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Miranda-Cortés A, Mota-Rojas D, Crosignani-Outeda N, Casas-Alvarado A, Martínez-Burnes J, Olmos-Hernández A, Mora-Medina P, Verduzco-Mendoza A, Hernández-Ávalos I. The role of cannabinoids in pain modulation in companion animals. Front Vet Sci 2023; 9:1050884. [PMID: 36686189 PMCID: PMC9848446 DOI: 10.3389/fvets.2022.1050884] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/13/2022] [Indexed: 01/05/2023] Open
Abstract
The use of cannabinoids in both veterinary and human medicine is controversial for legal and ethical reasons. Nonetheless, the availability and therapeutic use of naturally occurring or synthetic phytocannabinoids, such as Δ9-tetrahydrocannabidiol and cannabidiol, have been the focus of attention in studies regarding their medical uses. This review aims to examine the role of cannabinoids in pain modulation by analyzing scientific findings regarding the signaling pathways of the endocannabinoid system and discussing the analgesic effects of synthetic cannabinoids compared to cannabinoid extracts and the extent and involvement of their receptors. In animals, studies have shown the analgesic properties of these substances and the role of the cannabinoid binding -1 (CB1) and cannabinoid binding -2 (CB2) receptors in the endocannabinoid system to modulate acute, chronic and neuropathic pain. This system consists of three main components: endogenous ligands (anandamide and 2-arachidonoylglycerol), G protein-coupled receptors and enzymes that degrade and recycle the ligands. Evidence suggests that their interaction with CB1 receptors inhibits signaling in pain pathways and causes psychoactive effects. On the other hand, CB2 receptors are associated with anti-inflammatory and analgesic reactions and effects on the immune system. Cannabis extracts and their synthetic derivatives are an effective therapeutic tool that contributes to compassionate pain care and participates in its multimodal management. However, the endocannabinoid system interacts with different endogenous ligands and neurotransmitters, thus offering other therapeutic possibilities in dogs and cats, such is the case of those patients who suffer from seizures or epilepsy, contact and atopic dermatitis, degenerative myelopathies, asthma, diabetes and glaucoma, among other inflammatory diseases. Moreover, these compounds have been shown to possess antineoplastic, appetite-stimulating, and antiemetic properties. Ultimately, the study of the endocannabinoid system, its ligands, receptors, mechanism of action, and signaling, has contributed to the development of research that shows that hemp-derived and their synthetic derivatives are an effective therapeutic alternative in the multimodal management of pain in dogs and cats due to their ability to prevent peripheral and central sensitization.
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Affiliation(s)
- Agatha Miranda-Cortés
- Department of Biological Science, Clinical Pharmacology and Veterinary Anesthesia, Universidad Nacional Autónoma de México (UNAM), FESC, Mexico City, Mexico
| | - Daniel Mota-Rojas
- Neurophysiology of Pain, Behavior and Assessment of Welfare in Domestic Animals, DPAA, Universidad Autónoma Metropolitana, (UAM), Mexico City, Mexico,*Correspondence: Daniel Mota-Rojas ✉
| | - Nadia Crosignani-Outeda
- Department of Clinics and Veterinary Hospital, School of Veterinary, University of Republic, Montevideo, Uruguay
| | - Alejandro Casas-Alvarado
- Neurophysiology of Pain, Behavior and Assessment of Welfare in Domestic Animals, DPAA, Universidad Autónoma Metropolitana, (UAM), Mexico City, Mexico
| | - Julio Martínez-Burnes
- Animal Health Group, Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma de Tamaulipas, Ciudad Victoria, Tamaulipas, Mexico
| | - Adriana Olmos-Hernández
- Department Bioterio and Experimental Surgery, Instituto Nacional de Rehabilitación-Luis Guillermo Ibarra Ibarra (INR-LGII), Calzada México Xochimilco, Mexico City, Mexico
| | - Patricia Mora-Medina
- Livestock Science Department, Universidad Nacional Autónoma de México (UNAM), FESC, Mexico City, Mexico
| | - Antonio Verduzco-Mendoza
- Department Bioterio and Experimental Surgery, Instituto Nacional de Rehabilitación-Luis Guillermo Ibarra Ibarra (INR-LGII), Calzada México Xochimilco, Mexico City, Mexico
| | - Ismael Hernández-Ávalos
- Department of Biological Science, Clinical Pharmacology and Veterinary Anesthesia, Universidad Nacional Autónoma de México (UNAM), FESC, Mexico City, Mexico,Ismael Hernández-Ávalos ✉
