What is chronic pain?
Chronic pain is an unpleasant sense of discomfort that persists or progresses over a long period. In contrast to acute pain that arises suddenly in response to a specific injury and is usually treatable, chronic pain persists over time and is often resistant to medical treatments.
The following are scenarios whose rate of occurrence is closer to that of osteoarthritis:-
Chronic, Active inflammatory pain
The therapeutic rationale of these pain phenomena is from the understanding of the disease pathophysiology.
Chronic, Active Inflammatory Pain
Examples of Chronic, Active Inflammatory Pain include the following:-
Chronic periodontal disease (Dental disease)
Feline lymphocytic—plasmacytic stomatitis (Inflammation of the mucous membranes of the mouth)
Idiopathic feline lower urinary tract disease (Kidney disease)
Inflammatory bowel disease (Inflammation/infection of the Digestive Tract)
Meningoencephalitides (Inflammation/infection of the brain)
Otitis external (Inflammation/infection of the outer ear)
Feline interstitial cystitis (Inflammation / Infection of the urinary bladder)
Treatment
The treatment order for this category of chronic pain should be in the following order:
Anti-inflammatory medications: non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids
Treatment of underlying disease or aggravating comorbidities
Neuromodulatory analgesic drugs, such as gabapentin, tramadol, and amitriptyline
Weight optimization.
Further reading
References
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[2] K. A. Mathews, "Neuropathic pain in dogs and cats: if only they could tell us if they hurt," Veterinary Clinics of North America: Small Animal Practice, vol. 38, no. 6, pp. 1365-1414, 2008.
[3] R. A. Gupta and R. N. DuBois, "Colorectal cancer prevention and treatment by inhibition of cyclooxygenase-2," Nature Reviews Cancer, vol. 1, pp. 11-21, 2001.
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[9] R. I. Krontveit, C. Trangerud, B. K. Sævik, H. K. Skogmo and A. Nødtvedt, "Risk factors for hip-related clinical signs in a prospective cohort study of four large dog breeds in Norway.," Preventive veterinary medicine, vol. 103, no. 2-3, pp. 219-227., 2012.
[10] J. G. Smith, R. L. Hannon, L. Brunnberg, V. Gebski and D. Cullis-Hill, "A randomised, double-blind, comparator-controlled study of the efficacy of sodium pentosan polysulfate injections and carprofen capsules in arthritic dogs.," Osteoarthritis and Cartilage, vol. 9, no. Supplement B, p. 21., 2001.
[11] J. M. Vandeweerd, C. Coisnon, P. Clegg, C. Cambier, A. Pierson, F. Hontoir, C. Saegerman, P. Gustin and S. Buczinski, "Systematic review of the efficacy of nutraceuticals to alleviate clinical signs of osteoarthritis.," Journal of Veterinary Internal Medicine, vol. 26, no. 3, pp. 448-456, 2012.
[12] B. D. X. Lascelles, J. S. Gaynor, E. S. Smith, S. C. Roe, D. J. Marcellin‐Little, G. Davidson, E. Boland and J. Carr, "Amantadine in a multimodal analgesic regimen for the alleviation of refractory osteoarthritis pain in dogs.," Journal of Veterinary Internal Medicine, vol. 22, no. 1, pp. 53-59, 2008.
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