Clinical efficacy of hydrocodone-acetaminophen and tramadol for control of postoperative pain in dogs following tibial plateau leveling osteotomy

Abstract

Overall, differences in pain scores between dogs that received hydrocodone-acetaminophen or tramadol were minor. The percentage of dogs with treatment failure in both groups was considered unacceptable.

Extracorporeal shock wave therapy improves short‐term limb use after canine tibial plateau leveling osteotomy

“…Reported complications associated with ESWT include mild bruising, redness, transient superficial pain at the treatment site, and the requirement for sedation or general anesthesia for treatment . Subjective pain evaluation 24 hours after surgery in this study may not have been of sufficient resolution to detect differences between treatments, although the rubric used is well established for comparison of postoperative comfort levels . More objective forms of pain evaluation, such as kinetic gait, mechanical threshold testing with an algometer, or stance analysis, could have been performed …”

“…Pain was assessed via the short form of the Glasgow Composite Pain Scale, which includes six behaviors: vocalization, attention to wound, mobility, response to touch, demeanor, and posture/activity . Although it is used to measure pain in dogs, the scale is subjective and may be influenced by how the dog interacts with observers, differences in interpretation of scoring criteria among observers, and varying thresholds of pain tolerance among dogs …”

“…The tibial plateau leveling osteotomy (TPLO) is among the most frequent surgeries performed to stabilize canine CrCL deficient stifles . As with most stifle stabilization surgeries, recovery is between 8 and 12 weeks, and pain management may consist of nonsteroidal anti‐inflammatory drugs (NSAID) and opioids . Complications of asymmetrical gait associated with postoperative pain include decreased stifle joint range of motion, muscle atrophy, and increased loading of other limbs .…”

“…Use of NSAID to control postoperative pain can be limited by potential side effects and patient comorbidities . Controlled drug regulations complicate opioid availability and administration, and the efficacy of oral administration in dogs has recently been questioned . A mechanism to enhance standard pain management strategies and reduce postoperative discomfort may help restore normal gait, reduce postoperative complications, and improve patient outcomes.…”

The present and future of opioid analgesics in small animal practice

“…Recent trials have indicated that oral, epidural, and parenteral administration of tramadol does not produce significant concentrations of the opioid M1 metabolite (O‐desmethyltramadol) in dogs which are required to produce an opioid effect in other species (Matthiesen et al ., ; Vettorato et al ., ; KuKanich & Papich, ; Kögel et al ., ; Benitez et al ., ). The drug alone did not provide adequate postoperative analgesia in dogs undergoing tibial plateau leveling osteotomy (Davila et al ., ; Benitez et al ., ). In addition, the nonopioid mechanisms of action of tramadol produced limited antinociception in an acute pain model in dogs (Kögel et al ., ).…”