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Devinsky O, Boesch JM, Cerda-Gonzalez S, Coffey B, Davis K, Friedman D, Hainline B, Houpt K, Lieberman D, Perry P, Prüss H, Samuels MA, Small GW, Volk H, Summerfield A, Vite C, Wisniewski T, Natterson-Horowitz B. A cross-species approach to disorders affecting brain and behaviour. Nat Rev Neurol 2019; 14:677-686. [PMID: 30287906 DOI: 10.1038/s41582-018-0074-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Structural and functional elements of biological systems are highly conserved across vertebrates. Many neurological and psychiatric conditions affect both humans and animals. A cross-species approach to the study of brain and behaviour can advance our understanding of human disorders via the identification of unrecognized natural models of spontaneous disorders, thus revealing novel factors that increase vulnerability or resilience, and via the assessment of potential therapies. Moreover, diagnostic and therapeutic advances in human neurology and psychiatry can often be adapted for veterinary patients. However, clinical and research collaborations between physicians and veterinarians remain limited, leaving this wealth of comparative information largely untapped. Here, we review pain, cognitive decline syndromes, epilepsy, anxiety and compulsions, autoimmune and infectious encephalitides and mismatch disorders across a range of animal species, looking for novel insights with translational potential. This comparative perspective can help generate novel hypotheses, expand and improve clinical trials and identify natural animal models of disease resistance and vulnerability.
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Affiliation(s)
- Orrin Devinsky
- Department of Neurology, New York University (NYU) Langone Medical Center and NYU School of Medicine, New York, NY, USA.
| | - Jordyn M Boesch
- College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | | | - Barbara Coffey
- Department of Child and Adolescent Psychiatry, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Kathryn Davis
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Daniel Friedman
- Department of Neurology, New York University (NYU) Langone Medical Center and NYU School of Medicine, New York, NY, USA
| | - Brian Hainline
- Department of Neurology, New York University (NYU) Langone Medical Center and NYU School of Medicine, New York, NY, USA
| | - Katherine Houpt
- College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Daniel Lieberman
- Department of Human Evolutionary Biology, Harvard University, Cambridge, MA, USA
| | - Pamela Perry
- College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Harald Prüss
- Department of Neurology with Experimental Neurology, Charité University Medicine Berlin, Berlin, Germany, and German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
| | | | - Gary W Small
- University of California-Los Angeles (UCLA) Brain Research Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Holger Volk
- Veterinary Neurology and Neurosurgery, The Royal Veterinary College, University of London, London, UK
| | - Artur Summerfield
- Institute of Virology and Immunology and Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Charles Vite
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Thomas Wisniewski
- Department of Neurology, New York University (NYU) Langone Medical Center and NYU School of Medicine, New York, NY, USA
| | - Barbara Natterson-Horowitz
- Department of Ecology and Evolutionary Biology, Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Abstract
Mice and rats are valuable and commonly used as models for the study of cancer. The models and methods of experimentation have the potential to cause pain to some degree, and all charged with ensuring animal welfare must determine how to manage it. A commonly posed question, especially from investigators and IACUC, is whether the provision of analgesic agents will render the model invalid. Left untreated, pain is a stressor and has negative consequences, most notably immune system perturbations. In addition, analgesic agents in the opioid and NSAID drug classes exhibit immunomodulatory activity and influence processes such as cell proliferation, apoptosis, and angiogenesis that are important in cancer formation. Therefore, both pain and the agents used to alleviate it have the potential to act as confounding factors in a study. This review article presents data from both human medicine and work with animal models in an attempt to help inform discussions about the withholding of analgesic agents from animals used in cancer studies.
