Cyclooxygenases 1 and 2 inhibition and analgesic efficacy of dipyrone at different doses or meloxicam in cats after ovariohysterectomy

Objectives This study aimed to compare the analgesic effect between carprofen and grapiprant every 12 or 24 h on postoperative pain in cats undergoing ovariohysterectomy, in addition to the effects on the hematological, biochemical and urinalysis variables. Methods A total of 32 female cats were randomly divided into three groups, according to the treatment administered with the first dose given orally 90 mins before surgery, as follows: CAR (cats received 4 mg/kg carprofen, n = 11); GRA1 (cats received 2 mg/kg grapiprant, n = 10); and GRA2 (cats received 2 mg/kg grapiprant q12h, n = 11). Pain was assessed by UNESP-Botucatu Multidimensional Composite Pain Scale (UNESP) and Glasgow Feline Composite Measure Pain Scale (GLASGOW) for cats preoperatively (baseline) and at 1, 3, 6, 8, 12 and 24 h after extubation. Venous blood was collected at baseline, and 12 and 24 h after the administration of carprofen or grapiprant to perform a complete blood count (CBC), the percentage of Heinz bodies and serum biochemistry (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyltransferase, creatinine and urea). Urinalysis was performed at baseline and 24 h after extubation. Glucose levels were evaluated at baseline and 1 h postoperatively. Results Pain scores were not significantly different among groups in both scales, although pain was higher at 3 h in comparison with 24 h in all groups. In the GRA1 and GRA2 groups, 67% (14/21) of cats needed rescue analgesia compared with 18% (2/11) in the CAR group. Glucose increased from baseline to 1 h in the GRA1 and GRA2 groups. None of the CBC, serum biochemistry and urinalysis variables differed among groups. Conclusions and relevance Grapiprant did not promote adequate analgesia during the first 3 h postoperatively in cats undergoing ovariohysterectomy compared with carprofen, and no benefits were observed by administering grapiprant every 12 h.

Section: Discussionmentioning

confidence: 99%

Grapiprant or carprofen following ovariohysterectomy in the cat: analgesic efficacy, hematological, biochemical and urinalysis evaluation

Teixeira

Vaccarin

Schimites

et al. 2022

“…< Metamizole (dipyrone) is a phenolic compound and atypical NSAID with COX-1 and some COX-2 anti-inflammatory activity. 154 The drug has potent analgesic effects that may be due to central inhibition of the COX-3 enzyme. 155 Activation of the opioid and cannabinoid systems is also a possible mechanism of action for metamizole.…”

Section: Adjuvant Analgesic Drugsmentioning

confidence: 99%

“…158 In another investigation, metamizole induced sialorrhoea when administered orally (drops) in the home environment to cats following ovariohysterectomy; rescue analgesia was required for some cats receiving either 12.5 mg/kg q12h or 25 mg/kg q24h, showing that unimodal therapy (similar to meloxicam) may not induce adequate analgesia. 154 < Gabapentin binds to voltage-gated calcium channels, but other mechanisms of action have been identified including activation of the descending noradrenergic inhibitory system. 160 The drug has high bioavailability in cats (90-95%) following oral administration of 10 mg/kg; peak plasma concentrations occur at between 45 mins and 2 h, and elimination half-lives were reported to be between 3 and 4 h. 161,162 Repeated dosing did not affect terminal half-life and other pharmacokinetic parameters.…”

