Zero Pain Philosophy Zero Pain Philosophy

Meet Prof Paulo Steagall. Hear about his career, where the
feline grimace scale developed from, and what the future of the FGS is.

In this episode, Matt & Carl chat through all things relating to feline pain scoring with Paulo and explore a number of questions.

Where does AI fit with the future of the feline grimace scale?
Can pet owners use the feline grimace scale?

Are cats difficult to pain score?

The podcast takes a look at how pain scoring is just one
part of the picture of enabling us to give optimal care to our feline patients.


Listen to Paulo’s reflections on burprenorphine and how the
use of the FGS has enhanced our understanding

 

Show notes below are the papers that we refer to within the podcast and you can link to the mentioned pain scale resource here

 

Steagall PV, Robertson S, Simon B, Warne LN, Shilo-Benjamini
Y, Taylor S. 2022 ISFM Consensus Guidelines on the Management of Acute Pain in
Cats. J Feline Med Surg. 2022 Jan;24(1):4-30. doi: 10.1177/1098612X211066268.
PMID: 34937455.

 

Steagall PV, Monteiro BP. Acute pain in cats: Recent
advances in clinical assessment. J Feline Med Surg. 2019 Jan;21(1):25-34. doi:
10.1177/1098612X18808103. Epub 2018 Oct 15. PMID: 30320529.

 

Marangoni S, Beatty J, Steagall PV. An ethogram of acute
pain behaviors in cats based on expert consensus. PLoS One. 2023 Sep
28;18(9):e0292224. doi: 10.1371/journal.pone.0292224. PMID: 37768967; PMCID:
PMC10538801.

 

Evangelista MC, Watanabe R, Leung VSY, Monteiro BP, O'Toole
E, Pang DSJ, Steagall PV. Facial expressions of pain in cats: the development
and validation of a Feline Grimace Scale. Sci Rep. 2019 Dec 13;9(1):19128. doi:
10.1038/s41598-019-55693-8. PMID: 31836868; PMCID: PMC6911058.

 

Steagall PV, Monteiro-Steagall BP, Taylor PM. A review of
the studies using buprenorphine in cats. J Vet Intern Med. 2014
May-Jun;28(3):762-70. doi: 10.1111/jvim.12346. Epub 2014 Mar 21. PMID:
24655078; PMCID: PMC4895465.

 

Watanabe R, Frank D, Steagall PV. Pain behaviors before and
after treatment of oral disease in cats using video assessment: a prospective,
blinded, randomized clinical trial. BMC Vet Res. 2020 Apr 10;16(1):100. doi:
10.1186/s12917-020-02302-w. PMID: 32272922; PMCID: PMC7146962.

 

Watanabe R, Doodnaught G, Proulx C, Auger JP, Monteiro B,
Dumais Y, Beauchamp G, Segura M, Steagall P. A multidisciplinary study of pain
in cats undergoing dental extractions: A prospective, blinded, clinical trial.
PLoS One. 2019 Mar 1;14(3):e0213195. doi: 10.1371/journal.pone.0213195. PMID:
30822336; PMCID: PMC6396900.

 

Monteiro BP, Lee NH, Steagall PV. Can cat caregivers
reliably assess acute pain in cats using the Feline Grimace Scale? A large
bilingual global survey. J Feline Med Surg. 2023 Jan;25(1):1098612X221145499.
doi: 10.1177/1098612X221145499. PMID: 36649089.

 

Belli M, de Oliveira AR, de Lima MT, Trindade PHE, Steagall
PV, Luna SPL. Clinical validation of the short and long UNESP-Botucatu scales
for feline pain assessment. PeerJ. 2021 Apr 12;9:e11225. doi:
10.7717/peerj.11225. PMID: 33954046; PMCID: PMC8048399.


Zero Pain Philosophy is an educational resource for vet professionals.
If you are a pet owner, please encourage for vet to connect with us. We are
unable to offer advice direct to pet owners.

It's been two years since bedinvetmab was launched as a treatment for the pain associated with osteoarthritis - quickly followed by frunevetmab. During that time Matt has lectured around the world on the topic. This podcast brings together a number of questions that have been raised as part of those lectures - and we always say that if someone has a question, then 10 are people are thinking the same thing!

After this podcast you will have a better understanding of the anti nerve growth factor agents. If you have questions, we would love to help. Please use the contact box to send us a message.

