Pain In Cats Research Articles

Automated video-based pain recognition in cats using facial landmarks.

Affective states are reflected in the facial expressions of all mammals. Facial behaviors linked to pain have attracted most of the attention so far in non-human animals, leading to the development of numerous instruments for evaluating pain through facial expressions for various animal species. Nevertheless, manual facial expression analysis is susceptible to subjectivity and bias, is labor-intensive and often necessitates specialized expertise and training. This challenge has spurred a growing body of research into automated pain recognition, which has been explored for multiple species, including cats. In our previous studies, we have presented and studied artificial intelligence (AI) pipelines for automated pain recognition in cats using 48 facial landmarks grounded in cats' facial musculature, as well as an automated detector of these landmarks. However, so far automated recognition of pain in cats used solely static information obtained from hand-picked single images of good quality. This study takes a significant step forward in fully automated pain detection applications by presenting an end-to-end AI pipeline that requires no manual efforts in the selection of suitable images or their landmark annotation. By working with video rather than still images, this new pipeline approach also optimises the temporal dimension of visual information capture in a way that is not practical to preform manually. The presented pipeline reaches over 70% and 66% accuracy respectively in two different cat pain datasets, outperforming previous automated landmark-based approaches using single frames under similar conditions, indicating that dynamics matter in cat pain recognition. We further define metrics for measuring different dimensions of deficiencies in datasets with animal pain faces, and investigate their impact on the performance of the presented pain recognition AI pipeline.

Surgeon experience affects perioperative pain in cats undergoing elective ovariohysterectomy: a randomized clinical trial.

This study aimed to compare the outcomes between surgeries performed by either experienced or inexperienced surgeons by assessing intraoperative nociception and perioperative analgesia. 16 healthy, client-owned female cats were randomly allocated into 2 groups of 8: one undergoing surgery by an experienced surgeon (GES group) and the other by inexperienced surgeons (GIS group). Both groups received IM premedication with acepromazine (0.05 mg/kg) and methadone (0.3 mg/kg). After 20 minutes, venipuncture and induction with propofol (dose-response, IV) were performed. Maintenance was achieved with inhaled isoflurane. Intraoperative vital parameters were monitored, and fentanyl (2.5 µg/kg, IV) was administered as rescue analgesia when needed. Postoperatively, pain was assessed with a visual analog scale and the multidimensional pain scale of the Universidade Estadual Paulista in Botucatu; morphine (0.2 mg/kg, IM) was used for rescue analgesia, as necessary. In the GIS group, significant increases in heart rate and systolic blood pressure were noted during surgery, especially during pedicle clamping. Respiratory rate and end-tidal isoflurane levels were higher in the GIS group at specific surgical stages. Survival analysis indicated that the GIS group had a greater need for fentanyl. Postoperative pain scores were generally low, but a higher proportion of GIS cats required rescue analgesia. Surgeon experience influences intraoperative parameters and fentanyl consumption. Inexperienced surgeons contribute to increased postoperative pain and poorer wound healing outcomes in cats undergoing elective ovariohysterectomy. Ovariohysterectomy is a common procedure in veterinary practice, and surgical expertise significantly impacts pain management and recovery. Yet, its effects have been underexplored, potentially compromising animal welfare.

276 Use of triaxial accelerometers and a machine learning algorithm for behavioral identification to assess the effectiveness of a joint supplement in old domestic cats (Felis catus)