Section: Adjuvant Analgesic Drugsmentioning

confidence: 99%

2022 ISFM Consensus Guidelines on the Management of Acute Pain in Cats

Steagall

Robertson

Simon

et al. 2021

Practical relevance: Increases in cat ownership worldwide mean more cats are requiring veterinary care. Illness, trauma and surgery can result in acute pain, and effective management of pain is required for optimal feline welfare (ie, physical health and mental wellbeing). Validated pain assessment tools are available and pain management plans for the individual patient should incorporate pharmacological and non-pharmacological therapy. Preventive and multimodal analgesia, including local anaesthesia, are important principles of pain management, and the choice of analgesic drugs should take into account the type, severity and duration of pain, presence of comorbidities and avoidance of adverse effects. Nursing care, environmental modifications and cat friendly handling are likewise pivotal to the pain management plan, as is a team approach, involving the cat carer. Clinical challenges: Pain has traditionally been under-recognised in cats. Pain assessment tools are not widely implemented, and signs of pain in this species may be subtle. The unique challenges of feline metabolism and comorbidities may lead to undertreatment of pain and the development of peripheral and central sensitisation. Lack of availability or experience with various analgesic drugs may compromise effective pain management. Evidence base: These Guidelines have been created by a panel of experts and the International Society of Feline Medicine (ISFM) based on the available literature and the authors’ experience. They are aimed at general practitioners to assist in the assessment, prevention and management of acute pain in feline patients, and to provide a practical guide to selection and dosing of effective analgesic agents.

“…1 Scales such as the Glasgow Feline Composite Measure Pain Scale (CMPS-Feline), the UNESP-Botucatu Multidimensional Composite Pain Scale (UNESP-Botucatu MCPS) and the Colorado State University Feline Acute Pain Scale (CSU-FAPS) have been developed and validated for acute pain specifically. [2][3][4][5][6][7] While they are commonly used and are seemingly simple to perform, there is an inherent degree of subjectivity when using them. One of their limitations is that they rely on behavioural indicators, namely posture, facial expressions and reaction to stroking/palpation that can be affected by fear and anxiety, especially when the cats are assessed in an unfamiliar environment such as the veterinary hospital.…”

Section: Introductionmentioning

confidence: 99%

Use of mechanical thresholds in a model of feline clinical acute pain and their correlation with the Glasgow Feline Composite Measure Pain Scale scores

Nicholls

Merchant-Walsh²,

Dunne³

et al. 2021

Objectives The aim of this study was to evaluate the use of mechanical thresholds (MT), measured with the SMALGO (Small Animal ALGOmeter), and to determine whether there was a correlation between MT and Glasgow Feline Composite Measure Pain Scale (CMPS–Feline) scores in cats undergoing ovariohysterectomy. Methods Client-owned cats undergoing flank ovariohysterectomy were recruited. Pain scores for the pre- and postoperative periods were obtained using the CMPS-Feline in each cat by two independent investigators (A and B). Following CMPS–Feline scoring, MT were measured with the SMALGO, in the surgical area, pre- and postoperatively, only by investigator A. Each cat served as its own control for the comparison of pre- and postoperative variables. Reliability statistics were used to assess the level of inter-observer agreement (A vs B) with respect to pre- and postoperative CMPS–Feline scores, while Spearman’s correlation statistics were used to analyse the relationship between MT and CMPS–Feline scores. Results Twenty-nine cats completed the study. Preoperative MT (340 g [range 108–691]) were significantly higher than postoperatively (233 g [range 19–549]; P = 0.001). CMPS–Feline scores were not found to differ significantly between the preoperative period (2 [range 0–7] for investigator A and 3.2 ± 2.3 for investigator B) and postoperative period (2 [range 0–10] for investigator A and 3 [range 0–8] for investigator B) for either investigator. Reliability statistics revealed that the level of inter-observer agreement with respect to CMPS–Feline was fair for the preoperative assessments but poor for the postoperative evaluations. There was no correlation between MT and CMPS-Feline scores. Conclusions and relevance Although there was no correlation with CMPS–Feline scores performed at the same timepoint, MT increased postoperatively vs baseline. Assuming that, despite analgesia, susceptibility of the surgical area to mechanical stimulation would increase after surgery, this finding suggests that MT might be useful to assess feline surgical pain. The poor level of inter-observer agreement with respect to postoperative CMPS–Feline scores highlights the potential limitations of this scale.