Dog Owner Dashboard

Pain Management

Cannabinoids as Pharmacotherapies for Neuropathic Pain: From the Bench to the Bedside.

Summary:

A review of studies evaluating cannabinoids for neuropathic pain management in the clinical and preclinical literature.

Conclusion:

“The present review suggests that cannabinoids show promise for treatment of neuropathic pain in humans either alone or as an add-on to other therapeutic agents. Further evaluation of safety profiles associated with long term effects of cannabinoids are, therefore, warranted.”

Author & Journal:Rahn, EJ, et al, Neurotherapeutics, 2009
Learn More

Opioids Out, Cannabis In Negotiating the Unknowns in Patient Care for Chronic Pain

Summary:

“Unless the nation develops an increased tolerance to chronic pain, reduction in opioid prescribing leaves a vacuum that will be filled with other therapies.” Consideration for the pharmacological, social and legal role of cannabis as an alternative for prescribing opioids.

Conclusion:

The prescribing of opioid therapy for chronic noncancer pain advanced unchecked until opioid-related adverse events and other consequences reached epic proportions. To ensure the medical community does not repeat this mistake with cannabis, physicians should balance the need to keep pace with the swiftly evolving cultural, social, and legal climate surrounding cannabis use for pain with the imperative to guide practice with sound science.

Author & Journal:Choo, Esther K. et al, JAMA, 2016
Learn More

2015 AAHA/AAFP Pain Management Guidelines for Dogs and Cats

Summary:

The included pain management “guidelines continue the trend in all branches of medicine toward evidence-based consensus statements that address key issues in clinical practice. Although not a review article, this compilation is a force multiplier for the busy practitioner, consolidating in a single place current recommendations and insights from experts in pain management.”

Conclusion:

“Behavioral changes are the principal indicator of pain and its resolution, for which there are now several validated, clinical scoring instruments. Pain is not an isolated event but instead exists either as a continuum of causation, progression, and resolution or as a chronic condition. Thus treatment of pain should consist of a continuum of care in the form of anticipatory analgesia through the anticipated pain period followed by longer-term or even chronic treatment that relies on periodic reassessment of the patient’s response.”

Author & Journal:Epstein, Mark et al, Journal of the American Animal Hospital Association, 2016
Learn More

Inhibition of cyclooxygenase-2 expression and prostaglandin E2 production in chondrocytes by avocado soybean unsaponifiables and epigallocatechin gallate

Summary:

“To evaluate the anti-inflammatory effect of the combination of avocado soybean unsaponifiables (ASU) and epigallocatechin gal- late (EGCG) on cyclooxygenase-2 (COX-2) expression and prostaglandin E2 (PGE2) production in cytokine-activated equine chondrocytes.”

Conclusion:

“The present study demonstrates that the anti-inflammatory activity of ASU and EGCG is potentiated when used in combination. This combination may offer an attractive supplement or alternative to non-steroidal anti-inflammatory drugs (NSAIDs) in the management of osteoarthritis.”

Author & Journal:Heineckey, L.F., et al, Osteoarthritis and Cartilage, 2010
Learn More

Outpatient Oral Analgesics in Dogs and Cats Beyond Nonsteroidal Anti-inflammatory Drugs

Summary:

This article evaluates the current literature on oral analgesics and analgesic adjuncts in dogs and cats. An overview of how dosing recommendations are made covering controlled clinical trials, experimental study design, and pharmacokinetic studies is included.

Conclusion:

The weight of evidence for each drug [Polysulfated glycosaminoglycans, Amantadine, Tramadol, Gabapentin, Pregabalin, Codeine, Hydrocodone, Amitriptyline, Venlafaxine, Duloxetine, Glucosamine and chondroitin, Morphine, Oxycodone, Methadone] is reviewed and compared with the gold standard, controlled clinical trials. Other evidence such as experimental studies, extrapolation of pharmacokinetic studies, and case reports/series is also considered.

Author & Journal:KuKanich, Butch, Veterinary Clinics of North America: Small Animal Practice, 2013
Learn More

Amantadine in a Multimodal Analgesic Regimen for Alleviation of Refractory Osteoarthritis Pain in Dogs

Summary:

“Nonsteroidal anti-inflammatory drugs (NSAIDs) do not always provide sufficient pain relief in dogs with osteoarthritis (OA). Hypothesis: The use of amantadine in addition to NSAID therapy will provide improved pain relief when compared with the use of nonsteroidal analgesics alone in naturally occurring OA in dogs.”

Conclusion:

“In dogs with osteoarthritic pain refractory to an NSAID, physical activity is improved by the addition of amantadine. Amantadine might be a useful adjunct therapy for the clinical management of canine osteoarthritic pain.”

Author & Journal:Lascelles, B.D. et al, Journal of Veterinary Internal Medicine, 2008
Learn More

Assessing Chronic Pain In Dogs

Summary:

“Finding precise, reliable, and accurate measures of chronic pain in animals is a difficult effort. However, much research has gone into developing measurement methods to evaluate chronic pain in dogs (and, more recently, cats); this article reviews the pain scales currently available.”

Conclusion:

Details in linked article reviews the following pain scales: Helsinki Chronic Pain Index, Canine Brief Pain Index, Cincinnati Orthopedic Disability Index, Liverpool Osteoarthritis in Dogs.

Author & Journal:Epstein, Mark E., Today’s Veterinary Practice, 2013
Learn More

Pharmacokinetics, Safety, and Clinical Efficacy of Cannabidiol Treatment in Osteoarthritic Dogs

Summary:

“The objectives of this study were to determine basic oral pharmacokinetics, and assess safety and analgesic efficacy of a cannabidiol (CBD) based oil in dogs with osteoarthritis (OA).”

Conclusion:

“Pharmacokinetics revealed an elimination half-life of 4.2 h at both doses and no observable side effects. Clinically, canine brief pain inventory and Hudson activity scores showed a significant decrease in pain and increase in activity (p < 0.01) with CBD oil. Veterinary assessment showed decreased pain during CBD treatment (p < 0.02). No side effects were reported by owners, however, serum chemistry showed an increase in alkaline phosphatase during CBD treatment (p < 0.01).”

Author & Journal:Gamble, Lauri-Jo et al, Frontiers in Veterinary Science, 2018
Learn More