Abstract Degenerative joint disease (DJD) has a 90% prevalence in older cats and adversely affects quality of life1. Long-term administration of non-steroidal anti-inflammatory drugs is usually required but can have adverse effects2. Nutraceuticals have been shown to relieve joint pain in cats without such side effects; however, due to differences in dose rates and formulations there is no consensus as to their efficacy. Most studies have utilized subjective insensitive measures such as veterinary or owner-assessed changes in activity. Accelerometers can provide objective data on cat activity and can identify specific behaviors3.Triaxial accelerometers (ActiGraph, Pensacola, FL) were fitted to the collars of 16 cats (aged 11 to 16 yr; Massey University, Palmerston North, NZ) for 20 wk to assess their activity and behavior. The cats were fed the same diet (Chef: Kraft Heinz Wattie’s Ltd., Hastings, NZ) for 4 wk to collect baseline acceleration data, before being divided into two groups balanced for physical activity. After 4 wk, a blood sample were taken from all of the cats to establish their baseline levels of a range of inflammatory markers (e.g., IL-6, TNFα, INF- γ, SDF-1). The test group (n = 8) then received a joint supplement added to the baseline diet while the control group (n = 8) were fed the diet unsupplemented for 16 wk. The commercial joint supplement contained glucosamine, chondroitin sulphate, and green-lipped mussel (Tandem, Wellington, NZ), at daily doses shown previously to be effective in cats4,5,6. The aim of the work was to assess the efficacy of the joint supplement in maintaining or promoting activity and specific behaviors in the cats. At the end of the period of supplementation a second blood sample was taken and assessed for the same range of inflammatory markers. Overall physical activity was not different between groups at baseline but was greater over the study in the test group compared with the control (P < 0.03). Grooming, as identified by the algorithm, showed a tendency (P = 0.051) to be greater in the test group than the control. These results suggest that the supplement had a positive effect on both overall activity and more specifically on grooming behavior in old cats. However, no differences in the range of inflammatory markers were seen before or after supplementation. While the behavioral measures could indicate the supplement reduced the effects of DJD, further research is required to confirm this.1Cunningham et al (2022) Journal of Feline Medicine and Surgery 24, 962-974. 2Lemetayer and Taylor (2014) Journal of Feline Medicine and Surgery 16, 547-562; 3Smit et al., (2023) Sensors 23, 7165; 4Corbee (2022) Veterinary Medicine and Science 8, 1025–1035; 5Corbee et al. (2013) Journal of Animal Physiology and Animal Nutrition 97, 846–853; 6Lascelles et al. (2010) Journal of Veterinary Internal Medicine, 24, 487–495.

Utility of facial thermography in the recognition of acute pain in hospitalized cats (Felis catus)

Different clinical conditions have been associated with the presence of pain in animals, so understanding the pathophysiological changes associated with their response is essential in in-hospital clinical monitoring. The objective of this study was to describe the usefulness of facial thermography in the recognition of acute pain in hospitalized cats (Felis catus), for which 71 cats were studied with an average weight of 4.3±1.4 Kg and an age average of 4.4±3.5 years. Facial temperature values were obtained in different region of interest (ROI) and compared according to the values of the Grimace pain scale in cats according to the following subclassification: Group 1, control animals (n=10); Group 2, animals classified with score 0-3 (n=21); Group 3, animals classified with score 4-6 (n=30) and Group 4, animals classified with score 7-10 (n=10). The global average temperature of the facial (F), auricular (A), periocular (PO), nasal (N) and rectal (R) regions was 33.7±1.9; 31.4±3.6; 32.1±0.9; 28.9±4.5 and 38.3±0.8 oC respectively. A difference (p<0.05) was observed between the temperature of A and PO as well as between PO and N, but not between A and N. The present study allowed us to show an increase (p=0.0484) in the temperature mean PO ROI in G4 animals compared to G1 and a correlation with R temperature and peak temperature in the PO region in all groups. It is concluded that the increase in temperature of the periocular region and the nasal plane observed through infrared thermal imaging of the facial surface of hospitalized cats suggests the presence of clinically relevant acute pain. Facial thermography is a safe and non-invasive diagnostic method that complements other methods of identifying pain in cats.

Assessing the Analgesic Efficacy of Lumbosacral Epidural Morphine in Cats Undergoing Ovariohysterectomy: A Comparative Study of Two Doses.