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Affiliation(s)
- Douglas K Taylor
- Division of Animal Resources, Emory University, Atlanta, Georgia;,
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Monteiro BP, de Lorimier LP, Moreau M, Beauchamp G, Blair J, Lussier B, Pelletier JP, Troncy E. Pain characterization and response to palliative care in dogs with naturally-occurring appendicular osteosarcoma: An open label clinical trial. PLoS One 2018; 13:e0207200. [PMID: 30521538 PMCID: PMC6283659 DOI: 10.1371/journal.pone.0207200] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 10/26/2018] [Indexed: 12/22/2022] Open
Abstract
This study aimed to characterize bone cancer pain (quantitative sensory testing (QST), stance asymmetry index, actimetry, scores of pain and quality of life (QoL)) in dogs with appendicular osteosarcoma (OSA), and to evaluate a stepwise palliative analgesic treatment. The pain profile of thirteen client-owned dogs with OSA was compared with seven healthy dogs. Dogs with OSA were then enrolled in a prospective, open-label, clinical trial. Outcome measures included: primary and secondary mechanical thresholds (MT), conditioned pain modulation (CPM), stance asymmetry index, actimetry (most and least active periods), visual analog scales and QoL. After baseline assessments, stepwise treatment comprised orally administered cimicoxib (2 mg/kg q 24h), amitriptyline (1–1.5 mg/kg q 24h) and gabapentin (10 mg/kg q 8h); re-evaluations were performed after 14 (D14), 21 (D21) and 28 (D28) days, respectively. Statistics used mixed linear models (α = 5%; one-sided). Centralized nociceptive sensitivity (primary and secondary MT, and dynamic allodynia) was recorded in OSA dogs. Healthy dogs had responsive CPM, but CPM was deficient in OSA dogs. Construct validity was observed for the QST protocol. Asymmetry index was significantly present in OSA dogs. The CPM improved significantly at D14. When compared with baseline (log mean ± SD: 4.1 ± 0.04), most active actimetry significantly improved at D14 (4.3 ± 0.04), D21 and D28 (4.2 ± 0.04 for both). When compared with baseline, least active actimetry significantly decreased after treatment at all time-points indicating improvement in night-time restlessness. No other significant treatment effect was observed. Except for tactile threshold and actimetry, all outcomes worsened when gabapentin was added to cimicoxib-amitriptyline. Dogs with bone cancer are affected by widespread somatosensory sensitivity characterized by peripheral and central sensitization and have a deficient inhibitory system. This severe pain is mostly refractory to palliative analgesic treatment, and the latter was only detected by specific and sensitive outcomes.
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Affiliation(s)
- Beatriz P. Monteiro
- GREPAQ (Groupe de recherche en pharmacologie animale du Québec), Department of biomedical sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Quebec, Canada
| | | | - Maxim Moreau
- GREPAQ (Groupe de recherche en pharmacologie animale du Québec), Department of biomedical sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Quebec, Canada
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Guy Beauchamp
- GREPAQ (Groupe de recherche en pharmacologie animale du Québec), Department of biomedical sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Quebec, Canada
| | - Jeffrey Blair
- Vétoquinol SA, Global–Le Groupe Vétoquinol, Magny-Vernois, France
| | - Bertrand Lussier
- GREPAQ (Groupe de recherche en pharmacologie animale du Québec), Department of biomedical sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Quebec, Canada
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - Eric Troncy
- GREPAQ (Groupe de recherche en pharmacologie animale du Québec), Department of biomedical sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Quebec, Canada
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
- * E-mail:
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Formenton MR, Pereira MAA, Fantoni DT. Small Animal Massage Therapy: A Brief Review and Relevant Observations. Top Companion Anim Med 2017. [PMID: 29525233 DOI: 10.1053/j.tcam.2017.10.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Massage therapy is becoming increasingly popular in human and animal physiotherapy and rehabilitation. Wider application of the technique led to research efforts aimed at providing scientific support to anecdotal beneficial effects, particularly pain relief. Recent studies have shown that massage therapy alters dopamine and serotonin levels, decreases noradrenaline levels, and modulates the immune system. Psychological effects such as reduction of stress and anxiety, with improvement of depressive patients, have been reported in humans. This article set out to review the major aspects of massage therapy based on recent publications on the topic, and to extrapolate concepts and practical aspects described in human physiotherapy to the veterinary patient, particularly the applicability of different techniques in Small Animal Medicine. Indications of massage therapy in small animals include pain relief, orthopedic rehabilitation, Canine Sports Medicine, intensive care, and management of nonspecific edema. Techniques described in this article were originally intended for use in humans and scientific data supporting anecdotal, beneficial effects in domestic animals are still lacking; this fruitful area for research is therefore open to veterinary professionals.
