1
|
Rusbridge C. Neuropathic pain in cats: Mechanisms and multimodal management. J Feline Med Surg 2024; 26:1098612X241246518. [PMID: 38710218 PMCID: PMC11156241 DOI: 10.1177/1098612x241246518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
PRACTICAL RELEVANCE 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.
Collapse
Affiliation(s)
- Clare Rusbridge
- BVMS, PhD, DipECVN, FRCVS School of Veterinary Medicine, The University of Surrey, Guildford, Surrey, UK; and Wear Referrals Veterinary Specialist & Emergency Hospital, Bradbury, Stockton-on-Tees, UK
| |
Collapse
|
2
|
Taylor S, Gruen M, KuKanich K, X Lascelles BD, Monteiro BP, Sampietro LR, Robertson S, Steagall PV. 2024 ISFM and AAFP consensus guidelines on the long-term use of NSAIDs in cats. J Feline Med Surg 2024; 26:1098612X241241951. [PMID: 38587872 PMCID: PMC11103309 DOI: 10.1177/1098612x241241951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
PRACTICAL RELEVANCE Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used and are effective for the management of pain in cats. These Guidelines will support veterinarians in decision-making around prescribing NSAIDs in situations of chronic pain, to minimise adverse effects and optimise pain management. Information is provided on mechanism of action, indications for use, screening prior to prescription, use in the presence of comorbidities, monitoring of efficacy, and avoidance and management of adverse effects. CLINICAL CHALLENGES The cat's unique metabolism should be considered when prescribing any medications, including NSAIDs. Chronic pain may be challenging to detect in this species and comorbidities, particularly chronic kidney disease, are common in senior cats. Management of chronic pain may be complicated by prescription of other drugs with the potential for interactions with NSAIDs. EVIDENCE BASE These Guidelines have been created by a panel of experts brought together by the International Society of Feline Medicine (ISFM) and American Association of Feline Practitioners (AAFP). Information is based on the available literature, expert opinion and the panel members' experience.
Collapse
Affiliation(s)
- Samantha Taylor
- Panel ChairInternational Society of Feline Medicine, International Cat Care, Tisbury, Wi Itshire, UK
| | - Margaret Gruen
- Comparative Pain Research Laboratory; and Behavioural Medicine Service - Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, NC, USA
| | - Kate KuKanich
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, KS, USA
| | - B Duncan X Lascelles
- Translational Research in Pain (TRiP) Program and Comparative Pain Research and Education Centre (CPREC), North Carolina State University, NC, USA
| | - Beatriz P Monteiro
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Universite de Montreal, Saint-Hyacinthe, QC, Canada
| | | | - Sheilah Robertson
- Lap of Love Veterinary Hospice, Lutz, FL, USA; and Courtesy Lecturer, Shelter Medicine Program, University of Florida, FL, USA
| | - Paulo V Steagall
- Department of Veterinary Clinical Sciences and Centre for Animal Health and Welfare, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, SAR China; and Department of Clinical Sciences, Faculty of Veterinary Medicine, Universite de Montreal, Saint-Hyacinthe, QC, Canada
| |
Collapse
|
3
|
Norfolk M, Bielby J, Figueiredo Passos L, Reddon AR, Rendle M. Nutraceutical supplementation increases mobility in aged captive non-domesticated felids. Vet Rec 2024; 194:e3797. [PMID: 38379254 DOI: 10.1002/vetr.3797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/06/2023] [Accepted: 12/08/2023] [Indexed: 02/22/2024]
Abstract
BACKGROUND Musculoskeletal diseases (MSDs) are an increasing issue as the lifespan of captive animals increases. Extracts of green-lipped mussels have been linked to alleviation of MSDs in domestic carnivores. Understanding their efficacy in non-domestic felids could provide another tool to improve the welfare of aged individuals in collections. METHODS A within-subject study design quantified steps per minute in each of 18 cats of 13 species before and after the addition of a nutraceutical containing green-lipped mussel extract (Antinol) to their diets. The age structure of four commonly kept subspecies of non-domestic cats was quantified to provide a demographic context to the need for managing aged individuals. RESULTS Each of the 18 cats exhibited a higher number of steps per minute after the addition of Antinol to their diet. At the group level, a paired t-test showed that the step rate was significantly increased after the addition of Antinol to the diet. LIMITATIONS While our results showed a strong significant increase in step rate following Antinol supplementation, further studies that incorporate a placebo, more individuals and more detailed metrics of mobility would provide a more detailed evidence base for practitioners. CONCLUSION Nutraceuticals may yield benefits to aged individual felids, including species kept widely in European collections. Their use warrants further, detailed research in collections.
Collapse
Affiliation(s)
- Matthew Norfolk
- School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK
| | - Jon Bielby
- School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK
| | - Luiza Figueiredo Passos
- School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK
| | - Adam R Reddon
- School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK
| | - Matthew Rendle
- Association of Zoo and Exotic Veterinary Nurses, Market Harborough, UK
| |
Collapse
|
4
|
Delsart A, Otis C, Leung VSY, Labelle É, Moreau M, Frezier M, Drag M, Martel-Pelletier J, Pelletier JP, Troncy E. 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. Animals (Basel) 2024; 14:711. [PMID: 38473097 DOI: 10.3390/ani14050711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/15/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
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.
Collapse
Affiliation(s)
- Aliénor Delsart
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Université de Montréal, St-Hyacinthe, QC J2S 2M2, Canada
| | - Colombe Otis
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Université de Montréal, St-Hyacinthe, QC J2S 2M2, Canada
| | - Vivian S Y Leung
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Université de Montréal, St-Hyacinthe, QC J2S 2M2, Canada
| | - Émilie Labelle
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Université de Montréal, St-Hyacinthe, QC J2S 2M2, Canada
| | - Maxim Moreau
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Université de Montréal, St-Hyacinthe, QC J2S 2M2, Canada
- Osteoarthritis Research Unit, University of Montreal Hospital Research Center (CRCHUM), Montreal, QC H2X 0A9, Canada
| | - Marilyn Frezier
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Université de Montréal, St-Hyacinthe, QC J2S 2M2, Canada
| | - Marlene Drag
- Boehringer Ingelheim Animal Health, Fulton, MO 65251, USA
| | - Johanne Martel-Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Center (CRCHUM), Montreal, QC H2X 0A9, Canada
| | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Center (CRCHUM), Montreal, QC H2X 0A9, Canada
| | - Eric Troncy
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Université de Montréal, St-Hyacinthe, QC J2S 2M2, Canada
- Osteoarthritis Research Unit, University of Montreal Hospital Research Center (CRCHUM), Montreal, QC H2X 0A9, Canada
| |
Collapse
|
5
|
Ihrke A. Multimodal Approach to Pain Management in Veterinary Rehabilitation. Vet Clin North Am Small Anim Pract 2023; 53:731-742. [PMID: 37019720 DOI: 10.1016/j.cvsm.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
Pain recognition, assessment, and management is a primary focus and an integral part of veterinary rehabilitation. Evidence-based pain mitigation protocols will use both pharmacologic tools and nonpharmacologic methods to create a customized, safe, and effective treatment plan. A multimodal, patient-centered approach will allow for the best outcomes for pain relief and improved quality of life.
