Wednesday, September 28, 2022

Pain Meds For Cats After Surgery

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How to give oral medication to a cat

Your cat should be interested in food after surgery, although it may take 12-24 hours for her appetite to return after anesthesia and the stress of the procedure.

Continue to feed your cat according to your veterinarians instructions. If you are concerned about your cats appetite, please contact your veterinarian, as some oral medications can cause decreased appetite and nausea .

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Give Better Relief With Multiple Medications

In our interview with feline pain expert Stephen Cital, we learn that when the body is in pain, it releases cortisol. This causes internal stress, delays wound healing and can even suppress the immune system. Attacking pain in multiple ways will speed up the healing. Using smaller amounts of multiple drugs has a better effect than one big dose of one drug.

When I say multimodal, that means multiple different drugs, not just one drug like you mentioned at a high dose, says Cital. And whats nice about mixing different drugs or doing polypharmacy is when you mix different drugs, some of these drugs play really nice together and they can potentiate each other so it makes them work better and we can use them at lower dosages, which is going to get rid of some of the negative side effects we would see with a big, huge dose of buprenorphine or a big, huge dose of a particular nonsteroidal anti-inflammatory.

To learn even more about managing post-amputation pain medication for cats, listen to our conversation with Stephen Cital. Its on the Tripawd Talk Radio episode, Tripawd Cat Pain Management Tips and Tricks.

Local Anesthetics In Feline Pain Management

Local anesthetics are an important part of the feline pain prevention approach. Everyone has had a local anesthetic shot at the dentist before a cavity is drilled. It keeps you from feeling the pain associated with the drilling. It also minimizes your discomfort even after the local anesthetic wears off, by having helped prevent pain, to begin with. Local anesthetics are used in feline dental work and in nearly all surgical procedures just as they are in human medicine.

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Pain Relief After Major Surgery

A primary goal of pain management after major surgery is for you to awaken relatively comfortable and to experience an uninterrupted transition to pain control, but some discomfort is common and should be anticipated after surgery.

Patient-controlled analgesia

A patient-controlled analgesia system allows you to give yourself a dose of intravenous pain medicine, with the push of a button. This system decreases any pain and anxiety you may feel while waiting for medicine.

Epidural delivery of pain medication

In epidural analgesia, pain relievers are injected into the epidural space, which is within the spinal canal but outside the spinal fluid. A long, thin tube called a catheter , inserted between two vertebrae in the back, delivers the medication.

Dog Surgery Aftercare Faqs

My female kitten (6 months) has been spayed (ovariohysterectomy ...

After your dogs surgery, youll likely be asked to administer medications for pain, monitor the surgery area, and perform special tasks at home to help your dog on the road to recovery.

While these may be simple tasks for a veterinary professional, they can be a bit overwhelming to a dog owner. Knowing what to expect and what to watch for can be helpful. Specific aftercare instructions will vary depending on the nature of your dogs surgery, their condition before the procedure, and whether there were any complications.

This guide for dog surgery aftercare will answer the most frequently asked questions, explain what you can expect, and tell you what to look for as your dog recovers at home.

Jump to a section:

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Behaviors Suggestive Of Postoperative Pain In Cats

In people, pain is what the patient says it is. But in animals, it’s what we say it is. To better recognize acute pain in cats, observe patients for the behavioral changes described here.

In the United States, pet cats outnumber pet dogs, yet our understanding and treatment of pain in cats has lagged behind that in dogs. Veterinarians consider surgical procedures in dogs and cats to be equally painful but treat cats perioperatively for pain less often than dogs.1 This undertreatment of pain results, in part, from the difficulty in recognizing and assessing pain in cats.

Various pain-scoring systems have been used to assess postoperative pain. These systems measure physiologic data or evaluate behavior or do both. Algometers and pressure platform gait analysis are objective pain measuring tools, whereas the visual analog scale is an example of a widely used subjective scoring system. The basic VAS used for assessing pain consists of a continuous line anchored at either end with a description of the scale’s limits. For example, “no pain” would be at one end of the scale and “severe pain” would be at the other. The observer places a mark on the line that he or she thinks correlates to the animal’s degree of pain. This mark is later converted to a number by measuring the distance of the mark from zero.