Opioids are administered epidurally (PV) to provide trans- and postoperative analgesia. Twenty healthy female cats aged between 6 and 24 months and weighing between 2 and 3.7 kg, undergoing elective ovariohysterectomy (OVH), were induced with propofol (8 mg/kg), followed by continuous infusion (0.1-0.4 mg/kg/min). Three groups were defined: CG (0.1 mL/kg of iodinated contrast, n = 6), G0.1 (0.1 mg/kg of morphine, n = 7), and G0.2 (0.2 mg/kg of morphine, n = 7) per VP. All received 0.1 mL/kg of iodinated contrast per VP and injection water to obtain a total of 0.3 mL/kg. Heart rate (HR), systolic blood pressure (SBP), temperature, expired CO2, oxygen saturation, and number of rescue analgesics were monitored. Postoperatively, a multidimensional scale was used to assess acute pain in cats for 12 h. The mean HR and SBP in the CG were higher at the time of maximum noxious stimulation and required fentanyl in all groups. Postoperatively, 83%, 28%, and 7% of the animals in CG, G0.1, and G0.2, respectively, received rescue analgesia. In cats undergoing OVH, epidural morphine at doses of 0.1 and 0.2 mg/kg did not prevent the need for intraoperative rescue analgesia but reduced the postoperative analgesic needed.

First site-specific conjugation method for native goat IgG antibodies via glycan remodeling at the conserved Fc region.

Despite their triumph in treating human diseases, antibody therapies for animals have gained momentum more slowly. However, the first approvals of animal antibodies for osteoarthritic pain in cats and dogs may herald the dawn of a new era. For example, goats are vital to economies around the world for their milk, meat, and hide products. It is therefore imperative to develop therapies to safeguard goats-with antibodies at the forefront. Goat antibodies will be crucial in the development of therapeutic antibodies, for example, as tracers to study antibody distribution in vivo, reagents to develop other therapeutic antibodies, and therapeutic agents themselves (e.g., antibody-drug conjugates). Hamstringing this effort is a still-burgeoning understanding of goat antibodies and their derivatization. Historically, goat antibody conjugates were generated through stochastic chemical modifications, producing numerous attachment sites and modification ratios, thereby deleteriously impacting antigen binding. Site-specific methods exist but often require substantial engineering and have not been demonstrated with goat antibodies. Nevertheless, we present herein a novel method to site-specifically conjugate native goat antibodies: chemo-enzymatic remodeling of the native Fc N-glycan introduces a reactive azide handle, after which click chemistry with strained alkyne partners affords homogeneous conjugates labeled only on the Fc domain. This process is robust, and resulting conjugates retain their antigen binding and specificity. To our knowledge, our report is the first for site-specific conjugation of native goat antibodies. Furthermore, our approach should be applicable to other animal antibodies-even with limited structural information-with similar success.

Owner survey suggests cats may be undertreated for pain compared to dogs after an elective ovariohysterectomy or orchiectomy.

To investigate differences in pain management between dogs and cats after surgical sterilization. We hypothesized that dogs would be more likely to be discharged with analgesics after sterilization compared to cats and that owner compliance would be better in dogs. 175 respondents owning 92 dogs and 83 cats from a high-volume, low-cost veterinary clinic in Michigan during August 2022. Owners received an online survey designed to assess their pet's postoperative analgesic care. They were asked demographic information about themselves and their pets. Additionally, they were asked if their pet was discharged with analgesics, if they were administered as prescribed, and if their pet was painful at home. Dogs and cats were included if they were sterilized within 6 months of survey completion and in the owner's care at the time of the procedure. The survey was distributed to 5,241 owners and received 227 responses, a response rate of 4.4%. Analgesics were prescribed for 19 of 162 (12%) pets: 14 of 88 (16%) dogs and 5 of 74 (6.7%) cats. There was no difference in the prescription of analgesics between dogs and cats after ovariohysterectomy (P = .09) or orchiectomy (P = .73). 15 of 19 owners reported their compliance in administering analgesics at 78.9%. Owners' subjective assessments showed that 24 of 86 (28%) dogs and 12 of 68 (17%) cats appeared painful at home. Postoperative pain in cats may not be appropriately managed.

