Non-steroidal anti-inflammatory drugs (NSAIDs) are good for chronic and acute . . . → Read More: Pain medication for dogs]]> Medication can be used to treat chronic or acute pain in dogs.
Chronic pain is associated with conditions such as arthritis or dysplasia:
Acute pain may be caused by surgery or injury. Some medications are used for both types of pain. Continue for pain medication charts and comparisons.

Non-steroidal anti-inflammatory drugs (NSAIDs) are good for chronic and acute pain, but can cause ulcers. COX-2 inhibitors are less likely to cause ulcers but can have other side effects. Call your vet if the dog has diarrhea, stool that are black and tarry,decreased appetite or vomiting.
See link for chart below for non-narcotic pain meds.

Narcotic pain meds:
Narcotic medications will work well in combination with NSAIDs, but also work well alone. Certain narcotics should not be used at the same time or one right after another. A veterinarian should supervise administration of narcotics. Your vet may not keep in stock narcotics but can write your dog a prescription. Check your local pharmacies for prices, which may vary widely.
Sedation and constipation are common side effects of narcotic medications. Opioid absorption is only about 15% from orally administered meds.
See link for chart below.

non-narcotic pain meds
narcotic pain meds

Alternative therapies:

Acupuncture seems to work very well for some patients for both acute or chronic pain. Some patients still need pain medication but either at a lower dose or a less potent medication may be able to be used. Acupuncture frequently needs to be ongoing for chronic pain conditions. Check for a veterinary acupuncturist who is certified.<

Objective; To determine and compare levels of sedation achieved by IM administration of diphenhydramine, saline (0.9% NaCl) solution, and . . . → Read More: Sedative prior to anesthesia]]> Benadryl as a sedative prior to anesthesia
Abstract

Objective; To determine and compare levels of sedation achieved by IM administration of diphenhydramine, saline (0.9% NaCl) solution, and acepromazine in dogs.

April 1, 2005 (Vol. 226, No. 7)
Evaluation of diphenhydramine as a sedative for dogs
Erik H. Hofmeister, DVM, and Christine M. Egger, DVM, MVSc, DACVA *

Design;Prospective randomized study.

Animals;56 dogs.

Procedure;”Dogs were randomly assigned to receive diphenhydramine at 2, 4, or 8 mg/kg (0.9, 1.8, or 3.6 mg/lb, respectively) IM; acepromazine at 0.1 mg/kg (0.05 mg/lb) IM; or saline solution at 0.05 mL/kg (0.02 mL/lb) IM. Sedation was assessed by use of a 6-category descriptive system based on observation and interaction.

Results;”Dogs in the acepromazine group had significantly higher sedation scores than did dogs in the saline solution or diphenhydramine groups at 30 minutes. Dogs in the diphenhydramine groups did not have significantly different sedation scores from dogs in the saline solution group at any time point.

Conclusions and Clinical Relevance;”Diphenhydramine did not cause clinically appreciable sedation in healthy dogs. Diphenhydramine is not suitable as a sole sedative prior to general anesthesia in dogs. (J Am Vet Med Assoc 2005;226:1092–1094)

A must have book for referencing dog medication is the Pill Book Guide to Medication for your Dog and Cat by Bantam books for about $7.00 avail. at most bookstores. If you have a molosser be sure that your vet or vet anesthesiologist knows not to premedicate him with acepromazine.<

Many post-surgical patients at the Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania wear patches on their rumps, sticky plasters that slowly release painkillers into the animal’s bloodstream through the skin. The animals appear to be calm and comfortable. They don’t fret, pant or whine. “We manage acute . . . → Read More: Post op pain management]]> Chronic Pain — A Veterinary Frontier
April 1, 2003

Many post-surgical patients at the Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania wear patches on their rumps, sticky plasters that slowly release painkillers into the animal’s bloodstream through the skin. The animals appear to be calm and comfortable. They don’t fret, pant or whine.
“We manage acute pain, such as post-operative pain, very well,” says Dr. Dorothy Brown, assistant professor of surgery. “But we are not so adept at managing chronic pain in our patients.”
Veterinary medicine is paying increased attention to the management of chronic pain as animals are living longer, just like people. And they have the same kinds of ailments such as arthritis, disk disease, cancer and other ailments.
“Owners ask veterinarians to treat chronic pain in their pets,” says Brown. “We have a limited number of drugs at our disposal and we are just learning how to manage chronic pain in pets.”

Painkillers can generally be divided into two categories, opiates and nonsteroidals.

“In essence, painkillers either come from the poppy or tree bark,” says Brown. “The products on the market are all derivatives of these ancient ingredients. People have manipulated the properties of the poppy and aspirin and have developed a multitude of products. Some are helpful to our patients, others are lethal because animals metabolize these substances differently.”
To manage pain in animals is difficult. They can’t verbally communicate that they are in pain or where they hurt. Often signs that an animal is in pain are subtle and it takes a very observant owner to pick up these frequently slight behavior changes. And sometimes a slowing down is assumed to be due to advancing age and not pain. It is the owner who assumes, by the pet’s changed behavior, that it is in pain. The veterinarian then has to decide what kind of pain it is — acute or chronic — and how severe it is.

