References

Abbass K. Efficacy of gabapentin for treatment of adults with phantom limb pain. Ann Pharmacother. 2012; 46:(12)1707-11 https://doi.org/10.1345/aph.1Q793

Achterberg WP, Erdal A, Husebo BS, Kunz M, Lautenbacher S. Are chronic pain patients with dementia being undermedicated?. J Pain Res. 2021; 14:431-439 https://doi.org/10.2147/JPR.S239321

Anderson BJ. Paracetamol (acetaminophen): mechanisms of action. Paediatr Anaesth. 2018; 18:915-921 https://doi.org/10.1111/j.1460-9592.2008.02764.x

Ballantyne JC, Mao J. Opioid therapy for chronic pain. New Engl Med J. 2013; 349:1943-1953 https://doi.org/10.1056/NEJMra025411

Benito J, DePuy V, Hardie E Reliability and discriminatory testing of a client-based metrology instrument, feline musculoskeletal pain index (FMPI) for the evaluation of degenerative joint disease-associated pain in cats. The Vet J. 2013; 196:(3)368-373 https://doi.org/10.1016/j.tvjl.2012.12.015

Bennett D, Morton C. A study of owner observed behavioural and lifestyle changes in cats with musculoskeletal disease before and after analgesic therapy. J Feline Med Surg. 2009; 11:(12)997-1004 https://doi.org/10.1016/j.jfms.2009.09.016

Bimonte S, Cascella M, Forte CA, Esposito G, Cuomo A. The role of anti-nerve growth factor monoclonal antibodies in the control of chronic cancer and non-cancer pain. J Pain Res. 2021; 14:1959-1967 https://doi.org/10.2147/JPR.S302004

Boesch JM, Roinestad KE, Lopez DJ The Canine Postamputation Pain (CAMPPAIN) initiative: a retrospective study and development of a diagnostic scale. Vet Anaesth Analg. 2021; 48:(6)861-870 https://doi.org/10.1016/j.vaa.2021.07.003

Bone M, Critchley P, Buggy DJ. Gabapentin in postamputation phantom limb pain: a randomized, double-blind, placebo-controlled, cross-over study. Reg Anesth Pain Med. 2002; (5)481-6 https://doi.org/10.1053/rapm.2002.35169

Brondani JT, Mama KR, Luna SPL Validation of the English version of the UNESP-Botucatu multidimensional composite pain scale for assessing postoperative pain in cats. BMC Veterinary Res. 2013; 9 https://doi.org/10.1186/1746-6148-9-143

Brown DC, Boston RC, Coyne JC, Farrar JT. Development and psychometric testing of an instrument designed to measure chronic pain in dogs with osteoarthritis. Am J Vet Res. 2007; 6:(68)637-63 https://doi.org/10.2460/ajvr.68.6.631

Budke CM, Levine JM, Kerwin SC Evaluation of a questionnaire for obtaining owner-perceived, weighted quality-of-life assessments for dogs with spinal cord injuries. Journal of the American Veterinary Medical Association. 2008; 233:(6)925-930 https://doi.org/10.2460/javma.233.6.925

Burma NE, Leduc-Pessah H, Fan CY, Trang T. Animal models of chronic pain: Advances and challenges for clinical translation. J Neurosci Res. 2017; 95:1242-1256 https://doi.org/10.1002/jnr.23768

Corrêa JMX, Soares PCLR Evaluation of the Antinociceptive Effect of Maropitant, a Neurokinin-1 Receptor Antagonist, in Cats Undergoing Ovariohysterectomy. Vet Med Int. 2019; 2019 https://doi.org/10.1155/2019/9352528

Cruz FF, Rocco PR, Pelosi P. Anti-inflammatory properties of anesthetic agents. Crit Care. 2017; 21:(1) https://doi.org/10.1186/s13054-017-1645-x

Dahl JB, Kehlet H. Preventive analgesia. Curr Opin Anaesthesiol. 2011; 24:(3)331-338 https://doi.org/10.1097/ACO.0b013e328345afd9

