Lung Lobectomy as an Adjunctive Treatment for Refractory Pulmonary Coccidioidomycosis in a Dog

Abstract

The robust advances in pain management for companion animals underlie the decision of AAHA and AAFP to expand on the information provided in the 2007 AAHA/AAFP Pain Management Guidelines for Dogs and Cats . The 2015 guidelines summarize and offer a discriminating review of much of this new knowledge. Pain management is central to veterinary practice, alleviating pain, improving patient outcomes, and enhancing both quality of life and the veterinarian-client-patient relationship. The management of pain requires a continuum of care that includes anticipation, early intervention, and evaluation of response on an individual-patient basis. The guidelines include both pharmacologic and nonpharmacologic modalities to manage pain; they are evidence-based insofar as possible and otherwise represent a consensus of expert opinion. Behavioral changes are currently the principal indicator of pain and its course of improvement or progression, and the basis for recently validated pain scores. A team-oriented approach, including the owner, is essential for maximizing the recognition, prevention, and treatment of pain in animals. Postsurgical pain is eminently predictable but a strong body of evidence exists supporting strategies to mitigate adaptive as well as maladaptive forms. Degenerative joint disease is one of the most significant and under-diagnosed diseases of cats and dogs. Degenerative joint disease is ubiquitous, found in pets of all ages, and inevitably progresses over time; evidence-based strategies for management are established in dogs, and emerging in cats. These guidelines support veterinarians in incorporating pain management into practice, improving patient care.

Analgesia in the Perioperative Period

“…They are incorporated into a balanced analgesic plan in several ways and it is recommended that they be included in the plan of every surgical patient. 28 Local anesthetics prevent the conduction and propagation of nerve impulses by binding to voltage-gated sodium channels, producing complete analgesia. 29 Adverse events associated with local anesthetic administration are usually the result of inadvertent intravenous administration (bupivacaine) or overdose.…”

Catestatin, vasostatin, cortisol, and pain assessments in dogs suffering from traumatic bone fractures

“…However, despite receiving morphine analgesia, the subjective pain assessment scores were still higher in dogs with fractures than in the healthy dogs, indicating a suboptimal analgesic effect. Traumatic bone fractures may require multimodal analgesia and single morphine injections are often insufficient [2, 5, 56, 57]. The administration route and circulatory competency of the patient may affect the bioavailability of morphine sulfate.…”

Gestion de la douleur en chirurgie vétérinaire : aspects éthiques et pratiques chez le chien

“…Elle est moins simple à repérer, bien que responsable de plus de souffrance et de mal-être. Elle se caractérise plutôt par un état de dépression et par l'absence de comportements normaux tels que la locomotion, l'exploration, l'appétit et l'interaction (Epstein et al 2015). Reconnaître l'expression de la douleur nécessite un évaluateur averti et expérimenté qui utilise intuitivement plusieurs paramètres d'observation pour se faire une opinion.…”

“…Tout particulièrement en chirurgie, connaissances et savoir-faire à propos de la prise en charge de la douleur ont considérablement progressé et deviennent incontournables. La gestion de la douleur en chirurgie vétérinaire est devenue une obligation (Epstein et al 2015).…”