“We have to rely on the owners for information,” says Brown. “They have to tell us about behavioral changes and from that we have to decide what we are dealing with. It is difficult, particularly in chronic pain cases. The owner’s idea of severe may be different from the veterinarian’s notion of severe. We don’t have behavior-based chronic pain scales for dogs or other pets.”

Such pain scales exist in human medicine and they are used with great frequency. Many hospitals regard pain as the fifth vital sign, similar to blood pressure, pulse, temperature and respiratory rate, and have institutionalized pain assessment. This is particularly important with patients who do not communicate well. In human medicine it is known that chronic pain is frequently undertreated; this may be due to patients’ reluctance to seek medical help, to resignation of living with pain, or to physicians’ hesitation to prescribe a stronger medication.

“We don’t know whether chronic pain is undertreated in veterinary medicine,” says Brown. “We have to rely on the owner to tell us whether the animal is more comfortable after being given pain medication. We don’t know whether we have maximum pain relief because the animal can’t tell us and we have no behavior based pain scales for animals.”

Dr. Brown is exploring the development of such pain scales for dogs. She is conducting a study of dogs with bone cancer. This disease also occurs in humans and the stages of pain severity as the disease progresses to the end stage are known. The cancer presents the same histologic picture, whether the tumor sample comes from a human or a dog. It affects the same population — primarily large males, and can have a similar age of onset in both species.

Brown is treating her canine patients with an experimental painkiller and the owners report on their animal’s response to the drug, whether they perceive the pain as being relieved and to what extent. Brown has developed several questionnaires with the help of Dr. John Farrar from Penn’s School of Medicine. Owners complete it by answering questions about the dog’s behavior and the amount of pain they feel the animal is experiencing prior to and after administration of the drug. Brown hopes that this yearlong study will yield better information on chronic pain in canines and point to a way to manage it. It may also aid in the development of chronic pain scales.

“There is no specific marker for pain that we know,” Brown says. “Certain values, such as cortisol, go up when an animal is in pain. But they also go up when an animal is stressed. If you anesthetize two animals, spay one, do nothing to the other, both will have the same stress markers even though the one that experienced the surgery may have pain. So we are dependent on observation. This is where behavioral pain scales come in. They would enable the veterinarian to better tailor painkilling drugs to the patient.”

The study is not yet completed and it will take many months of work to evaluate the questionnaires. One thing is clear, there is a need for objective evaluation of chronic pain.
“When I contacted referring veterinarians for leads on probable cases, I was overwhelmed by the response,” says Brown. “There is a great need to learn more about chronic pain in pets and how to manage it. We are just at the beginning.”

http://www.upenn.edu/researchatpenn/article.php?653&sciSource: Bellwether: For Additional Information Contact: University Communications at 215-898-8721.

While it is true that post op pain limits the dog’s mobility so that they will be more sedentary, narcotic analgesia will also make . . . → Read More: Pain management]]> Pain management

While it is true that post op pain limits the dog’s mobility so that they will be more sedentary, narcotic analgesia will also make the dog feel more lethargic without experiencing undue pain. If your dog is having surgery, we recommend that you treat your canine friend with kindness and ask your vet to prescribe a post op narcotics. Other anesthesia considerations can be referenced at www.agri.huji.ac.il/~hylton/newisvet/ad.htm

http://opioids.com/fentanyl/caninefentanyl.html
Postoperative pain management using
fentanyl patches in dogs
by
Gilbert DB, Motzel SL, Das SR.
Merck Research Laboratories,
Laboratory Animal Resources,
Merck and Co. Inc., P.O. Box 4,
Sumneytown Pike, West Point,
PA 19486, USA.
Contemp Top Lab Anim Sci. 2003 Jul;42(4):21-6.

ABSTRACT

To the ability of the fentanyl patch to control pain in a postoperative canine model, we provided two male beagles with 25-mg/h patches and two with 50-mg/h patches 24 h prior to surgery. Each animal underwent a major abdominal surgical procedure to place three separate catheters with associated vascular access ports. Serum plasma levels of fentanyl were analyzed at multiple time points throughout the study period. Animals were subjectively assessed for postoperative pain by using a Simple Descriptive Scale at regular intervals postoperatively. Other parameters observed and recorded included heart and respiration rates, rectal temperature, appetite, and activity. The fentanyl patch appeared to adequately control postoperative pain in our canine abdominal surgical model. Three animals demonstrated mild pain 1 to 2 h postoperatively. Two animals, one from each dose group, showed mild pain 8 h postoperatively. Mild pain is commensurate with USDA category C, which encompasses procedures that do not result in more than momentary or slight pain or distress and do not require intervention. At no other time points were any of the animals considered to be in pain. Our study also suggested that increased subcutaneous fat delayed the rate of absorption of fentanyl. The lower body-weight beagles, which had the 25-mg/h patches, reached reported human serum analgesic levels within 8 h after placement, whereas the heavier beagles with the 50-mg/h patches reached human serum analgesic levels 12 h after placement. Fentanyl concentrations remained at the reported human analgesic levels in all animals between 2 to 4 h after the patches were removed. Regardless of the dose, decreases in heart rate, respiration rate, and temperature were observed in all four animals 12 h after placing the patches. Issues regarding the regulatory requirements to prevent drug abuse, the side effects and potency of fentanyl, and the prolonged duration of action as a transdermal system should be addressed by the veterinarian when considering usage of this analgesic method. <