Davis KN, Hellyer PW, Carr ECJ, Wallace JE, Kogan LR. Qualitative study of owner perceptions of chronic pain in their dogs. J Am Vet Med Assoc. 2019; 254:(1)88-92 https://doi.org/10.2460/javma.254.1.88

Enomoto M, Mantyh PW, Murrell J Anti-nerve growth factor monoclonal antibodies for the control of pain in dogs and cats. Vet Rec. 2018; (1) https://doi.org/10.1136/vr.104590

Fitzcharles MA, Cohen SP, Clauw DJ Nociplastic pain: towards an understanding of prevalent pain conditions. Lancet. 2021; 397:2098-110 https://doi.org/10.1016/s1474-4422(02)00074-1

Flor H. Phantom-limb pain: characteristics, causes, and treatment. The Lancet Neurol. 2002; 1:(3)182-189 https://doi.org/10.1016/s1474-4422(02)00074-1

Galvin DA, McCrory C. The role of T-lymphocytes in neuropathic pain initiation, development of chronicity and treatment. Brain Behav Immun Health. 2021; 18 https://doi.org/10.1016/j.bbih.2021.100371

Giorgi M, Owen H. Mirtazapine in veterinary medicine a pharmacological rationale for its application in chronic pain. Am J Anim Vet Sci. 2012; 7:42-47 https://doi.org/10.3844/ajavsp.2012.42.47

Gunaydın C, Bilge SS. Effects of nonsteroidal anti-inflammatory drugs at the molecular level. Eurasian J Med. 2018; 50:116-21 https://doi.org/10.5152/eurasianjmed.2018.0010

Gwilym SE, Pollard TCB, Carr AJ. Understanding pain in osteoarthritis. J Bone Joint Surg Br. 2008; 90:(3)280-287 https://doi.org/10.1302/0301-620X.90B3.20167

Holton L, Pawson P, Nolan A Development of a behaviour-based scale to measure acute pain in dogs. Vet Rec. 2001; 148:(17)525-531 https://doi.org/10.1136/vr.148.17.525

Ito S, Suto T, Saito S Repeated administration of duloxetine suppresses neuropathic pain by accumulating effects of noradrenaline in the spinal cord. Anesth Analg. 2018; 126:(1)298-307 https://doi.org/10.1213/ANE.0000000000002380

Kosek E, Cohen M, Baron R Do we need a third mechanistic descriptor for chronic pain states?. Pain. 2016; 157:(7)1382-1386 https://doi.org/10.1097/j.pain.0000000000000507

Kuffler DP. Origins of phantom limb pain. Mol Neurobiol. 2018; 55:(1)60-69 https://doi.org/10.1007/s12035-017-0717-x

Kukanich B, Cohen RL. Pharmacokinetics of oral gabapentin in greyhound dogs. The Vet J. 2011; 187:(1)133-5 https://doi.org/10.1016/j.tvjl.2009.09.022

Levine JM, Budke CM, Levine GJ Owner-perceived, weighted quality-of-life assessments in dogs with spinal cord injuries. J Am Vet Med Assoc. 2008; 233:(6)931-5 https://doi.org/10.2460/javma.233.6.931

Li XH, Miao HH, Zhuo M. NMDA Receptor dependent long-term potentiation in chronic pain. Neurochem Res. 2019; 44:531-538 https://doi.org/10.1007/s11064-018-2614-8

Luna SP, Basílio AC, Steagall PV, Machado LP Evaluation of adverse effects of long-term oral administration of carprofen, etodolac, flunixin meglumine, ketoprofen, and meloxicam in dogs. Am J Vet Res. 2007; 68:(3)258-264 https://doi.org/10.2460/ajvr.68.3.258

MacFarlane PD, Tute AS, Alderson B. Therapeutic options for the treatment of chronic pain in dogs. J Small Anim Pract. 2014; 55:(3)127-134 https://doi.org/10.1111/jsap.12176

Maxwell SR. Rational prescribing: the principles of drug selection. Clinical Medicine (London). 2016; 16:(5)459-464 https://doi.org/10.7861/clinmedicine.16-5-459