Is Spaying Or Neutering My Dog Safe

Yes. These surgeries are common veterinary medical procedures that most vets get plenty of experience performing. That said, as with people, whenever an animal is put under anesthesia for a procedure, there is some risk involved. Your veterinarian will closely monitor your dog throughout the surgery and be on the lookout for signs of illness or any possible complications.

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Fda Approves First Topical Opioid For Postoperative Pain Cats

Its been a good month for cats at the US Food and Drug administration .

On January 13, the FDA approved Zoetis Solensia for the control of pain associated with osteoarthritis in cats. Its the first monoclonal antibody new animal drug approved by the FDA for use in any animal species.

Then, a week later, on January 20, the agency approved another first for pain-management in cats: Elancos Zorbium , the first transdermal buprenorphine animal drug intended to control postoperative pain in cats.

Buprenorphine is an opioid pain medication that works by acting on pain receptors in the central nervous system. Zorbium is a solution thats applied to the skin at the base of the cats neck and is rapidly absorbed into the layers of the skin. It provides pain relief within one to two hours following administration and continually releases buprenorphine into the body over a period of days.

Because Zorbium is a long-acting transdermal solution applied in the veterinary hospital, it may eliminate or reduce the need for cat owners to administer additional pain medications. A single application provides pain relief to the cat for four days.

This approval gives veterinarians an additional option for controlling pain in cats after surgery.

The FDA approved an injectable buprenorphine for use in cats in 2015. The FDA also previously approved a nonsteroidal anti-inflammatory drug called Onsior, available as both an injectable and as a tablet for use in cats for postoperative pain.

A Balancing Actbenefits Versus Risks

Multimodal Management of Feline Surgical Pain

FDA-approved nonsteroidal anti-inflammatory drugs offer pain relief for many dogs with osteoarthritis. These drugs also help veterinarians effectively manage pain after surgery in both dogs and cats. Yet, there are risks.

NSAIDs account for a large number of animal drug side effects reported to FDAs Center for Veterinary Medicine. If you consider the two most common groups of pets that receive NSAIDs, you can see why there are so many reported side effects:

  • Dogs with osteoarthritis. These dogs are usually older and often have another disease in addition to osteoarthritis, such as kidney or liver disease.
  • Surgery patients. These dogs and cats were recently under anesthesia which reduces blood flow to the kidneys.

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Dogs Are Not Small People

Tinker Bells owner isnt alone. When owners see their dog or cat limping or showing other signs of pain, they often think about giving their pet an over-the-counter pain reliever for people. But even if data show an NSAID is safe and effective in people, the drug may not be safe and effective in dogs because the drug may:

  • Last longer
  • Be absorbed faster by the stomach and intestines and
  • Reach higher blood levels.

Administered With Ease & Accuracy

Ideally, for optimal practical administration, NSAIDs should be:

  • Available in an injectable and palatable, oral formulation
  • Easily titrated and have an easy-to-determine dose.

These 2 formulations should be usable and approved for use, interchangeably. For example, an injectable formulation facilitates both perioperative and immediate postoperative pain management, when it may be difficult or impossible to medicate animals orally. However, an oral formulation is beneficial for postoperative pain management upon discharge and long-term chronic pain management because it allows the drug to be administered in the home environment.

For cats specifically, palatable oral formulations facilitate administration and complianceimportant components of pain management. Cats are selective about what they eat, and it is difficult to hide an unpalatable pill or medication in food or a treat, as is often done with dogs. If the cat wont willingly take the medication, it must be restrained and dosed.

An NSAID formulation should be easily titrated, if necessary, and/or have an easy-to-determine dose. In tablet form, it should have a wide dose range that allows for administration of whole tablets, rather than fractioning tablets in order to stay within the therapeutic range.

