Chronic Pain Lecture Flashcards
Discuss the basics of ‘chronic pain’
Chronicc pain is ‘pathologic pain’
‘pain without apparent biological value which has persisted beyond normal tissue healing time
pain without apparent biological value” –> that has simply peristed, or persisted beyond expected tissue healing time
Discuss pathologic pain
- also called ‘maladaptive pain’
- anything thats chronic is pathologic
What changes are listed for acute pathologic pain?
- periperhal sensitization
- central sensiztation
How is acute pathologic pain different than that of chornic pain
- Physical and pathologic chnages in the pain pathway
- can persist without the intial cause
- ## ,may not repsond to traditonal theraoy
Discuss the different cuases of chronic pain
- Most common cause –> osteoarthritis (OA) or degenrative joint disease (DJD) in all animal species
- neuropatjic –> disc disease; nerve injury;
- lamintis
Cancer (more in small animals)
What is the lameness scale in cattle
- has to do with the cow and how it stands (is the back arched a lot or no) and howit walks and placement of its feet
Discuss small animal chornic pain therapy
- Anti inflammatory: NASAID or piprant
- Gabapentin
- Nutraceuticals & joinnt healh modifiers
- Tramaodol
- opiods
Like acute pain, **multimodal ** therapy will be required for moderate-severe chroinc pain
Discuss large animal chornic pain therapy
- Non steroidal antiinflammatory drugs (NSAIDS)
- joint health moidifers
- non-pharmaocological antagonists
- ## Bisphosphonates
Discuss antiinflammatories
- analgesics
- anti inflammatory
- ## treat pain at its source
Discuss NSAIDS in cattle vs horses
FDA approved NSAIDS in horses:
- Flunixin meglumine
- phenylabutazone
- ketoprofen
- firocoxib
- \diclofenac sodium (topical)
FDA approved NSAIDs in cattle:
- topical flunixin meglumine
Discuss gabapentin
- Used an an anti-seizure drug in both humans and animals
- Also used tp treat ‘neuropathic pain’
Discuss amantadine
- originally released as an antiviral agent
- also an N-methyl-D-aspartae receptor antagonist (NMDA-antagonist)
- so it has a role in poain management
- amanatdine in a multimodal analgesic regimen for alleviation of refractory osteroarthritis (OA) pain in dogs
What are some joint modifiers in small animals
- Adequan
- ## theres a bbunch of them when considers joint health modifiers for horses
Discuss ketamine infusions
- ## main thing here is you can administer with an opioid (smal animal) and/or lidocaine
Discuss bisphosphonates
Bisphosphonaytes, such as tiludronate, are used to normalize bone metabolism via inhibition of bone resorption. Areas of increased bone repsorrion and dormation are typical lesions in a diseased navicular bone