Collapse
|
6
|
Deabold K, Montalbano C, Miscioscia E. Feline Osteoarthritis Management. Vet Clin North Am Small Anim Pract 2023; 53:879-896. [PMID: 36964025 DOI: 10.1016/j.cvsm.2023.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2023]
Abstract
Feline osteoarthritis is common; despite vague clinical signs, it can result in mobility impairment and quality of life concerns. An integrative approach to management may include analgesic medications, dietary modifications, nutraceuticals, environmental modifications, physical rehabilitation, acupuncture, and regenerative medicine. Management of concurrent disease and consideration for patient tolerance and owner compliance are critical in formulating a treatment plan in cats with osteoarthritis.
Collapse
Affiliation(s)
- Kelly Deabold
- Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL 32608, USA
| | | | - Erin Miscioscia
- Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL 32608, USA.
| |
Collapse
|
7
|
Repetti CSF, Rueda JR, Porto CD, Franco RP, Girio RJS, Manhoso FFR, da Costa IB. Palliative care for cancer patients in veterinary medicine. VET MED-CZECH 2023; 68:2-10. [PMID: 38384994 PMCID: PMC10878255 DOI: 10.17221/76/2022-vetmed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 12/15/2022] [Indexed: 02/23/2024] Open
Abstract
Neoplasms account for approximately half of the deaths of dogs over ten years of age. This finding, associated with the fact that canine cancer patients will often suffer from the consequences of the systemic spread of the tumour and paraneoplastic syndromes, shows the importance of understanding palliative care by veterinarians and owners. In view of this, this review aims to address palliative care that can be used in veterinary medicine to promote the patient's well-being and quality of life.
Collapse
Affiliation(s)
| | | | - Camila Dias Porto
- Department of Veterinary Science, University of Marília, Marília/SP, Brazil
| | | | | | | | | |
Collapse
|
8
|
Monteiro BP, Lascelles BDX, Murrell J, Robertson S, Steagall PVM, Wright B. 2022
WSAVA
guidelines for the recognition, assessment and treatment of pain. J Small Anim Pract 2022. [DOI: 10.1111/jsap.13566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- B. P. Monteiro
- Department of Clinical Sciences, Faculty of Veterinary Medicine Université de Montréal 3200 rue Sicotte, Saint‐Hyacinthe Quebec Canada
| | - B. D. X. Lascelles
- Comparative Pain Research Laboratory and Surgery Section North Carolina State University 4700 Hillsborough Street Raleigh NC USA
| | - J. Murrell
- Highcroft Veterinary Referrals 615 Wells Rd, Whitchurch Bristol BS149BE UK
| | - S. Robertson
- Senior Medical Director Lap of Love Veterinary Hospice 17804 N US Highway 41 Lutz FL 33549 USA
| | - P. V. M. Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine Université de Montréal 3200 rue Sicotte, Saint‐Hyacinthe Quebec Canada
| | - B. Wright
- Mistral Vet 4450 Thompson Pkwy Fort Collins CO 80534 USA
| |
Collapse
|
9
|
Beuve MS, Espana B, Pin D, Prouillac C. Ex-vivo study of the percutaneous absorption of a tramadol formulation through feline inner pinna skin. Res Vet Sci 2022; 151:57-63. [PMID: 35868201 DOI: 10.1016/j.rvsc.2022.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 04/28/2022] [Accepted: 05/16/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Oral medication of small animals, particularly cats, is often challenging. The transdermal route may provide an easier option for owners to administer chronic treatment. Tramadol is an analgesic mainly used in humans; it is also commonly used in dogs, despite some controversy over its clinical efficacy. Recent studies have suggested that tramadol is efficacious for pain management in cats. In cats, the inner pinna is the most commonly used site for transdermal drug therapy; the use of this site has been validated in experimental studies of methimazole and mirtazapine treatment. This ex vivo study aimed to characterise the percutaneous absorption pharmacokinetics of a formulation of tramadol in Pentravan through feline inner pinna skin. METHODS High-performance liquid chromatography was used to assess the stability of the tramadol formulation (100 mg/ml in Pentravan) over three months at room temperature. Forced degradation was also assessed in neutral, acidic, alkaline, and oxidative conditions. A Franz cell system was employed to evaluate percutaneous absorption of a finite dose of tramadol. RESULTS The tramadol formulation was stable for three months at room temperature. Tramadol penetrated through ex vivo feline inner pinna skin, but considerable intra- and inter-individual variability in kinetics was observed. Comparison with another vehicle, Lipoderm, revealed no significant difference in the percutaneous absorption of tramadol. CONCLUSIONS AND RELEVANCE The Pentravan formulation assessed in this study supported tramadol absorption across the feline inner ear skin. In vivo studies are necessary to evaluate the pharmacokinetics and efficacy of this formulation.
Collapse
Affiliation(s)
| | | | - Didier Pin
- Université de Lyon, VetAgro Sup, Marcy l'Etoile, France
| | | |
Collapse
|
10
|
Kane LP, Cook JL, Archibald KE, Suedmeyer WK, Langan JN, Adkesson MJ. Complications associated with total hip arthroplasty in four large nondomestic felids. Am J Vet Res 2021; 83:180-187. [PMID: 34941567 DOI: 10.2460/ajvr.21.10.0161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION A 9-year-old 37-kg sexually intact male snow leopard (Panthera uncia) with no history of lameness but radiographic evidence of right femoral subluxation and flattening of both femoral heads, 2 juvenile (< 1 year old) 25-kg sexually intact male cheetahs (Acinoynx jubatus) with unilateral hind limb lameness resulting from trauma, and an 11-year-old 110-kg sexually intact female Amur tiger (Panthera tigris altaica) with a 2-year history of left hip joint osteoarthritis were examined. CLINICAL FINDINGS No clinically relevant clinical findings other than hip joint problems were identified. All 4 felids underwent staged bilateral (snow leopard) or unilateral (cheetahs and tiger [Panthera tigris]) total hip arthroplasty (THA). TREATMENT AND OUTCOME In the snow leopard, both femoral THA components were found to be luxated 1 year after surgery. Treatment consisted of autogenous corticocancellous rib graft augmentation of the dorsal acetabular rims and synthetic suture capsulorrhaphies. The snow leopard lived for an additional 4 years with no additional THA-related complications. In the other 3 animals, catastrophic complications (luxation in the cheetahs and femoral fracture in the tiger) occurred shortly after THA. The THA implants were removed, and excision arthroplasty was performed. Long-term outcomes were good in all 3. CLINICAL RELEVANCE Findings underscore the challenges associated with THA in large nondomestic felids. Given the high risk for early catastrophic failure as a result of luxation or fracture, plans must be made and resources must be available in case revision surgery or implant removal with excision arthroplasty becomes necessary.
