed with xylazine-ketamine combination, (1.0 mg/kg+10 mg/kg BW, IM). When the bitch is attaining lateral recumbency, diazepam (0.5 mg/kg, BW, IV) was given. Maintenance of anesthesia was achieved by giving Ketamine (5.0 mg/kg, IV) for the bitches that showed movement during surgery. Tramadol (2.0 mg/kg, BW, IV) was administered only in group I bitches immediately after induction of anesthesia. The physiological parameters and pain scoring using Glasgow Composite Measure Pain Scale (GCMPS) and Categorized Numerical Rating Scale (CNRS) were assessed at different stages of analgesia. There was a significant (p<0.05) reduction in the rectal temperature, respiratory rate and heart rate at postoperative 0, 30, 60 and 90 minutes in group I bitches as compared to group II. Postoperative pain assessment by GCMPS as well as CNRS revealed reduction in pain at postoperative 0, 30, 60, and 90 minutes in group I bitches as compared to group II due to the inclusion of tramadol in group I which favored better postoperative analgesic effect. No complications were encountered in any of the bitches in the present study revealing that the anesthetic and analgesic protocol employed was safe. However further longterm studies are needed to compare the efficacy of tramadol for various surgeries.

Efficacy and safety of oral robenacoxib (tablet) for the treatment of pain associated with soft tissue surgery in client-owned dogs

BackgroundNon-steroidal anti-inflammatory drugs (NSAIDs) have been proven to be effective in controlling peri-operative pain in dogs. Robenacoxib is an NSAID with high selectivity for the cyclooxygenase (COX)-2 isoform. The objective of this study was to assess the efficacy and safety of an oral tablet formulation of robenacoxib in client-owned dogs undergoing soft tissue surgery. The study was a prospective, multi-center, randomized, masked, placebo-controlled, parallel-group clinical trial. A total of 239 dogs were included and randomly allocated in a 1:1 ratio to receive either robenacoxib or placebo. Each dog received an oral tablet administration of either robenacoxib, at a target dose of 2 mg/kg, or placebo once prior to surgery and for two additional days post-operatively. All dogs also received a pre-anesthetic dose of 0.2 mg/kg butorphanol (intravenous or intramuscular). Pain assessments were performed using the short form of the Glasgow Composite Measure Pain Scale. Robenacoxib was compared to the placebo group on a success/failure basis. Treatment failure was defined as the need for rescue therapy to control post-operative pain.ResultsSignificantly (P = 0.019) more dogs administered robenacoxib were considered treatment successes (89 of 116, 76.72%) compared to dogs given placebo (74 of 115, 64.35%). The percentage of treatment failure was therefore 23.28% in the robenacoxib and 35.65% in the placebo group. The least squares mean total pain scores were significantly different between groups and in favor of robenacoxib at 3 and 5 hours (P < 0.05) and 8 hours post-extubation (P < 0.01). Pain at the surgery sites (response to touch) was also significantly improved at 3, 5 and 8 hours post-extubation in dogs receiving robenacoxib versus placebo (P < 0.01). In addition, a significant overall improvement in posture/activity was revealed with robenacoxib having lower scores versus placebo (P < 0.01). No significant differences between the robenacoxib and placebo groups in the frequency of reported adverse events were observed.ConclusionsRobenacoxib by oral (tablet) administration was effective and well tolerated in the control of peri-operative pain and inflammation associated with soft tissue surgery in dogs.

Efficacy and Safety of Injectable Robenacoxib for the Treatment of Pain Associated With Soft Tissue Surgery in Dogs.

BackgroundNonsteroidal anti‐inflammatory drugs (NSAIDs) are used routinely to control pain and inflammation after surgery in dogs. Robenacoxib is a cyclooxygenase‐2 selective NSAID.Hypothesis/ObjectiveAssess the clinical efficacy and safety of an injectable formulation of robenacoxib in dogs undergoing surgery.AnimalsThree hundred and seventeen client‐owned dogs (N = 159 robenacoxib or N = 158 placebo).MethodsIn this prospective, multicenter, randomized, masked, placebo‐controlled, parallel‐group study, dogs received a SC injection of either robenacoxib, at a target dose of 2.0 mg/kg, or placebo once prior to surgery and for 2 additional days postoperatively. Pain assessments were performed using the short form of the Glasgow Composite Measure Pain Scale (CMPS‐SF). The primary efficacy variable was treatment success/failure, with failure defined as the need for rescue therapy to control pain or withdrawal of the dog from the study due to an adverse event.ResultsSignificantly (P = .006) more dogs administered robenacoxib were considered treatment successes (108 of 151, 73.7%) compared to dogs given placebo (85 of 152, 58.1%). Total pain scores (P < .01), pain at the surgery sites (response to touch, P < .01), and posture/activity (P < .05) were significantly improved at 3, 5, and 8 hours postextubation in dogs receiving robenacoxib versus placebo.Conclusions and Clinical ImportanceRobenacoxib administered by SC injection prior to surgery and for 2 additional days postoperatively was effective and well tolerated in the control of postoperative pain and inflammation associated with soft tissue surgery in dogs.