A multidisciplinary study of pain in cats undergoing dental extractions: A prospective, blinded, clinical trial

Abstract

This study aimed to evaluate pain scores, analgesic requirements, food intake and serum inflammatory cytokines in cats before and after clinically recommended dental treatment. Twenty-four cats were included in a prospective, blinded clinical trial. Cats were equally divided into minimal (minimal dental treatment) or severe (multiple dental extractions) oral disease groups. They were admitted (day 0) and underwent oral examination/radiographs/treatment under general anesthesia (day 1; acepromazine-hydromorphone-propofol-isoflurane-meloxicam-local anesthetic blocks). Serum inflammatory cytokines were measured on days 0 and 6. Pain was scored using the Glasgow composite measure pain scale-feline (CMPS-F). Rescue analgesia was administered with hydromorphone if CMPS-F ≥ 5/20. Dry and soft food intake (%) during 3 minutes and 2 hours, and daily soft food were calculated. The Cochran-Mantel-Haenszel and Chi-square tests, Spearman’s rank correlation and linear mixed models were used for statistical analysis (alpha = 0.05). Pain scores were significantly increased in cats with severe disease when compared with baseline (up to day 4) and minimal disease (all postoperative time points). Prevalence of rescue analgesia was significantly higher in severe (91.7%) than minimal disease (0%); analgesics were required up to day 3. Pain scores and frequency of rescue analgesia were significantly correlated with the number of tooth extractions, gingival and calculus index. Prevalence of rescue analgesia was significantly correlated with the number of missing teeth, teeth extractions and gingival index. Dry and soft food intake during 3 minutes, and dry food intake during 2 hours were significantly lower in the severe than minimal disease group throughout the study. Some cytokines differed between groups between day 0 and day 6 and were associated with the presence of tooth resorption and number of missing tooth and tooth fractures. Long-term analgesia is required after dental extractions in cats with severe oral disease. This condition reduces food intake and influences serum inflammatory cytokines.

Pain behaviors before and after treatment of oral disease in cats using video assessment: a prospective, blinded, randomized clinical trial

“…Descriptive statistics for age, body weight, body condition score, dental score and number of extracted teeth are presented in Table 1. Cats in the minimal oral disease group were younger and lighter than those in the severe oral disease group as previously reported [12] (Table 1).…”

“…This study identified specific pain-induced behaviors associated with oral disease in cats undergoing dental treatment. According to our hypotheses, these behaviors differed between cats with minimal and severe oral disease, and new behaviors appeared after the dental procedure due to postoperative pain [12]. Overall, cats with severe oral disease were less active when compared with baseline or cats with minimal oral disease.…”

“…Chewing the dry food by using the remained teeth but also the gingiva/wound where teeth were extracted may produce pain. Our previous study showed that the amount of dry and soft food intake for 3 min, and dry food intake for 2 h were significantly decreased in cats with severe oral disease [12]. The study concluded that cats with oral pain require longer periods of time to eat both dry and soft food than those with minimal pain.…”

“…dental cleaning, extractions, etc.) until pain is severe, and when there is a substantial impact on the cat's nutritional/welfare status [12]. Additionally, it is not known how behaviors associated with oral pain differ between painful and non-painful cats, and how they are affected by treatment of oral disease.…”

“…In addition, dental extractions would produce postoperative pain and induce the appearance of new behaviors. This exploratory study represents a follow-up report on a recent publication where pain scores and prevalence of rescue analgesia, food intake, changes in inflammatory biomarkers, and the correlation between pain and the number of tooth extractions, gingival and calculus index were studied before and after oral treatment in cats with minimal and severe disease [12].…”