Collapse
Affiliation(s)
- Lauren P Kane
- 1Chicago Zoological Society, Brookfield Zoo, Brookfield, IL.,2Illinois Zoological and Aquatic Animal Residency Program, Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL
| | - James L Cook
- 3Missouri Orthopaedic Institute, University of Missouri, Columbia, MO
| | | | | | | | | |
Collapse
|
11
|
Aldrich LA, Roush JK, KuKanich B. Plasma concentrations of tramadol after transdermal application of a single metered dose of a compounded tramadol gel to cats. Am J Vet Res 2021; 82:840-845. [PMID: 34554876 DOI: 10.2460/ajvr.82.10.840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine plasma tramadol concentrations in cats following a single dose of oral and transdermal formulations and the pharmacokinetics for and the concentration of tramadol in the transdermal formulation. ANIMALS 8 healthy client-owned domestic shorthair cats. PROCEDURES 1 cat was orally administered 1 dose of tramadol (2 mg/kg), and 7 cats received 1 dose of a proprietary compounded tramadol gel product (median actual dose, 2.8 mg/kg) applied to their inner pinnae. Plasma tramadol concentrations were measured with high-performance liquid chromatography-mass spectrometry at fixed times over 24 hours. RESULTS Plasma tramadol concentrations were undetectable or much lower (range, < 1 to 4.3 ng/mL) following application of the transdermal formulation, compared with those following oral administration (maximum plasma tramadol concentration, 261.3 ng/mL [at 4 hours]). Tramadol pharmacokinetics for the transdermal formulation could not be determined. Tramadol concentrations of the transdermal gel product exceeded the estimated label dose in all analyzed gel samples, with concentrations greater than the 90% to 110% United States Pharmacopeia standard for compounded drugs. CONCLUSIONS AND CLINICAL RELEVANCE Application of 1 dose of the proprietary transdermal formulation did not yield clinically relevant plasma tramadol concentrations in cats. Although this proprietary formulation is currently available to prescribing veterinarians, it should be used with caution.
Collapse
|
12
|
Ray M, Carney HC, Boynton B, Quimby J, Robertson S, St Denis K, Tuzio H, Wright B. 2021 AAFP Feline Senior Care Guidelines. J Feline Med Surg 2021; 23:613-638. [PMID: 34167339 PMCID: PMC10812122 DOI: 10.1177/1098612x211021538] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The '2021 AAFP Feline Senior Care Guidelines' are authored by a Task Force of experts in feline clinical medicine and serve as an update and extension of those published in 2009. They emphasize the individual patient evaluation and the process of aging, with references to other feline practice guidelines for a more complete discussion of specific diseases. Focusing on each cat encourages and empowers the owner to become a part of the cat's care every step of the way. A comprehensive discussion during the physical examination and history taking allows for tailoring the approach to both the cat and the family involved in the care. Videos and analysis of serial historical measurements are brought into the assessment of each patient. These Guidelines introduce the emerging concept of frailty, with a description and methods of its incorporation into the senior cat assessment. Minimum database diagnostics are discussed, along with recommendations for additional investigative considerations. For example, blood pressure assessment is included as a minimum diagnostic procedure in both apparently healthy and ill cats. Cats age at a much faster rate than humans, so practical timelines for testing frequency are included and suggest an increased frequency of diagnostics with advancing age. The importance of nutrition, as well as senior cat nutritional needs and deficiencies, is considered. Pain is highlighted as its own syndrome, with an emphasis on consideration in every senior cat. The Task Force discusses anesthesia, along with strategies to allow aging cats to be safely anesthetized well into their senior years. The medical concept of quality of life is addressed with the latest information available in veterinary medicine. This includes end of life considerations like palliative and hospice care, as well as recommendations on the establishment of 'budgets of care', which greatly influence what can be done for the individual cat. Acknowledgement is given that each cat owner will be different in this regard; and establishing what is reasonable and practical for the individual owner is important. A discussion on euthanasia offers some recommendations to help the owner make a decision that reflects the best interests of the individual cat.
Collapse
Affiliation(s)
| | - Hazel C Carney
- WestVet Emergency and Specialty Center, Garden City, ID, USA
| | - Beth Boynton
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, CA, USA
| | - Jessica Quimby
- The Ohio State University, Department of Veterinary Clinical Sciences, Columbus, OH, USA
| | - Sheilah Robertson
- Senior Medical Director, Lap of Love Veterinary Hospice, Lutz, FL, USA
| | | | - Helen Tuzio
- Forest Hills Cat Hospital, Middle Village, NY, USA
| | | |
Collapse
|
13
|
Navarro KL, Huss M, Smith JC, Sharp P, Marx JO, Pacharinsak C. Mouse Anesthesia: The Art and Science. ILAR J 2021; 62:238-273. [PMID: 34180990 PMCID: PMC9236661 DOI: 10.1093/ilar/ilab016] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/04/2021] [Accepted: 12/01/2020] [Indexed: 12/15/2022] Open
Abstract
There is an art and science to performing mouse anesthesia, which is a significant component to animal research. Frequently, anesthesia is one vital step of many over the course of a research project spanning weeks, months, or beyond. It is critical to perform anesthesia according to the approved research protocol using appropriately handled and administered pharmaceutical-grade compounds whenever possible. Sufficient documentation of the anesthetic event and procedure should also be performed to meet the legal, ethical, and research reproducibility obligations. However, this regulatory and documentation process may lead to the use of a few possibly oversimplified anesthetic protocols used for mouse procedures and anesthesia. Although a frequently used anesthetic protocol may work perfectly for each mouse anesthetized, sometimes unexpected complications will arise, and quick adjustments to the anesthetic depth and support provided will be required. As an old saying goes, anesthesia is 99% boredom and 1% sheer terror. The purpose of this review article is to discuss the science of mouse anesthesia together with the art of applying these anesthetic techniques to provide readers with the knowledge needed for successful anesthetic procedures. The authors include experiences in mouse inhalant and injectable anesthesia, peri-anesthetic monitoring, specific procedures, and treating common complications. This article utilizes key points for easy access of important messages and authors’ recommendation based on the authors’ clinical experiences.
Collapse
Affiliation(s)
- Kaela L Navarro
- Department of Comparative Medicine, Stanford University, Stanford, California, USA
| | - Monika Huss
- Department of Comparative Medicine, Stanford University, Stanford, California, USA
| | - Jennifer C Smith
- Bioresources Department, Henry Ford Health System, Detroit, Michigan, USA
| | - Patrick Sharp
- Office of Research and Economic Development, University of California, Merced, California, USA
- Animal Resources Authority, Murdoch, Australia
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia, Australia
| | - James O Marx
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Cholawat Pacharinsak
- Corresponding Author: Cholawat Pacharinsak, DVM, PhD, DACVAA, Stanford University, Department of Comparative Medicine, 287 Campus Drive, Stanford, CA 94305-5410, USA. E-mail:
| |
Collapse
|
14
|
Shipley H, Flynn K, Tucker L, Wendt-Hornickle E, Baldo C, Almeida D, Allweiler S, Guedes A. Owner evaluation of quality of life and mobility in osteoarthritic cats treated with amantadine or placebo. J Feline Med Surg 2021; 23:568-574. [PMID: 33112193 PMCID: PMC10741303 DOI: 10.1177/1098612x20967639] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of the study was to determine if amantadine improves owner-identified mobility impairment and quality of life associated with osteoarthritis in cats. METHODS Using a blinded, placebo-controlled, randomized, crossover design, 13 healthy client-owned cats with clinical and radiographic evidence of osteoarthritis and owner-identified mobility impairment were studied. Cats received 5 mg/kg amantadine or placebo q24h PO for 3 weeks each with no washout period in between. Locomotor activity was continuously assessed with a collar-mounted activity monitor system, and owners chose and rated two mobility-impaired activities using a client-specific outcome measures (CSOM) questionnaire on a weekly basis. Locomotor activity on the third treatment week was analyzed with two-tailed paired t-tests. The CSOM scores were analyzed using a mixed-effect model and the Bonferroni post-hoc test. Owner-perceived changes in quality of life were compared between treatments using the χ2 test. Statistical significance was set at P <0.05. RESULTS Mean ± SD activity counts during the third week of each treatment were significantly lower with amantadine (240,537 ± 53,880) compared with placebo (326,032 ± 91,759). CSOM scores assigned by the owners were significantly better with amantadine on the second (3 ± 1) and third (3 ± 1) weeks compared with placebo (5 ± 2 and 5 ± 1, respectively). A significantly greater proportion of owners reported improvement in quality of life with amantadine compared with placebo. CONCLUSIONS AND RELEVANCE Amantadine significantly decreased activity, but improved owner-identified impaired mobility and owner-perceived quality of life in cats with osteoarthritis. Amantadine appears to be an option for the symptomatic treatment of osteoarthritis in cats.