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Is It Bad For My Cat To Lick The Incision Site Does My Cat Have To Wear A Cone

Grooming and licking the surgical site can cause secondary complications such as infections, irritation, and damage to the sutures, making them fall out before they should.

In order to ensure proper healing of the area, your cat should not lick the surgery area, as their paws and mouth harbor bacteria that can lead to infection. Secondary infections of the skin are common from licking and grooming the surgery site.

Protecting the surgery area is very important, and for many incisions, bandages are not recommended since many wounds need air to help with healing. Also, bandages can create pressure that can cause other secondary issues.

What Analgesia Should Be Provided Following Neutering

Shelter Vets Perform FHO, Save Kitten

The 2022 ISFM Consensus Guidelines on the Management of Acute Pain in Cats strongly recommends the use of preventative and multimodal analgesia, along with good nursing care and optimisation of both the clinical and home environments as part of a successful pain management plan.4

Depending on the peri-operative analgesia protocol used, analgesia following castration or ovariohysterectomy/ovariectomy may be required for least 1 and up to 3 days after surgery using non-steroidal anti-inflammatory drugs. Local analgesia such as testicular blocks and local application to the ovarian pedicle can also improve post-neutering comfort as part of a multimodal pain management plan, as described in the guidelines.4

Want to learn more?

Watch our free to view webinar Building optimal analgesic protocols with the ISFM acute pain management guidelines presented by Dr Paulo Steagall Associate professor of Veterinary Anesthesiology and Pain Management at the Université de Montréal, Canada.

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How To Care For Your Cats Stitches

The surgical incision site should be monitored. A little swelling is expected immediately after surgery however, promptly bring to your veterinarians attention any discharge or oozing, pain, excessive bruising or foul odor.

  • Do not apply topical ointments or creams to the incision site.
  • Do not pet, brush or groom the incision area or bathe the cat while he has sutures in place.
  • The skin in that area will be tender and sensitive, and the incision should not be allowed to get wet.
  • Use an Elizabethan collar on your cat, as felines are notorious for their ability to quickly chew out the sutures that are holding the incision together.

Most sutures can be removed 10 to 14 days after the surgery. This allows your veterinarian to observe the incision and see how well the patient is doing in person. Because the first 24 to 48 hours post-operatively are the most important, its imperative that you know where to take your cat if a problem develops after hours. This is not a problem if your veterinarians facility is open around the clock however, if your vets office closes in the evening, know where the nearest 24-hour emergency facility is. Bring to the emergency clinic any medications that youve been administering and a copy of any written discharge orders given to you by your veterinarian.

Thumbnail: Photography by Shutterstock.

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Good Surgical Technique Minimizes Feline Pain

Surgical technique is very important when minimizing feline pain. A gentle surgical technique induces less pain than a rougher one. A technique that damages less tissue induces less pain. The proper surgical equipment, in the proper condition, can also influence the amount of post-operative pain experienced by the patient. Sharp tissue scissors are an excellent example of this everyone knows that a cut from a very sharp edge hurts less than one from a blunt edge. The experience and expertise of the surgeon is very important in feline pain prevention, as is the choice and condition of the instruments used.

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So How Do We Control Pain In Dogs And Cats After Surgery

The time when your pet is given an anaesthetic drug to make them unconscious is referred to as induction of anaesthesia. The provision of pain relief starts before induction. Drugs given just before the induction of anaesthesia are referred to as premeds short for premedication or preanaesthetic medication.

My Cat Is Sneezing After Surgery Why

CATS AFTER ANESTHESIA

Some sneezing may occur three to seven days after your cat undergoes a surgical procedure.

Speak with your veterinarian about certain medical conditions that can cause upper respiratory conditions in cats. The most common reason for this sneezing is Feline Upper Respiratory Complex. This condition occurs during times of physical or mental stress due to a series of underlying virusesherpesvirus, among others.

Around 95% of cats carry herpesvirus, and it is subclinical until a stressful event occurs. You might see clear nose and eye discharge along with sneezing. These symptoms will resolve in five to seven days. The symptoms are very mild and should not progress to other issues like open-mouth breathing, discolored eye and nasal discharge, or decreased eating.