McCleane GJ, Suzuki R, Dickenson AH. Does a single intravenous injection of the 5HT3 receptor antagonist ondansetron have an analgesic effect in neuropathic pain? A double-blinded, placebo-controlled cross-over study. Anesth Analg. 2003; 97:(5)1474-1478 https://doi.org/10.1213/01.ANE.0000085640.69855.51

Menchetti M, Gandini G, Gallucci A Approaching phantom complex after limb amputation in the canine species. J Vet Behav. 2017; 22:24-28 https://doi.org/10.1016/j.jveb.2017.09.010

Noble CE, Wiseman-Orr LM, Scott ME Development, initial validation and reliability testing of a web-based, generic feline health-related quality-of-life instrument. J Feline Med Surg. 2019; 21:(2)84-94 https://doi.org/10.1177/1098612X18758176

Patetsos E, Horjales-Araujo E. Treating chronic pain with SSRIs: what do we know?. Pain Res Manag. 2016; https://doi.org/10.1155/2016/2020915

Pertovaara A, Kauppila T, Jyväsjärvi E Involvement of supraspinal and spinal segmental alpha-2-adrenergic mechanisms in the medetomidine-induced antinociception. Neurosci. 1991; 44:705-714 https://doi.org/10.1016/0306-4522(91)90089-7

Reddi D. Preventing chronic postoperative pain. Anaesth. 2015; 71:64-71 https://doi.org/10.1111/anae.13306

Reid J, Nolan A, Hughes J Development of the short-form Glasgow Composite Measure Pain Scale (CMPS-SF) and derivation of an analgesic intervention score. Anim Welf. 2007; 8:97-104

Reid M, Eccleston C, Pellimer K. Management of Chronic Pain in Older Adults. BMJ. 2015; 350:532-42 https://doi.org/10.1136/bmj.h532

Reid J, Scott EM, Calvo G Definitive Glasgow acute pain scale for cats: validation and intervention level. Vet Rec. 2017; 180:449-449 https://doi.org/10.1136/vr.104208

Reid J, Wiseman-Orr L, Scott M. Shortening of an existing generic online health-related quality of life instrument for dogs. J Small Anim Pract. 2018a; 59:(6)334-342 https://doi.org/10.1111/jsap.12772

Reid J, Nolan AM, Scott EM. Measuring pain in dogs and cats using structured behavioural observation. The Vet J. 2018b; 236:72-79 https://doi.org/10.1016/j.tvjl.2018.04.013

Rose MA, Kam PCA. Gabapentin: pharmacology and its use in pain management. Anaesthesia. 2002; 57:451-462 https://doi.org/10.1046/j.0003-2409.2001.02399.x

Suzuki R, Morcuende S, Webber M Superficial NK1-expressing neurons control spinal excitability through activation of descending pathways. Nature Neuroscience. 2002; 5:1319-1326 https://doi.org/10.1038/nn966

Takeda M, Takahashi M, Matsumoto S. Suppression of neurokinin-1 receptor in trigeminal ganglia attenuates central sensitization following inflammation. J Peripher Nerv Syst. 2012; 17:169-181 https://doi.org/10.1111/j.1529-8027.2012.00404.x

Taylor McLeod G. Basic pharmacology of local anaesthetics. BJA Education. 2020; 20:(2)34-41 https://doi.org/10.1016/j.bjae.2019.10.002

Treede RD, Rief W, Barke A Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain. 2019; 160:(1)19-27 https://doi.org/10.1097/j.pain.0000000000001384

The British Pain Society. Useful definitions and glossary. 2023. https://www.british-painsociety.org/people-with-pain/useful-definitions-and-glossary/#top (accessed 24 January 2023)

Tracey WD. Nociception. Curr Biol. 2017; 27:(4)129-133 https://doi.org/10.1016/j.cub.2017.01.037

Veterinary Medicines Directorate. The cascade: prescribing unauthorised medicines. 2015. https://www.gov.uk/guidance/the-cascade-prescribing-unauthorised-medicines (accessed 24 January 2023)