Neuropathic pain in cats: Mechanisms and multimodal management.

Chronic pain is a significant welfare concern in cats, and neuropathic pain, which arises from aberrant processing of sensory signals within the nervous system, is a subcategory of this type of pain. To comprehend this condition and how multimodal pharmacotherapy plays a central role in alleviating discomfort, it is crucial to delve into the anatomy of nociception and pain perception. In addition, there is an intricate interplay between emotional health and chronic pain in cats, and understanding and addressing the emotional factors that contribute to pain perception, and vice versa, is essential for comprehensive care.Clinical approach:Neuropathic pain is suspected if there is abnormal sensation in the area of the distribution of pain, together with a positive response to trial treatment with drugs effective for neuropathic pain. Ideally, this clinical suspicion would be supported by confirmation of a lesion at this neurolocalisation using diagnostic modalities such as MRI and neuroelectrophysiology. Alternatively, there may be a history of known trauma at that site. A variety of therapies, including analgesic, anti-inflammatory and adjuvant drugs, and neuromodulation (eg, TENS or acupuncture), can be employed to address different facets of pain pathways.Aim:This review article, aimed at primary care/ general practitioners, focuses on the identification and management of neuropathic pain in cats. Three case vignettes are included and a structured treatment algorithm is presented to guide veterinarians in tailoring interventions.Evidence base:The review draws on current literature, where available, along with the author's extensive experience and research.

Evaluation of the analgesic efficacy of grapiprant compared with robenacoxib in cats undergoing elective ovariohysterectomy in a prospective, randomized, masked, non-inferiority clinical trial.

The main objective of this study was to compare the postoperative analgesic effects of grapiprant with those of robenacoxib in cats undergoing ovariohysterectomy (OVH). In total, 37 female cats (age range 4 months-10 years, weighing ⩾2.5 kg) were enrolled in a prospective, randomized, masked, non-inferiority (NI) clinical trial. Cats received oral robenacoxib (1 mg/kg) or grapiprant (2 mg/kg) 2 h before OVH. Analgesia was assessed via the Feline Grimace Scale (FGS), the Glasgow Composite Measure Pain Scale-Feline (CMPS-F), von Frey monofilaments (vFFs) and pressure algometry (ALG) 2 h before treatment administration, at extubation, and 2, 4, 6, 8, 18 and 24 hours after extubation. Hydromorphone (<8 h postoperatively) or buprenorphine (>18 h postoperatively) were administered to cats with scores of ⩾5/20 on CMPS-F and/or ⩾4/10 on FGS. NI margins for CMPS-F and vFFs were set at 3 and -0.2, respectively. A mixed-effect ANOVA was used for FGS scores (P <0.05). Data are reported as mean ± SEM. The data from 33 cats were analyzed. The upper limit of the 95% confidence interval (CI) (0.35) was less than the NI margin of 3 for CMPS-F, and the lower limit of the 95% CI (0.055) was greater than the NI margin of -0.2 for vFFs, indicating NI of grapiprant. The FGS scores were greater than baseline at extubation for both treatments (1.65 ± 0.63; P = 0.001); however, there was no difference between treatments. There was no difference between treatments, nor treatment by time interaction, for vFFs (P <0.001). The CMPS-F scores for both treatments were higher at extubation but returned to baseline after 4 h (P <0.001). For ALG, there was no difference in treatment or treatment by time interaction. The robenacoxib group had lower pressure readings at extubation and 6 h compared with baseline. These results indicate that grapiprant was non-inferior to robenacoxib for mitigating postsurgical pain in cats after OVH performed via ventral celiotomy. The impact of grapiprant for analgesia in OVH via the flank is unknown.

Concurrent Validation of MI-CAT(V), a Clinical Metrology Instrument for Veterinarians Assessing Osteoarthritis Pain in Cats, through Testing for Firocoxib Analgesic Efficacy in a Prospective, Randomized, Controlled, and Blinded Study.