Collapse
Affiliation(s)
- Hilary Shipley
- Department of Veterinary Clinical
Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN,
USA
- Wisconsin Veterinary Referral Center,
Waukesha, WI, USA
| | - Kristi Flynn
- Department of Veterinary Clinical
Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN,
USA
| | - Laura Tucker
- Department of Veterinary Clinical
Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN,
USA
- Ontario Veterinary College, University
of Guelph, Guelph, ON, Canada
| | - Erin Wendt-Hornickle
- Department of Veterinary Clinical
Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN,
USA
| | - Caroline Baldo
- Department of Veterinary Clinical
Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN,
USA
| | - Daniel Almeida
- Department of Veterinary Clinical
Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN,
USA
| | - Sandra Allweiler
- Department of Veterinary Clinical
Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN,
USA
- Department of Clinical Sciences, College
of Veterinary Medicine, Oregon State University, Corvallis, OR, USA
| | - Alonso Guedes
- Department of Veterinary Clinical
Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN,
USA
| |
Collapse
|
15
|
Gruen ME, Myers JAE, Lascelles BDX. Efficacy and Safety of an Anti-nerve Growth Factor Antibody (Frunevetmab) for the Treatment of Degenerative Joint Disease-Associated Chronic Pain in Cats: A Multisite Pilot Field Study. Front Vet Sci 2021; 8:610028. [PMID: 34124212 PMCID: PMC8195238 DOI: 10.3389/fvets.2021.610028] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 04/06/2021] [Indexed: 01/21/2023] Open
Abstract
Background: Pain management for cats with degenerative joint disease (DJD) remains a critical unmet need. Recent work has shown promise for a feline-specific anti-nerve growth factor monoclonal antibody (frunevetmab) to deliver safe and effective pain management. Our objectives were to evaluate the efficacy and safety of frunevetmab administered twice using two administration routes (subcutaneous and intravenous) compared to placebo. Methods: This was a randomized placebo-controlled, double-masked study. After a week-long pain and activity baseline, 126 cats were randomized to receive injections of frunevetmab (IV then SC; n = 42 or SC then SC; n = 43) or placebo (IV then SC; n = 41) on Days 0 and 28. Owners completed questionnaires on Days 14, 28, 42, and 56. Accelerometry data were collected continuously throughout. Results: Owner questionnaire results showed significant improvement in frunevetmab-treated cats [compared to placebo; (p < 0.05)] at Days 42 and 56; no difference was found between routes of administration for frunevetmab. All groups had decreased objectively measured weekly activity from baseline; frunevetmab-treated cats had a mean decrease of 0.9%, while placebo-treated cats had a mean decrease of 9.3%. Treatments were generally well-tolerated. The majority of adverse events included dermatitis/alopecia related to activity-monitor collars; these occurred in a higher percentage of frunevetmab, compared to placebo, treated cats. Conclusions and Clinical Relevance: Treatment with frunevetmab provided improvements in owner ratings of mobility over treatment with placebo; these results were supported by objectively measured accelerometry. Frunevetmab has the potential to address a critical gap in the treatment of chronic pain in cats.
Collapse
Affiliation(s)
- Margaret E. Gruen
- Translational Research in Pain Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
- Behavioral Medicine, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
- Comparative Pain Research and Education Center, North Carolina State University, Raleigh, NC, United States
| | - Jamie A. E. Myers
- Veterinary Medicine Research and Development, Zoetis, Inc., Kalamazoo, MI, United States
| | - B. Duncan X. Lascelles
- Translational Research in Pain Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
- Comparative Pain Research and Education Center, North Carolina State University, Raleigh, NC, United States
- Thurston Arthritis Center, University of North Carolina (UNC) School of Medicine, Chapel Hill, NC, United States
- Department of Anesthesiology, Center for Translational Pain Research, Duke University, Durham, NC, United States
| |
Collapse
|
16
|
A systematic review of the quality of life assessment tools for cats in the published literature. Vet J 2021; 272:105658. [PMID: 33941335 DOI: 10.1016/j.tvjl.2021.105658] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 03/12/2021] [Accepted: 03/17/2021] [Indexed: 11/22/2022]
Abstract
Quality of life (QoL) is an important parameter to assess in cats, as it can be pivotal to important decision-making. Research reports that owners of cats with heart disease would trade longevity for QoL, and treatment associated improvement in QoL is very important for cats with chronic kidney disease. This systematic review aimed to explore the published literature to identify the number and range of QoL assessment tools available to researchers and veterinary professionals, by discovering tools which have already been used in published studies. Medline and CAB Abstracts were searched in March 2018, using terms relevant to cats and QoL or well-being. Inclusion and exclusion criteria were applied and information on uniqueness, validation and a short description of each tool extracted. A total of 1138 manuscripts were identified, of which 96 met all criteria. Forty of 96 manuscripts contained an assessment of QoL, using one of 32 unique tools identified. Sixteen of the tools identified were structured, making detailed patient assessments. Only eight of the structured tools were validated, and of these, three could be applied to healthy cats; the remainder being specific to a disease or being hospitalised. Some validated tools appeared in more than one manuscript. Overall, 12 manuscripts used a validated tool. In the 16 unstructured tools, five tools assessed QoL by assigning a single word (e.g. 'poor'). Eight tools assessed QoL on a single Likert scale (e.g. a number between 1 and 5). This work identifies the tools that are currently available for the assessment of QoL by researchers and veterinary professionals. Additionally, it demonstrates that many are not validated or lack detailed animal assessment, highlighting that further work in this important area is needed.