In some cases, a secondary bacterial infection may occur. For these cases, take your cat for a recheck exam with your primary care veterinarian to determine the next steps in your cats care. If you notice yellow, green, or blood-tinged nasal discharge, this is not normal and should warrant a recheck as soon as possible.

Dental disease, upper and lower respiratory tract infections, heart disease, and other conditions can cause secondary respiratory complications. If your cat has had a procedure involving their teeth, chest, head, or lungs, ask your veterinarian if nasal discharge is expected after surgery.

Featured image: iStock.com/DenGuy

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What Can You Give Cats For Pain A Medical Solution

Besides medications, veterinarians can also offer other cat pain relief solutions. If your cat is extremely irritated, your vet might give them a few puffs of gas anesthesia. This will not harm them, but rather help them to relax so your vet can get a better look at their body to see where the cause of the pain might be.

While this isnt a long-lasting treatment, it can help to relax your cats body for a short period of time to give them quick relief.

Types Of Pain Medication

Post-surgical pain is usually managed with multiple pain-reducing medications . The appropriate type, delivery and dose of medications for you depend on the type of surgery and expected recovery, as well as your own needs.

Pain medications include the following:

  • Opioids, powerful pain medications that diminish the perception of pain, may be given after surgery. Intravenous opioids may include fentanyl, hydromorphone, morphine, oxycodone, oxymorphone and tramadol. Examples of opioids prescribed in pill form after surgery include oxycodone and oxycodone with acetaminophen .
  • Local anesthetics, such as lidocaine and bupivacaine, cause a short-term loss of sensation at a particular area of the body.
  • Nonsteroidal anti-inflammatory drugs such as ibuprofen , naproxen sodium , celecoxib or ketorolac lessen the inflammatory activity that worsens pain.
  • Other nonopioid pain relievers include acetaminophen and ketamine .
  • Other psychoactive drugs that may be used for treating post-surgical pain include the anti-anxiety medication midazolam or the anticonvulsants gabapentin and pregabalin .

While opioids may or may not be appropriate to use after your surgery, your surgeon will likely prescribe a combination of treatments. These may help to control pain, lessen side effects, enable you to resume activity appropriate for recovery and lower risks associated with opioids.

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Elizabethan Collars Rarely Needed

Elizabethan collars are rarely needed in feline medicine, although there are situations that require them. In most cases, Elizabethan collars cause great stress and frustration without corresponding benefit. In fact, when a cat licks a wounded area, a natural form of removing damaged tissue, or debridement, takes place, and circulation to the area is stimulated. It is far more often beneficial to allow a feline patient to lick an injured area than to prevent it, Only when a patient is injuring himself is an Elizabethan collar necessary.

Cats Are Not Small People Or Small Dogs

The Risk of Anesthesia in Pets

You have to be even more careful with cats. Compared to other species, cats have a reduced ability to break down NSAIDs.

These differences may lead to toxic effects in pets, such as ulcers and perforations in the digestive tract as well as liver and kidney damage.

Table 2: Common Over-the-Counter Pain Relievers for People

Active Ingredient
ALEVE, MIDOL EXTENDED RELIEF, NAPROSYN
Acetaminophen TYLENOL

Acetaminophen is not a nonsteroidal anti-inflammatory drug and doesnt have much anti-inflammatory activity. Scientists dont fully understand how acetaminophen works. The drug seems to have more than one mode of action to reduce fever and relieve pain.

  • Dose-dependent liver toxicitymeaning the higher the dose, the worse the liver damagethat may lead to liver failure and
  • Red blood cell damage that causes these cells to lose their ability to carry oxygen.

Dogs and cats can develop both forms of acetaminophen toxicity, but cats are more prone to red blood cell damage while dogs are more likely to get liver damage.

Acetaminophen is fatal to cats. Cats should never be given acetaminophen because they lack certain enzymes that the liver needs to safely break down the drug.

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