Veterinarians face the lack of a rapid, reliable, inexpensive, and treatment-sensitive metrological instrument reflecting feline osteoarthritis (OA) pain. The Montreal Instrument for Cat Arthritis Testing, for Use by Veterinarians (MI-CAT(V)) has been refined in 4 sub-sections, and we proposed its concurrent validation. Cats naturally affected by OA (n = 32) were randomly distributed into 4 groups of firocoxib analgesic (Gr. A: 0.40; B: 0.25; C: 0.15, and P: 0.00 mg/kg bodyweight). They were assessed during Baseline, Treatment, and Recovery periods using MI-CAT(V) and objective outcomes (effort path, stairs assay compliance, and actimetry). The MI-CAT(V) total score correlated to the effort path and actimetry (RhoS = -0.501 to -0.453; p < 0.001), also being sensitive to treatment responsiveness. The pooled treatment group improved its total, gait, and body posture scores during Treatment compared to the Baseline, Recovery, and placebo group (p < 0.05). The MI-CAT(V) suggested a dose-(especially for Gr. B) and cluster-response. Cats in the moderate and severe MI-CAT(V) clusters responded to firocoxib with a remaining analgesic effect, while the mild cluster seemed less responsive and experienced a negative rebound effect. The MI-CAT(V) was validated for its OA pain severity discriminatory abilities and sensitivity to firocoxib treatment, providing a new perspective for individualized care.

Efficacy of Preemptive Analgesia with Amantadine for Controlling Postoperative Pain in Cats Undergoing Ovariohysterectomy.

This study aimed to evaluate the effect of the preemptive administration of amantadine on postoperative analgesia in cats undergoing ovariohysterectomy and its influence on the physiological parameters. Twenty healthy domestic cats scheduled to undergo ovariohysterectomy at the Santa Cruz State University, Ilhéus, were divided into two groups: the control group (Group C; n = 10) and the amantadine group (Group A; n = 10). The cats in Group C received placebo capsules 30 min prior to the standard anesthetic protocol, whereas those in Group A received 5 mg/kg of amantadine orally 30 min prior to the standard anesthetic protocol. Postoperative pain was assessed using the visual analog scale and the UNESP-Botucatu multidimensional scale for the evaluation of postoperative pain in cats. The administration of amantadine had no effect on the physiological parameters evaluated. The pain scores in Group A were lower than those in Group C, indicating that the frequency of rescue analgesic administration cats in Group A was lower. That way, preemptive oral administration of amantadine at a dose of 5 mg/kg was effective at controlling postoperative pain in cats undergoing ovariohysterectomy. Moreover, no adverse effects or alterations in the physiological patterns were observed in the treated animals.

Evaluation of the analgesic efficacy of metamizole (dipyrone) compared with meloxicam in the treatment of postoperative pain in cats undergoing ovariohysterectomy

Con el objetivo de determinar la eficacia analgésica y las posibles alteraciones hematológicas y bioquímicas producidas durante el tratamiento del dolor posoperatorio con metamizol en felinos sometidos a ovariohisterectomía, se realizó un estudio en treinta gatas que fueron divididas aleatoriamente en 3 grupos: 1) (n=10) fue tratado con metamizol a dosis de 30 mg/kg IV cada 12 horas durante 3 días; 2) (n=10) fue tratado con metamizol a dosis de 20 mg/kg IV cada 12 horas durante 3 días; y 3) (n=10) fue tratado con meloxicam a dosis de 0,1 mg/kg IV cada 24 horas durante 3 días. Se tomaron muestras sanguíneas para hemoleucograma, alaninoaminotransferasa, creatinina, nitrógeno ureico sanguíneo, fosfatasa alcalina, albúmina, tiempo de protrombina y tiempo parcial de tromboplastina, al tiempo 0, 24 y 96 horas después de la primera aplicación del analgésico asignado. La valoración del dolor se realizó a las 6, 12, 24, 30, 36, 48, 54 y 60 horas, aplicando la versión en inglés de la escala de dolor compuesta multidimensional para evaluar el dolor posoperatorio en gatos UNESP-Botucatu. En relación con la evaluación del dolor, se encontraron diferencias significativas entre los grupos a las 12, 24, 30, 36, 54 y 60 horas, siendo menores los puntajes de dolor en los grupos tratados con metamizol con respecto al grupo tratado con meloxicam. El metamizol, administrado en dosis de 20 a 30 mg/kg IV cada 12 horas durante 3 días, provee una adecuada analgesia posoperatoria en gatas sometidas a ovariohisterectomía, comparado con el meloxicam. No se presentaron cambios hematológicos ni bioquímicos clínicamente significativos en la mayoría de pacientes tratados.