Collapse
|
17
|
Forman MA, Steiner JM, Armstrong PJ, Camus MS, Gaschen L, Hill SL, Mansfield CS, Steiger K. ACVIM consensus statement on pancreatitis in cats. J Vet Intern Med 2021; 35:703-723. [PMID: 33587762 PMCID: PMC7995362 DOI: 10.1111/jvim.16053] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 12/16/2022] Open
Abstract
Background Pancreatitis in cats, although commonly diagnosed, still presents many diagnostic and management challenges. Objective To summarize the current literature as it relates to etiology, pathogenesis, diagnosis, and management of pancreatitis in cats and to arrive at clinically relevant suggestions for veterinary clinicians that are based on evidence, and where such evidence is lacking, based on consensus of experts in the field. Animals None. Methods A panel of 8 experts in the field (5 internists, 1 radiologist, 1 clinical pathologist, and 1 anatomic pathologist), with support from a librarian, was formed to assess and summarize evidence in the peer reviewed literature and complement it with consensus clinical recommendations. Results There was little literature on the etiology and pathogenesis of spontaneous pancreatitis in cats, but there was much in the literature about the disease in humans, along with some experimental evidence in cats and nonfeline species. Most evidence was in the area of diagnosis of pancreatitis in cats, which was summarized carefully. In contrast, there was little evidence on the management of pancreatitis in cats. Conclusions and Clinical Importance Pancreatitis is amenable to antemortem diagnosis by integrating all clinical and diagnostic information available, and recognizing that acute pancreatitis is far easier to diagnose than chronic pancreatitis. Although both forms of pancreatitis can be managed successfully in many cats, management measures are far less clearly defined for chronic pancreatitis.
Collapse
Affiliation(s)
- Marnin A Forman
- Cornell University Veterinary Specialists, Stamford, Connecticut, USA
| | - Joerg M Steiner
- Gastrointestinal Laboratory, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - P Jane Armstrong
- College of Veterinary Medicine, University of Minnesota, St Paul, Minnesota, USA
| | - Melinda S Camus
- Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Lorrie Gaschen
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Louisiana, USA
| | - Steve L Hill
- Flagstaff Veterinary Internal Medicine Consulting, Flagstaff, Arizona, USA
| | | | - Katja Steiger
- Institute of Pathology, School of Medicine, Technical University of Munich, Munich, Germany
| |
Collapse
|
18
|
Microstructure and mechanical properties of subchondral bone are negatively regulated by tramadol in osteoarthritis in mice. Biosci Rep 2020; 40:226099. [PMID: 32803252 PMCID: PMC7475645 DOI: 10.1042/bsr20194207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 07/27/2020] [Accepted: 08/13/2020] [Indexed: 11/17/2022] Open
Abstract
Objectives: In the treatment of osteoarthritis (OA), tramadol, a common weak opioid, has become popular due to its effectiveness in inhibition of pain. In the present study, we aimed to explore the effect of tramadol on subchondral bone, especially changes in the microstructure and mechanical properties. Methods: A mouse model of OA was established in the present study by destabilization of the medial meniscus (DMM). A vehicle or drug was administered for 4 weeks. Specimens were harvested and analyzed radiologically and histologically using micro-computed tomography (micro-CT), scanning electron microscopy (SEM), atomic force microscopy (AFM) and histological staining to evaluate the knee joints of mice undergoing different forms of intervention. Results: In the early stages of OA induced by DMM, the subchondral bone volume fraction in the OA group was significantly higher than in the sham+vehicle (sham+veh) group, while the volume in the treatment groups was lower than in the DMM+vehicle (DMM+veh) and sham+veh groups. In addition, the elastic moduli in the treatment groups clearly decreased compared with the DMM+veh and sham+veh groups. Observations of the subchondral bone surface by SEM indicated serious destruction, principally manifesting as a decrease in lacunae and more numerous and scattered cracks. Histological staining demonstrated that there was no difference in the degeneration of either the articular cartilage or synovial cells whether tramadol was used or not. Conclusion: Although tramadol is effective in inhibiting pain in early OA, it negatively regulates the microstructure and mechanical properties of subchondral bone in joints.
Collapse
|
19
|
Dowgray N, Comerford E. Feline musculoskeletal ageing: How are we diagnosing and treating musculoskeletal impairment? J Feline Med Surg 2020; 22:1069-1083. [PMID: 33100170 PMCID: PMC10814220 DOI: 10.1177/1098612x20965832] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PRACTICAL RELEVANCE An understanding of the process of musculoskeletal ageing - which all senior and geriatric cats will experience - is vital to maintaining the health and welfare of our ageing cat population. CLINICAL CHALLENGES Assessment of the feline musculoskeletal system is not always straightforward. Diagnosis of impairment relies on input from owners and veterinarians in terms of visual observation, and clinical and orthopaedic examination, in addition to diagnostic imaging. AUDIENCE This review is written for the primary care veterinary team. AIMS The goals are to raise awareness and improve clinical diagnosis of musculoskeletal impairment as a result of ageing. The article also reviews therapeutic options and considers the evidence available for the prevention/deceleration of musculoskeletal ageing and impairment. EVIDENCE BASE There is good evidence of a high prevalence of osteoarthritis (OA) and degenerative joint disease (DJD) in older cats. There is also good evidence to indicate that functional impairment and chronic pain are sequelae of musculoskeletal disease. However, there is a paucity of information for what is best practice for the management and treatment of musculoskeletal impairment in a clinical situation. There is also a lack of evidence on how prevention of central stimulation of the nervous system caused by musculoskeletal impairment and, in turn the development of chronic pain, can be avoided.
Collapse
Affiliation(s)
| | - Eithne Comerford
- Institute of Life Course and Medical Sciences and School of Veterinary Science, University of Liverpool, UK
| |
Collapse
|
20
|
Chun N, Canapp S, Carr BJ, Wong V, Curry J. Validation and Characterization of Platelet-Rich Plasma in the Feline: A Prospective Analysis. Front Vet Sci 2020; 7:512. [PMID: 32851053 PMCID: PMC7431485 DOI: 10.3389/fvets.2020.00512] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 07/03/2020] [Indexed: 12/17/2022] Open
Abstract
Objective: To quantitate key parameters of the platelet-rich plasma (PRP) product from a commercially available system1 in healthy, adult felines. Materials and methods: A prospective study was performed from January 2019 to April 2019. 11 adult, healthy cats were used to prospectively analyze a commercially available PRP system1. A whole blood sample and a PRP sample that was processed immediately following blood draw according to the manufacturer's protocol were collected from each cat. The mean whole blood and PRP product platelet, RBC, WBC, neutrophil, monocyte, and lymphocyte concentrations were determined. The mean PRP product values were compared to the mean whole blood baseline values using a paired t-test with significance established at p = 0.05. Results: Mean platelet concentration was significantly increased (p = 0.0155). Mean RBC concentration was significantly decreased (p < 0.0001). Mean neutrophil concentration was significantly decreased (p < 0.0001). There was no statistically significant difference in mean WBC, monocyte, and lymphocyte concentrations. Clinical Relevance: The analyzed PRP system increased platelet concentration, while significantly reducing the RBC and neutrophil concentrations. Further study is warranted to determine the clinical applications and efficacy of PRP in felines, and the ideal concentrations of and relationships between platelets, red blood cells, and leukocytes needed for therapeutic effect.
