Perioperative use of non‐steroidal anti‐inflammatory drugs in cats and dogs

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) are efficacious analgesics that contribute to preventive and multimodal analgesic techniques. They are widely used for routine surgeries in cats and dogs and there is some evidence that it is advantageous to give NSAIDs before the start of surgery, rather than in the postoperative period. Despite their efficacy, the side effects of NSAIDs should always be taken into consideration when deciding whether to administer them to a particular patient. The kidney is a particularly vulnerable organ during anaesthesia, due to the high prevalence of hypotension in anaesthetised patients; the administration of a NSAID preoperatively means that it is imperative to monitor and support blood pressure during anaesthesia to prevent renal compromise on recovery. This article summarises the mechanism of action of NSAIDs and provides guidance for practitioners on their use in the perioperative period.

Acute intestinal obstruction after methylene‐diphenyl‐diisocyanate‐based glue ingestion in a dog

“…NSAIDs were not considered appropriate options for this patient as they can increase the risk of postoperative enteroanastomosis leakage, they affect production of vascular endothelial growth factor and angiogenesis, and they interfere with collagen formation and cross‐linking 22 . Cyclooxygenase‐derived prostaglandins are important in angiogenesis and healing in the gastrointestinal tract of dogs so NSAIDs were not administered in this case 23 . In addition, paracetamol was not used as there is lack of scientific evidence for its administration in dogs with gastrointestinal disease 23 .…”

“…Cyclooxygenase‐derived prostaglandins are important in angiogenesis and healing in the gastrointestinal tract of dogs so NSAIDs were not administered in this case 23 . In addition, paracetamol was not used as there is lack of scientific evidence for its administration in dogs with gastrointestinal disease 23 . There are limited published data on the analgesic efficacy of paracetamol in dogs, although anecdotally paracetamol has been used both intravenously and orally in some dogs where NSAIDs were contraindicated due to the risk of renal or gastrointestinal side effects 23 .…”

“…In addition, paracetamol was not used as there is lack of scientific evidence for its administration in dogs with gastrointestinal disease 23 . There are limited published data on the analgesic efficacy of paracetamol in dogs, although anecdotally paracetamol has been used both intravenously and orally in some dogs where NSAIDs were contraindicated due to the risk of renal or gastrointestinal side effects 23 . However, the relative safety of paracetamol compared to traditional NSAIDs is unknown 23 .…”

Prospective comparison of perioperative wound and pain score parameters in cats undergoing flank vs midline ovariectomy

“…21 Given that cats are also likely to experience discomfort following OVE, with evidence that behavioural changes can be observed in the first 3 days following surgery, the use of an extended course of oral NSAID should be considered for at least this time period following OVE. 20,22 Significant limitations of the long-term follow-up performed in this study include the declining proportion of cats returning for the 3 day and then 10 day reexaminations and that it was not possible to have a single assessor conduct all postoperative wound assessments, even for the same cat. Six veterinary surgeons participated in the study, all of whom were trained in the study protocol by the lead assessor prior to participating.…”

“…21 Given that cats are also likely to experience discomfort following OVE, with evidence that behavioural changes can be observed in the first 3 days following surgery, the use of an extended course of oral NSAID should be considered for at least this time period following OVE. 20,22…”