An ethogram of acute pain behaviors in cats based on expert consensus.

An improved understanding of behaviors reflecting acute pain in cats is a priority for feline welfare. The aim of this study was to create and validate a comprehensive ethogram of acute pain behaviors in cats that can discriminate painful versus non-painful individuals. An inventory of behaviors (ethogram) with their respective descriptors was created based on a literature review of PubMed, Web of Science and CAB Abstracts databases. The ethogram was divided into ten behavior categories that could be evaluated by duration and/or frequency: position in the cage, exploratory behaviors, activity, posture and body position, affective-emotional states, vocalization, playing (with an object), feeding, post-feeding and facial expressions/features. Thirty-six behaviors were analyzed independently by four veterinarians with postgraduate qualifications in feline medicine and/or behavior as (1) not relevant, (2) somewhat relevant, (3) quite relevant or (4) highly relevant and used for content (I-CVI) and face validity. Items with I-CVI scores > 0.67 were included. Twenty-four behaviors were included in the final ethogram. Thirteen items presented full agreement (i.e., I-CVI = 1): positioned in the back of the cage, no attention to surroundings, feigned sleep, grooming, attention to wound, crouched/hunched, abnormal gait, depressed, difficulty grasping food, head shaking, eye squinting, blepharospasm and lowered head position. Seven descriptors were reworded according to expert suggestions. The final ethogram provides a detailed description of acute pain behaviors in cats after content and face validity and can be applied to the characterization of different acute painful conditions in hospitalized cats.

Intraoperative and early postoperative pain in cats that underwent ovariohysterectomy using a spay hook: a randomised, masked, experimental study

BackgroundThis study aimed to compare the feasibility and practicality of the ovariohysterectomy (OHE) technique in cats with or without a spay hook with respect to the incision size, surgical time, surgical variables, and intra- and postoperative pain. Twenty-nine female cats underwent OHE using a spay hook (spay hook group [SHG], n = 15) or without using a spay hook (control group [CG], n = 14) to achieve the ovaries and cervix. Physiological parameters were monitored during the intraoperative period, and postoperative pain was assessed using a multidimensional composite and visual analogue pain scales.ResultsThe SHG had a significantly shorter operative time than the CG. The variables in the intraoperative period showed no statistically significant difference between both groups, as well as the early postoperative pain.ConclusionsLess invasive OHE using a spay hook could potentially be a viable and feasible technique when performed by an inexperienced surgeon with appropriate training, especially in sterilisation campaigns, reducing the time to perform the procedure and increasing the number of animals spayed per time.

Robenacoxib versus meloxicam following ovariohysterectomy in cats: A randomised, prospective clinical trial involving owner-based assessment of pain.