Don't forget that we offer a telemedicine service - so for case advice, please ask for our help!

Reflective learning

What further questions does this podcast content raise for you?

How will this understanding impact the management of your current and future patients?

Learning actions

Revise the mechanism of action of anti nerve growth factor agents (both references below)

Review the data sheet (summary of product characteristics) for bedinvetmab (Librela/Beransa) and frunevetmab (Solensia).

Practice discussion

As a practice team do we feel that anti-NGF agents are a first line treatment for OA in dogs and cats?

References

Enomoto M, Mantyh PW, Murrell J, Innes JF, Lascelles BDX. Anti-nerve growth factor monoclonal antibodies for the control of pain in dogs and cats. Vet Rec. 2019 Jan 5;184(1):23. doi: 10.1136/vr.104590. Epub 2018 Oct 27. PMID: 30368458; PMCID: PMC6326241.

Schmelz M, Mantyh P, Malfait AM, Farrar J, Yaksh T, Tive L, Viktrup L. Nerve growth factor antibody for the treatment of osteoarthritis pain and chronic low-back pain: mechanism of action in the context of efficacy and safety. Pain. 2019 Oct;160(10):2210-2220. doi: 10.1097/j.pain.0000000000001625. PMID: 31145219; PMCID: PMC6756297.

Join Matt & Carl as we discuss the two papers here that document the difference between using pregabalin and gabapentin after spinal surgery in dogs.

Reflective learning

After listening to this podcast do you see a place for gabapentinoids in the management of pain following spinal surgery?

How will this understanding impact the management of your current and future patients? 

Learning actions

Watch Gwen Covey Crump's webinar on gabapentinoids.

Watch Matt's webinar on descending modulation which explores the mechanism of action of gabapentinoids.

Practice discussion 

As a practice team discuss your use of gabapentinoids.

References

Aghighi SA, Tipold A, Piechotta M, Lewczuk P, Kästner SB. Assessment of the effects of adjunctive gabapentin on postoperative pain after intervertebral disc surgery in dogs. Vet Anaesth Analg. 2012 Nov;39(6):636-46. doi: 10.1111/j.1467-2995.2012.00769.x. Epub 2012 Aug 10. PMID: 22882632.

Almeida et al (2023) Evaluation of Gabapentin in the Treatment of Postoperative Pain after a Tibial Plateau Levelling Osteotomy in Dogs DOI https://doi.org/

10.1055/s-0042-1751069.

Crociolli GC, Cassu RN, Barbero RC, Rocha TL, Gomes DR, Nicácio GM. Gabapentin as an adjuvant for postoperative pain management in dogs undergoing mastectomy. J Vet Med Sci. 2015 Aug;77(8):1011-5. doi: 10.1292/jvms.14-0602. Epub 2015 Mar 29. PMID: 25816802; PMCID: PMC4565804.



Schmierer, P. A., Tünsmeyer, J., Tipold, A., Hartnack-Wilhelm, S., Lesczuk, P., & Kästner, S. B. R. (2020). Randomized controlled trial of pregabalin for analgesia after surgical treatment of intervertebral disc disease in dogs. Veterinary Surgery, 49(5), 905–913. https://doi.org/10.1111/vsu.13411

What is ERAS? What are the principles and components of ERAS? In this podcast Carl will explore these questions, some of the medical and veterinary literature and explain how we can incorporate this into our everyday clinical practice and pain management protocols.



Your learning outcomes for this podcast are;

Understand what ERAS is

Learn how some published studies can be used to practice ERAS in your clinic



Your option for reflection

Consider how you can incorporate ERAS into your daily practice



References

The references and further information are all contained within our Pain Update, which you can read here.

https://www.zeropainphilosophy.com/post/enhanced-recovery-after-surgery

In this episode, Matt reviews the literature on gabapentin in cats. Does the science support our use of gabapentin as an analgesic. How does gabapentin work? To end, Matt reports a recent study he conducted examining the anxiolytic benefit of gabapentin in hyperthyroid cats. 

Find the show notes with all references on the Pain Updates page. 

In this month’s members podcast we will be talking about the use of lidocaine as an intravenous infusion and its impact on survival following septic peritonitis in dogs. In this episode Carl will review a 2016 study on survival of dogs with septic peritonitis.