Collapse
Affiliation(s)
- Nicole Chun
- Veterinary Orthopedic and Sports Medicine, Annapolis Junction, MD, United States
| | - Sherman Canapp
- Veterinary Orthopedic and Sports Medicine, Annapolis Junction, MD, United States.,Orthobiologic Innovations, LLC, Annapolis Junction, MD, United States
| | - Brittany Jean Carr
- Veterinary Orthopedic and Sports Medicine, Annapolis Junction, MD, United States
| | - Valerie Wong
- IDEXX BioResearch, West Sacramento, CA, United States
| | - Jeff Curry
- Orthobiologic Innovations, LLC, Annapolis Junction, MD, United States
| |
Collapse
|
21
|
Yamazaki A, Edamura K, Tanegashima K, Tomo Y, Yamamoto M, Hirao H, Seki M, Asano K. Utility of a novel activity monitor assessing physical activities and sleep quality in cats. PLoS One 2020; 15:e0236795. [PMID: 32735625 PMCID: PMC7394395 DOI: 10.1371/journal.pone.0236795] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/13/2020] [Indexed: 11/18/2022] Open
Abstract
Osteoarthritis in cats is more prevalent because cats are living longer with advancement in veterinary medicine. Objective evaluation of behavioral changes in cats with osteoarthritis can facilitate an early diagnosis. The objective of this study was to investigate the utility of a novel activity monitor for analyzing physical activities and sleep quality in cats. First, a novel activity monitor (Plus Cycle®; JARMeC, Kanagawa, Japan), with a built-in three-directional accelerometer and an air pressure sensor specifically designed for cats, was compared to a human activity monitor (Actical®; Philips Respironics, OR, USA) previously used in cats (n = 10). Second, the validity of the measurement accuracy of the amount of physical activity, the number of vibrations, the number of jumps, and the resting and sleeping time was evaluated using Plus Cycle® in healthy cats (n = 6). Finally, the effects of gender and age of cats and time of day on the amount of physical activity, the number of vibrations, the number of jumps, and the resting and sleeping time were investigated in client-owned cats (n = 61). There were strong correlations between Plus Cycle® and Actical® in total activity (p < 0.05) and activity intensity (p < 0.05). When the physical activities were measured using Plus Cycle® in healthy cats, those data were quantified with high accuracy. In addition, it was also found to be very accurate in discriminating the resting and sleeping conditions of cats. In client-owned cats, there were no significant differences with respect to gender in any measured traits. The amount of physical activity and the number of jumps significantly decreased with the age of the cat. In contrast, the resting and sleeping times significantly increased with the age of the cat. In conclusion, Plus Cycle® can accurately and objectively assess physical activities and sleep quality with age of the cat, suggesting that this novel activity monitor can be used to manage the feline musculoskeletal health.
Collapse
Affiliation(s)
- Atsushi Yamazaki
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource and Sciences, Nihon University, Fujisawa, Kanagawa, Japan
| | - Kazuya Edamura
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource and Sciences, Nihon University, Fujisawa, Kanagawa, Japan
- * E-mail:
| | - Koji Tanegashima
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource and Sciences, Nihon University, Fujisawa, Kanagawa, Japan
| | - Yuma Tomo
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource and Sciences, Nihon University, Fujisawa, Kanagawa, Japan
| | - Makoto Yamamoto
- Japan Animal Referral Medical Center, Inc., Kawasaki, Kanagawa, Japan
| | - Hidehiro Hirao
- Japan Animal Referral Medical Center, Inc., Kawasaki, Kanagawa, Japan
| | - Mamiko Seki
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource and Sciences, Nihon University, Fujisawa, Kanagawa, Japan
| | - Kazushi Asano
- Laboratory of Veterinary Surgery, Department of Veterinary Medicine, College of Bioresource and Sciences, Nihon University, Fujisawa, Kanagawa, Japan
| |
Collapse
|
22
|
Sharon KP, Thompson CM, Lascelles BDX, Parrish RS. Novel use of an activity monitor to model jumping behaviors in cats. Am J Vet Res 2020; 81:334-343. [PMID: 32228255 DOI: 10.2460/ajvr.81.4.334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To develop methods to identify and characterize activity monitor (AM) data signatures for jumps performed by cats. ANIMALS 13 healthy, client-owned cats without evidence of osteoarthritis or degenerative joint disease. PROCEDURES Each cat was fitted with the same AM, individually placed in an observation room, then simultaneously recorded by 3 video cameras during the observation period (5 to 8 hours). Each cat was encouraged to jump up (JU), jump down (JD), and jump across (JA) during the observation period. Output from the AM was manually annotated for jumping events, each of which was characterized by functional data analysis yielding relevant coefficients. The coefficients were then used in linear discriminant analysis to differentiate recorded jumps as JUs, JDs, or JAs. To assess the model's ability to distinguish among the 3 jump types, a leave-one-out cross-validation method was used, and the misclassification error rate of the overall categorization of the model was calculated. RESULTS Of 731 jumping events, 29 were misclassified. Overall, the mean misclassification error rate per cat was 5.4% (range, 0% to 12.5%), conversely indicating a correct classification rate per cat of 94.6%. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that the model was successful in correctly identifying JUs, JDs, and JAs in healthy cats. With advancements in AM technology and data processing, there is potential for the model to be applied in clinical settings as a means to obtain objective outcome measures.
Collapse
|
23
|
Ferrari JT, Schwartz P. Prospective Evaluation of Feline Sourced Platelet-Rich Plasma Using Centrifuge-Based Systems. Front Vet Sci 2020; 7:322. [PMID: 32596269 PMCID: PMC7303265 DOI: 10.3389/fvets.2020.00322] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/11/2020] [Indexed: 12/30/2022] Open
Abstract
Objective: To evaluate the hematologic components of platelet-rich plasma (PRP) generated using feline blood with two commercially available centrifuge-based systems1,2. Materials and methods: Twenty healthy adult cats were enrolled in this prospective study from November 2018 to January 2019. Feline blood samples were obtained for analysis of whole blood (WB) cellular components and preparation of PRP product. PRP was prepared using two commercial systems and complete blood count (CBC) testing was performed on both WB and PRP samples. The cellular composition of the PRP product was compared to the WB sample for each patient. Results: Both systems showed significant decrease of median RBC concentration in PRP products compared to WB samples (P = 0.002 for both systems). System 1 significantly decreased median WBC concentration (P = 0.002). System 2 decreased WBC concentration, though statistical significance was not reached (P = 0.63). Median platelet concentration was decreased by 3% using System 1, and increased by 187% using System 2. Platelet aggregation presented a challenge with 8/20 (40%) of samples demonstrating platelet aggregation. Clinical relevance: Commercial systems available for generation of PRP may be useful for creating a feline sourced product and in this study showed promise in decreasing RBC and WBC concentration. Neither system tested achieved 2–5 times platelet concentration from baseline. Platelet aggregation presented a significant obstacle to reliable generation of PRP products using feline blood. This treatment modality may be particularly beneficial for feline patients with osteoarthritis and soft tissue injuries, though first characterizing the PRP product made using feline blood is critical to validate its use in further clinical studies.