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Affiliation(s)
- Maira Rezende Formenton
- Fisioanimal Veterinary Rehabilitation Center, Bioethicus Institute, São Paulo, Brazil; Graduated in Massage Therapy at the Bergovist Institute, São Paulo, Brazil; Surgery Department, Veterinary School, São Paulo University, São Paulo, Brazil.
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Rohrer Bley C. Principles for ethical treatment decision-making in veterinary oncology. Vet Comp Oncol 2017; 16:171-177. [DOI: 10.1111/vco.12347] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 08/03/2017] [Accepted: 08/06/2017] [Indexed: 11/26/2022]
Affiliation(s)
- C. Rohrer Bley
- Division of Radiation Oncology; Vetsuisse Faculty University of Zurich; Zurich Switzerland
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7
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Abstract
Veterinary surgeons in the UK were invited to complete an internet survey concerning their attitudes to chronic pain in dogs. UK veterinary surgeons numbering 215 completed surveys in full along with 48 worldwide specialists in anaesthesia and 37 worldwide specialists in oncology. Osteoarthritis, dental and aural disease, vertebral and spinal cord conditions, neoplasia and skin conditions were considered important causes of chronic pain in dogs. UK practitioners used significantly fewer classes of analgesic drugs regularly than either category of specialist. The major barriers to adequate treatment of chronic pain were reported as difficulties with pain assessment, expense of drugs, and difficulties with owner compliance. Illustrations of six common neoplastic conditions were used and scored for pain according to prior experience by practitioners. All six conditions were consistently described as involving some degree of pain with primary bone tumour and oral tumour, causing severe pain and moderate to severe pain, respectively. Years since graduation and specialist status affected the pain scores attributed to the conditions. There was a significant correlation between the pain score attributed to the illustrated condition, and the tendency to administer analgesia.
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Affiliation(s)
- A Bell
- School of Veterinary Medicine, University of Glasgow, Bearsden, Glasgow G61 1QH, UK
| | - J Helm
- School of Veterinary Medicine, University of Glasgow, Bearsden, Glasgow G61 1QH, UK
| | - J Reid
- School of Veterinary Medicine, University of Glasgow, Bearsden, Glasgow G61 1QH, UK
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Brabb T, Carbone L, Snyder J, Phillips N. Institutional animal care and use committee considerations for animal models of peripheral neuropathy. ILAR J 2014; 54:329-37. [PMID: 24615447 PMCID: PMC4383225 DOI: 10.1093/ilar/ilt045] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Peripheral neuropathy and neuropathic pain are debilitating, life-altering conditions that affect a significant proportion of the human population. Animal models, used to study basic disease mechanisms and treatment modalities, are diverse and provide many challenges for institutional animal care and use committee (IACUC) review and postapproval monitoring. Items to consider include regulatory and ethical imperatives in animal models that may be designed to study pain, the basic mechanism of neurodegeneration, and different disease processes for which neuropathic pain is a side effect. Neuropathic pain can be difficult to detect or quantify in many models, and pain management is often unsuccessful in both humans and animals, inspiring the need for more research. Design of humane endpoints requires clear communication of potential adverse outcomes and solutions. Communication with the IACUC, researchers, and veterinary staff is also key for successful postapproval monitoring of these challenging models.
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Affiliation(s)
- Thea Brabb
- Address correspondence and reprint requests to Dr. Thea Brabb, Box 357190, University of Washington, Seattle, WA 98195 or email
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Sleeckx N, de Rooster H, Veldhuis Kroeze EJB, Van Ginneken C, Van Brantegem L. Canine mammary tumours, an overview. Reprod Domest Anim 2011; 46:1112-31. [PMID: 21645126 DOI: 10.1111/j.1439-0531.2011.01816.x] [Citation(s) in RCA: 124] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Canine mammary tumours (CMTs) are the most common neoplasms in intact female dogs. Although the prevalence of these tumours decreases in regions where preventive ovari(ohyster)ectomy is performed, it remains an important disease entity in veterinary medicine. Moreover, treatment options are limited in comparison with human breast cancer. Nevertheless, recent human treatment protocols might have potential in bitches suffering from CMTs.
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Affiliation(s)
- N Sleeckx
- Department of Veterinary Sciences, University of Antwerp, Antwerp, Belgium
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