Neuropathic pain and prognosis of a dog submitted to limb amputation after diagnosis of soft tissue sarcoma - case report

Abstract

Neuropathic pain occurs when there is a lesion or a dysfunction of the nervous system. Humans and veterinary patients may develop neuropathic pain, but in veterinary it is not often reported probably because of its mistaken diagnosis. A canine patient was admitted to the Veterinary Hospital of UNESP-Jaboticabal-SP, Brazil with a nodule on the left thoracic limb. The nodule was surgically removed, and histopathological analysis demonstrated the tumor was a soft tissue sarcoma (STS) and the margins were not clean. Based on the patient’s health condition and the lack of suitable equipment, the next procedure was limb amputation. The patient received analgesic medication in the post-surgery period; nevertheless, clinical signs of neuropathic pain were present, such as compulsive licking and other behavioral disorders. Medications were administered for forty days, but clinical signs ceased only when replaced with a tryciclic antidepressant drug, Amitriptyline. Therapeutic management of the patient in this report can be considered effective, since five years after the end of the treatment there was no recurrence or presence of metastasis.

The link between neurology and behavior in veterinary medicine: A review

“…In case of meningitis or vertebral infections pain and behavioral changes could be the only symptoms in the absence of neurologic deficit (Bernardini, 2010;Gunn-Moore and Reed, 2011). Indeed, pain-related consequences due to neurological diseases can lead to aggressive behavior (Affenzeller et al, 2017;Barcelos et al, 2015;Belshaw and Yeates, 2018;Camps et al, 2012;Lascelles et al, 2019;Mills et al, 2020), noise hypersensitivity (Fagundes et al, 2018;Lindley, 2012;McPeake et al, 2017), obsessive-compulsive disorder (Dalğin et al, 2017;Ferreira et al, 2019;O'Hagan, 2006;Zulch et al, 2012), and changing in learning ability (Worth et al, 2013). As shown in Table 2, other behavioral signs linked to neurological conditions include inappropriate elimination, depression, reduced activity, somnolence, apathetic behavior, changes in ingestive behavior, cognitive dysfunction, learning and memory deficits, dementia, non-specific anxiety/fear and anomalies of sexual behavior.…”

Insights into the spatial ecology of severely injured free‐living felids: Iberian lynx, bobcat, and snow leopard

“…Limb amputation (a salvage surgical procedure to treat severe trauma, extensive nerve injury, malignant neoplasia, severe infection, ischemia, necrosis of the limb, severe disability, and congenital disorders) (Ferreira et al., 2019; Gabriel et al., 2017; Kim et al., 2020) may particularly impact individuals' long‐term fitness and survival (Argyros & Roth, 2016). Although rehabilitation and release or observation of carnivores that experienced a limb amputation has been described (e.g., river otter ( Lontra canadensis ), Kellnhauser, 1970; Iberian wolf ( Canis lupus signatus ), Rio‐Maior et al., 2016; raccoon dog ( Nyctereutes procyonoides ), Kim et al., 2020; Asiatic black bear ( Ursus thibetanus ), Jeong et al., 2021), there are no available reports of the rehabilitation, release, post‐release survival or movement patterns of amputee free‐living felids.…”