Managing Neuropathic Pain in Dogs

Abstract

Disorders of the somatosensory system such as neuropathic pain are common in people with chronic neurologic and musculoskeletal diseases, yet these conditions remain an underappreciated morbidity in veterinary patients. This is likely because assessment of neuropathic pain in people relies heavily on self-reporting, something our veterinary patients are not able to do. The development of neuropathic pain is a complex phenomenon, and concepts related to it are frequently not addressed in the standard veterinary medical curriculum such that veterinarians may not recognize this as a potential problem in patients. The goals of this review are to discuss basic concepts in the pathophysiology of neuropathic pain, provide definitions for common clinical terms used in association with the condition, and discuss pharmacological treatment options for dogs with neuropathic pain. The development of neuropathic pain involves key mechanisms such as ectopic afferent nerve activity, peripheral sensitization, central sensitization, impaired inhibitory modulation, and pathologic activation of microglia. Treatments aimed at reducing neuropathic pain are targeted at one or more of these mechanisms. Several drugs are commonly used in the veterinary clinical setting to treat neuropathic pain. These include gabapentin, pregabalin, amantadine, and amitriptyline. Proposed mechanisms of action for each drug, and known pharmacokinetic profiles in dogs are discussed. Strong evidence exists in the human literature for the utility of most of these treatments, but clinical veterinary-specific literature is currently limited. Future studies should focus on objective methods to document neuropathic pain and monitor response to therapy in veterinary patients.

Questionnaire‐based Analysis of Owner‐reported Scratching and Pain Signs in Cavalier King Charles Spaniels Screened for Chiari‐like Malformation and Syringomyelia

“…It is crucial to have quantitative measures of chronic pain that are valid and reliable in clinical patients to enable development and testing of interventions (such as drugs or surgical procedures) designed to decrease such pain. Given the importance of owner observations in describing and quantifying pain in their pets, and the growing interest in identifying and treating neuropathic pain in dogs, there is a need to better understand how to identify and quantify this pain using owner assessments. Limited data are available on the utility of owner questionnaires for this condition, and none of the available questionnaires have been developed after recognized psychometric approaches .…”

Generation and characterization of highly purified canine Schwann cells from spinal nerve dorsal roots as potential new candidates for transplantation strategies

“…The population consisted of 11 female (four spayed) and 15 male (four neutered) dogs. No adverse effects, such as hyperesthesia as reported in cases of SCI in humans, dogs and rats (Moore, 2016;Wu, Raver, Piao, Keller, & Faden, 2013), were noted in the dogs during daily clinical and neurological control examinations associated with the procedure of spinal nerve dorsal root biopsy. However, as the biopsies were taken from the dorsal nerve roots in the affected spinal cord area, pain sensation might be compromised in these paraplegic dogs.…”

Das Nervenwurzelsyndrom beim Kleintier

“…B. die Sensitisierung oder chronische Umbauprozesse, eine Rolle, bei denen NSAIDs und Steroide nicht oder kaum wirksam sind [11]. Zudem treten bei Langzeittherapie mit NSAIDs und Glukokortikoiden häufig unerwünschte Arzneimittelwirkungen auf [34].…”