Collapse
Affiliation(s)
- Jonathan T Ferrari
- Department of Surgery, The Animal Medical Center, New York, NY, United States
| | - Pamela Schwartz
- Department of Surgery, The Animal Medical Center, New York, NY, United States
| |
Collapse
|
24
|
Mills PO, Tansey CO, Genzer SC, Mauldin MR, Howard RA, Kling CA, Jackson FR, Matheny AM, Boothe DM, Lathrop GW, Powell N, Gallardo-Romero N. Pharmacokinetic Profiles of Gabapentin after Oral and Subcutaneous Administration in Black-tailed Prairie Dogs ( Cynomys ludovicianus). JOURNAL OF THE AMERICAN ASSOCIATION FOR LABORATORY ANIMAL SCIENCE : JAALAS 2020; 59:305-309. [PMID: 32213233 PMCID: PMC7210729 DOI: 10.30802/aalas-jaalas-19-000150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 11/24/2019] [Accepted: 11/27/2019] [Indexed: 11/05/2022]
Abstract
In veterinary and human medicine, gabapentin (a chemical analog of γ-aminobutyric acid) is commonly prescribed to treat postoperative and chronic neuropathic pain. This study explored the pharmacokinetics of oral and subcutaneous administration of gabapentin at high (80 mg/kg) and low (30 mg/kg) doses as a potential analgesic in black-tailed prairie dogs (Cynomys ludovicianus; n = 24). The doses (30 and 80 mg/kg) and half maximal effective concentration (1.4 to 16.7 ng/mL) for this study were extrapolated from pharmacokinetic efficacy studies in rats, rabbits, and cats. Gabapentin in plasma was measured by using an immunoassay, and data were evaluated using noncompartmental analysis. The peak plasma concentrations (mean ±1 SD) were 42.6 ±14.8 and 115.5 ±15.2 ng/mL, respectively, after 30 and 80 mg/kg SC and 14.5 ±3.5 and 20.7 ±6.1 ng/mL after the low and high oral dosages, respectively. All peak plasma concentrations of gabapentin occurred within 5 h of administration. Disappearance half-lives for the low and high oral doses were 7.4 ± 6.0 h and 5.0 ± 0.8 h, respectively. The results of this study demonstrate that oral administration of gabapentin at low (30 mg/kg) doses likely would achieve and maintain plasma concentrations at half maximum effective concentration for 12 h, making it a viable option for an every 12-h treatment.
Collapse
Affiliation(s)
- Patrick O Mills
- Comparative Medicine Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cassandra O Tansey
- Comparative Medicine Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sarah C Genzer
- Comparative Medicine Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Matthew R Mauldin
- Poxvirus and Rabies Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rex A Howard
- Comparative Medicine Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Chantal A Kling
- Poxvirus and Rabies Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Felix R Jackson
- Poxvirus and Rabies Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Audrey M Matheny
- Poxvirus and Rabies Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Dawn M Boothe
- Clinical Pharmacology Laboratory, Auburn University, Auburn, Alabama
| | - George W Lathrop
- Comparative Medicine Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nathaniel Powell
- Comparative Medicine Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nadia Gallardo-Romero
- Poxvirus and Rabies Branch, Centers for Disease Control and Prevention, Atlanta, Georgia;,
| |
Collapse
|
25
|
Analgesia: What Makes Cats Different/Challenging and What Is Critical for Cats? Vet Clin North Am Small Anim Pract 2020; 50:749-767. [PMID: 32354487 DOI: 10.1016/j.cvsm.2020.02.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Cats have unique anatomic, physiologic, and behavioral considerations that may influence analgesia and pain management. They present specific challenges that require an individualized, feline-specific approach. This article presents an overview of recent advances in feline pain management and their differences in relation to other species and evolves on its future challenges. The main specific anatomy and physiology of the cat and how it may affect analgesia is discussed. Validated pain assessment tools including the UNESP-Botucatu Multidimensional Composite Pain Scale, Glasgow Feline Composite Measure Pain Scale, and the Feline Grimace Scale are summarized.
Collapse
|
26
|
Abstract
This article reviews the current knowledge regarding osteoarthritis-related pain in cats as a structure in which to discuss the assessment of chronic pain in the research and clinical settings. The scientific evidence available for current and emerging drug therapies is described. The importance of environmental enrichment and positive emotions to reduce pain, stress, and anxiety as means to promote feline welfare and human-pet bond is discussed.
Collapse
|
27
|
Gencoglu H, Orhan C, Sahin E, Sahin K. Undenatured Type II Collagen (UC-II) in Joint Health and Disease: A Review on the Current Knowledge of Companion Animals. Animals (Basel) 2020; 10:E697. [PMID: 32316397 PMCID: PMC7222752 DOI: 10.3390/ani10040697] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/04/2020] [Accepted: 04/06/2020] [Indexed: 12/14/2022] Open
Abstract
OA is quite common in companion animals, especially in large breed dogs and horses. Collagen, the most abundant protein of mammals, has specific connective tissue types for skin, bones, reticulate, basal lamina, bones, cell surfaces, while type II collagen (UC-II) forms the main structure of cartilage tissue. Even at the smaller dosages, UC-II has also been reported to be more effective than the glucosamine and chondroitin sulfate supplements, which are the supplements most frequently used in the market. In this review, we summarize the effects of UC-II on joint health and function in health and disease conditions in companion animals.
Collapse
Affiliation(s)
- Hasan Gencoglu
- Department of Biology, Faculty of Science, Firat University, Elazig (+90) 424, Turkey;
| | - Cemal Orhan
- Department of Animal Nutrition, Faculty of Veterinary Medicine, Firat University, Elazig (+90) 424, Turkey; (C.O.); (E.S.)
| | - Emre Sahin
- Department of Animal Nutrition, Faculty of Veterinary Medicine, Firat University, Elazig (+90) 424, Turkey; (C.O.); (E.S.)
| | - Kazim Sahin
- Department of Animal Nutrition, Faculty of Veterinary Medicine, Firat University, Elazig (+90) 424, Turkey; (C.O.); (E.S.)
| |
Collapse
|
28
|
Elliott J, Alderson B. Managing cancer pain in dogs and cats. IN PRACTICE 2019. [DOI: 10.1136/inp.l5486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
29
|
Abstract
Adjuvant analgesics (ie, gabapentin, tramadol, and ketamine) are commonly used in small animal practice. Most of these drugs are prescribed for outpatients, when pain is refractory to classic analgesics (ie, local anesthetics, opioids, and nonsteroidal antiinflammatory drugs [NSAIDs]), or when contraindications exist to the administration of other analgesics, including NSAIDs. This article reviews the mechanisms of action, clinical use, potential adverse effects, and current evidence of adjuvant analgesics in the treatment of acute pain in companion animals. These drugs should be considered as alternatives aimed at reducing or replacing opioids.