Injectable non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed to queens undergoing ovariohysterectomy (OVH), but the requirement for postoperative administration is unclear and practices vary. Existing studies assessing efficacy rely on pain scoring by experienced clinicians. However, following OVH, most cats are discharged within hours of recovery. Cats undergoing OVH were randomly assigned to two treatment groups: MEL and ROB. Cats in the MEL group (n = 76) received meloxicam (0.2mg/kg) and those in the ROB group (n = 65) received robenacoxib (2mg/kg). Owners were contacted by a blinded assessor 3 days postoperatively and asked to identify physical or behavioural changes and to assign pain scores using a numerical rating scale. More cats in theROB group displayed abnormal behaviours than cats in the MEL group (p = 0.03). Most owners assigned a pain score of 0 (72%) (n = 101), but pain scores were significantly higher in the ROB group than in the MEL group (p = 0.005). Methods of owner assessment of pain in cats have not been validated. Both meloxicam and robenacoxib are effective in controlling postoperative pain. Meloxicam may have improved efficacy in certain patient populations. Applying a blanket approach to prescribing NSAIDs to cats undergoing OVH postoperatively may not be necessary. This has safety, environmental and cost implications.

Comparison between the effects of epidural lidocaine, tramadol, and lidocaine–tramadol on postoperative pain in cats undergoing elective orchiectomy

BackgroundIn veterinary clinical practice, orchiectomy is one of the most common surgical procedures for cats and is performed mainly in young animals. The purpose of this study was to compare three different epidural (EP) analgesic protocols used in cats undergoing orchiectomy in order to determine which protocol resulted in superior outcomes in terms of perioperative analgesia. Twenty-one client-owned male cats were premedicated with a combination of dexmedetomidine (10 µg/kg) and midazolam (0.2 mg/kg) injected intramuscularly. Anesthesia was induced intravenously with propofol. Cats were randomly divided in three treatment groups of seven animals each: Group L received EP lidocaine (2 mg/kg), Group T received EP tramadol (1 mg/kg), and Group LT received EP lidocaine (2 mg/kg) plus tramadol (1 mg/kg). The post-operative pain level was assessed using two different scales: the Glasgow Composite Measure Pain Scale-Feline (CMPS-F) and the Feline Grimace Scale (FGS). Rescue analgesia was administered when the CMPS-F total score was ≥5 or the FGS total score was ≥4.ResultsNo adverse effects related to tramadol or lidocaine were observed. Based on post-operative pain assessments, significant differences between groups were observed according to both pain scoring systems. In particular, in Group LT, the CMPS-F and FGS scores decreased significantly in the first six hours following castration.ConclusionsBased on our results, EP lidocaine plus tramadol provided the best post-operative analgesic effects in cats submitted to orchiectomy lasting 6 h and could also be a choice to consider for longer surgical procedures.

ACUTE PAIN MANAGEMENT IN CATS: ASSURANCE OF FELINE WELFARE FULFILLMENT WITHIN CLINICAL SETTING

Assessing, acknowledging, and managing pain in feline patients are often challenging. Failure to recognize and protect the cats from the harmful effects of nociception, therefore, often ensues. Feline patients that are afflicted with illness and tissue trauma that may arise from trauma or surgery have acute pain that needs to be addressed. Acute pain can present with varying degrees of intensity, a parameter of sensory-discriminatory aspect, and unpleasantness, a perceived feeling that is integral to affective aspect. Notwithstanding its usefulness to protect the tissue from further damage, acute pain is detrimental to the feline’s welfare, comprising physical and mental wellness if not managed properly. Uncontrolled pain has also been associated with increased morbidity, prolonged hospitalization period due to delayed recovery, increased health-care cost, and decreased quality of life. This review article is made with the aim to elucidate how acute pain in cats is recognized, prevented, and treated, both pharmacologically and non-pharmacologically.

Métodos utilizados para avaliação da eficácia analgésica de opioides e anti-inflamatórios não-esteroidais em gatos

Ineffective pain treatment causes complicated situations, such as poor recovery and chronic pain in the patient. The recognition of feline pain is a great challenge, requiring training and scoring systems to assess pain in cats. Pain classification methods were created with the aim of helping professionals. The aim of this review was to verify which pain assessment and antinociception methods were used to assess the analgesic efficacy of opioids and non-steroidal anti-inflammatory drugs in cats with acute pain. The most used pain assessment method was thermal stimulation. Most studies found showed the analgesic efficacy of drugs.