Voscopoulos C, Lema M. When does acute pain become chronic?. Brit J Anaesth. 2010; 105:(1)69-85 https://doi.org/10.1093/bja/aeq323

Wagner AE, Mich PM, Uhrig SR, Hellyer PW. Clinical evaluation of perioperative administration of gabapentin as an adjunct for postoperative analgesia in dogs undergoing amputation of a forelimb. J Am Vet Med Assoc. 2010; 236:(7)751-6 https://doi.org/10.2460/javma.236.7.751

Wiseman-Orr ML, Nolan AM Development of a questionnaire to measure the effects of chronic pain on health-related quality of life in dogs. Am J Vet Res. 2004; 65:(8)1077-1084 https://doi.org/10.2460/ajvr.2004.65.1077

Wagner AE, Walton JA, Hellyer PW, Gaynor JS, Mama KR. Use of low doses of ketamine administered by constant rate infusion as an adjunct for postoperative analgesia in dogs. J Am Vet Med Assoc. 2002; 221:(1)72-75 https://doi.org/10.2460/javma.2002.221.72

Zamprogno H, Hansen BD, Bondell HD Item generation and design testing of a questionnaire to assess degenerative joint disease–associated pain in cats. AmJ Vet Res. 2010; 71:(12)1417-1424 https://doi.org/10.2460/ajvr.71.12.1417

Acute and chronic pain in dogs and cats

02 January 2023
12 mins read
Volume 28 · Issue 3
Figure 2. The pain pathway, demonstrating the activation, transduction and modulation of signalling via the pain pathway at different levels and the perception of pain by higher centres. Descending inhibitory control is blue, descending facilitatory control is red. DRG = dorsal root ganglia.
Figure 2. The pain pathway, demonstrating the activation, transduction and modulation of signalling via the pain pathway at different levels and the perception of pain by higher centres. Descending inhibitory control is blue, descending facilitatory control is red. DRG = dorsal root ganglia.

Abstract

Pain is a common condition of dogs and cats that is managed by veterinary surgeons with variable degrees of success. The complex pathophysiology of different types of pain is a significant reason why they can be challenging to manage. It is important to consider the goals and outcomes of any intervention(s) for both acute and chronic pain, but the cornerstone of the management of both is regular objective assessment with a validated scoring system. The feasibility of any interventions should also be considered with both the owner and animal in mind. Consideration of relevant legislation must be made when prescribing pharmacological therapies. Effectively managing acute pain may reduce the incidence of chronic pain in dogs and cats.

Some pain in animals can be straightforward to recognise and classic behaviours are displayed, such as aversion to touch and vocalisation (Reid et al, 2007). Other types of pain are significantly more challenging to recognise and may only produce behavioural signs such as lethargy or restlessness. Owing to a lack of verbal communication with animals, successful management of their pain depends on our ability to recognise it. This article provides an overview of the pathophysiology of the different types of pain, with a focus on the development and management of chronic pain.

Pain is an emotive and sensory experience secondary to nociceptive or potentially nociceptive stimuli. It can be categorised as acute pain, lasting less than 12 weeks, or chronic pain which exceeds 12 weeks duration, as defined by The British Pain Society (2023) and the International Association for the Study of Pain Classification of Chronic Pain for the International Classification of Diseases 11 Coding (Treede et al, 2019). The transition from acute to chronic pain involves many complex changes (Voscopoulos and Lema, 2010) and there is little evidence in animals that strict timescales are observed. Furthermore, since animals are unable to ‘self-report’ it becomes more difficult to detect a point of transition to chronic pain, especially where pain is ‘waxing and waning’ in nature. Therefore, a more helpful definition may be that chronic pain persists beyond the expected time of healing, and may or may not be associated with an identifiable cause or actual tissue damage (Reid et al, 2015). This ‘persisting pain’ features in osteoarthritis and neoplasia, where there are ongoing features of both acute and chronic pain (Gwilym et al, 2008; Reddi, 2015).

Register now to continue reading

Thank you for visiting UK-VET Companion Animal and reading some of our peer-reviewed content for veterinary professionals. To continue reading this article, please register today.