Collapse
|
30
|
Kogan L, Hellyer P, Rishniw M, Schoenfeld-Tacher R. The US Opioid Epidemic and Its Impact on US General Practice Veterinarians. Front Vet Sci 2019; 6:222. [PMID: 31334257 PMCID: PMC6620788 DOI: 10.3389/fvets.2019.00222] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 06/19/2019] [Indexed: 11/30/2022] Open
Abstract
Objective: To assess the impact of the human opioid epidemic and associated shortages in drug supply on US general practice veterinarians. Design: Cross-sectional study. Sample: Members of the Veterinary Information Network (VIN). Procedures: An electronic survey was used to examine veterinarians' views regarding opioid use in veterinary medicine and the impact of the opioid shortage on the provision of care. The survey was distributed via the VIN data collection portal from October 12-November 6, 2018. Results: 697 veterinarians completed the survey. Most (99.7%) reported using, dispensing or prescribing opioids in veterinary practice. The most commonly used opioids were buprenorphine, tramadol and butorphanol. While most veterinarians (83.3%) reported difficulty in ordering opioids over the last 6 months, this decreased to 59.0% in the last month. The most difficult drugs to obtain were hydromorphone, morphine, injectable fentanyl, and oxymorphone. The reported rate of difficulty in obtaining all these drugs lessened over time. However, the opioid shortage caused significant difficulty in providing appropriate pain management for 41.1% of participants, and affected the ability of 44.8% of respondents to provide optimal anesthesia. Conclusions and Clinical Relevance: Veterinarians' ability to provide opioids for their patients has been impacted by the opioid shortage, with a greater impact on full mu opioid agonists as compared to drugs like butorphanol, buprenorphine, and tramadol. The results confirm the important role of opioid analgesics in the delivery of modern veterinary medicine and highlight the importance of medical health professionals being able to access these critical medications.
Collapse
Affiliation(s)
- Lori Kogan
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Peter Hellyer
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Mark Rishniw
- Veterinary Information Network, Davis, CA, United States
| | - Regina Schoenfeld-Tacher
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
| |
Collapse
|
31
|
Monteiro BP, Lambert C, Bianchi E, Genevois JP, Soldani G, Troncy E. Safety and efficacy of reduced dosage ketoprofen with or without tramadol for long-term treatment of osteoarthritis in dogs: a randomized clinical trial. BMC Vet Res 2019; 15:213. [PMID: 31238912 PMCID: PMC6591828 DOI: 10.1186/s12917-019-1960-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 06/13/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the safety and efficacy of reduced-dosage ketoprofen with or without tramadol in dogs. Five healthy dogs receiving standard-dosage ketoprofen (2 mg/kg SC, then 1 mg/kg PO daily) comprised Group A. Twenty dogs with osteoarthritis were randomized to receive reduced-dosage ketoprofen (0.5 mg/kg SC once; 0.25 mg/kg PO daily) alone (Group B) or in combination with tramadol (5 mg/kg/day PO) (Group C). Treatments were administered for 28 days. Platelet aggregation time (PAT), gastrointestinal (GI) endoscopy and glomerular filtration rate (GFR) were performed up to 60 days after treatment initiation. Pain was scored using a validated clinical metrology instrument up to D120. Data were analyzed with general linear mixed model for repeated measures (α = 0.05). RESULTS PAT was not different between groups but was increased with time for all groups. GI lesion scores were higher in Group A than Groups B and C (day 28; P = 0.005) and were increased with time for Group A (P = 0.005). GFR was lower in Group A than Groups B and C (day 28; P < 0.01) and were decreased with time for group A (P < 0.001). Standard-dosage ketoprofen administration resulted in clinically relevant adverse effects. Pain score decreased in both treated groups (B and C) from D0 to D28. Need of rescue analgesia from D29 to D120 was higher in Group B than in Group C (P = 0.039). CONCLUSIONS The long-term safety profile of reduced-dosage ketoprofen is similar whether the drug is administered alone or in combination with tramadol to dogs with osteoarthritis. Analgesic efficacy of the combination looks attractive.
Collapse
Affiliation(s)
- Beatriz P Monteiro
- Department of Biomedical Sciences, GREPAQ (Groupe de recherche en pharmacologie animale du Québec), Faculty of Veterinary Medicine - Université de Montréal, 3200 Sicotte Street, Saint-Hyacinthe, QC, J2S 2M2, Canada
| | - Cedric Lambert
- Department of Companion Animals, Vet-Agro Sup, Lyon, France
| | - Elena Bianchi
- Department of Pharmacology, College of Veterinary Medicine, University of Pisa, Pisa, Italy
| | | | - Giulio Soldani
- Department of Pharmacology, College of Veterinary Medicine, University of Pisa, Pisa, Italy
| | - Eric Troncy
- Department of Biomedical Sciences, GREPAQ (Groupe de recherche en pharmacologie animale du Québec), Faculty of Veterinary Medicine - Université de Montréal, 3200 Sicotte Street, Saint-Hyacinthe, QC, J2S 2M2, Canada.
| |
Collapse
|
32
|
Adrian D, Papich MG, Baynes R, Stafford E, Lascelles BDX. The pharmacokinetics of gabapentin in cats. J Vet Intern Med 2018; 32:1996-2002. [PMID: 30307652 PMCID: PMC6271300 DOI: 10.1111/jvim.15313] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 06/21/2018] [Accepted: 07/31/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Gabapentin is the most commonly prescribed medication for the treatment of chronic musculoskeletal pain in cats. Despite this common and chronic usage, clinically relevant pharmacokinetic data is lacking. OBJECTIVES To evaluate the pharmacokinetics of clinically relevant dosing regimens of gabapentin in cats. ANIMALS Eight research-purpose mixed-breed cats. METHODS Cats were enrolled in a serial order, non-randomized pharmacokinetic study. Gabapentin was administered as an IV bolus (5 mg/kg), orally (10 mg/kg) as a single dose or twice daily for 2 weeks, or as a transdermal gel (10 mg/kg) in serial order. Serial blood samples were collected up to 48 hours. Plasma concentrations were determined using Ultra Performance Liquid Chromatography-Mass Spectrometry. Compartmental analysis was used to generate gabapentin time-concentration models. RESULTS After IV administration CL (median (range)) and terminal half-life were 160.67 mL/kg*hr (119.63-199.11) and 3.78 hours (3.12-4.47), respectively. The oral terminal half-life was 3.63 hours (2.96-4.77), and 3.72 hours (3.12-4.51) for single and repeated dosing. TMAX and CMAX , as predicted by the model were 1.05 hours (0.74-2.11), and 12.42 μg/mL (8.31-18.35) after single oral dosing, and 0.77 hours (0.58-1.64), and 14.78 μg/mL (9.70-18.41) after repeated oral dosing. Bioavailability after a single oral dose was 94.77% (82.46-122.83). IMPORTANCE Repeated oral dosing of gabapentin did not alter the drug's pharmacokinetics, making dose adjustments unnecessary with long-term treatment. As prepared, the transdermal route is an inappropriate choice for drug administration. These relevant data are important for future studies evaluating potential efficacy of the medication for treating chronic pain states in cats.
Collapse
Affiliation(s)
- Derek Adrian
- Comparative Pain Research and Education Centre, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.,Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina
| | - Mark G Papich
- Molecular and Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Ronald Baynes
- Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Emma Stafford
- Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina.,Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.,Veterinary Clinical Pharmacy, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - B Duncan X Lascelles
- Comparative Pain Research and Education Centre, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.,Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina.,Center for Pain Research and Innovation, UNC School of Dentistry, Chapel Hill, North Carolina.,Center for Translational Pain Research, Department of Anesthesiology, Duke University, Durham, North Carolina
| |
Collapse
|