Incidence of perioperative hypothermia in a high-quality high-volume spay/neuter setting and association with environmental temperature

Introduction: Perioperative inadvertent hypothermia (PIH) can prolong anesthetic recovery times. Study goals included determining PIH incidence (rectal temperature&lt;36°C (96.8°F)) in the high-quality high-volume spay/neuter (HQHVSN) setting and evaluating associations between environmental temperature and PIH incidence. Secondary objectives included evaluating associations between PIH incidence, anesthesia recovery times, and postoperative pain. Methods: Prospective observational cohort study conducted at five HQHVSN shelters enrolling dogs undergoing ovariohysterectomy or castration and cats undergoing ovariohysterectomy. Blankets and electric heating pads were only used routinely in the immediate postoperative period. Regression models were used to evaluate associations between PIH incidence, environmental temperature, and pain data. Results: One hundred and forty dogs undergoing 65 castrations and 75 ovariohysterectomies, and 161 cats were enrolled. Mean surgical times were 19.6 (8.0) min (canine ovariohysterectomies), 7.2 (3.0) min (canine castrations), and 10.6 (3.6) min (feline ovariohysterectomies). PIH incidence was 22% (95% CI = 17–27). The risk of developing PIH was associated with environmental temperature, with a 22% increase in the odds of experiencing PIH for each degree centigrade decrease in environmental temperature (OR = 1.22, 95% CI = 1.03–1.44, P = 0.02) over a recorded range of 15.6–26.1°C (60.1–79.0°F). In cats, PIH was associated with a prolongation of time to extubation by 3.8 min (95% CI 2.27–5.37, P = 0.01). On average, each degree centigrade reduction in rectal temperature at extubation was associated with an increase in pain scale of 0.51 units (95% CI = 0.06–0.97, P = 0.03) for both species. In dogs, each degree centigrade reduction in rectal temperature at extubation was associated with a reduction in mechanical threshold (indicating increased sensitivity to pain) of 1.40 N (95% CI = 0.44–2.35, P = 0.004). Conclusion: PIH is common in a spay/neuter population despite rapid surgical times and is associated with prolonged anesthetic recovery in cats and increased postoperative pain in cats and dogs. Raising the environmental temperature in operative and recovery areas may reduce incidence.

In cats undergoing midline ovariohysterectomy, is the use of local anaesthesia with bupivacaine associated with a reduction in postoperative pain score?

PICO question In cats undergoing midline ovariohysterectomy, is the use of local anaesthesia with bupivacaine via intraperitoneal or subcutaneous injections, in comparison with the use of a control substance or other analgesic measure, associated with a reduction in postoperative pain score? Clinical bottom line The category of research question: Treatment. The number and type of study designs that were critically appraised: Three studies were critically appraised in this Knowledge Summary. They included two prospective, blinded, randomised, controlled clinical trials and one prospective randomised, blinded clinical trial. Strength of evidence: Weak. The outcomes reported: Bupivacaine does not eliminate postoperative pain in cats undergoing ovariohysterectomies; minimal evidence was found to suggest that it was better at reducing postoperative pain scores in comparison to other analgesics. However, bupivacaine may provide analgesic benefits to cats when administered via intraperitoneal or subcutaneous injections as local anaesthesia and in combination with other analgesic agents. The need for postoperative rescue analgesia was minimised when bupivacaine was administered prior to or during the ovariohysterectomy. Conclusion: When compared to a control, pain scores for the participating cats were lower after administration of bupivacaine, however, statistical significance was only reached in one of the studies. Additionally, other medications were found to lower the post operative pain score to a greater effect. However, bupivacaine administration is cheap and simple to perform, so it’s use as part of a multimodal analgesic protocol is supported. Confounding factors within the studies may have altered the perceived effectiveness of the analgesic properties of bupivacaine though, so further investigation involving larger cohorts with standardised controls would be prudent. How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.