Peer-reviewed veterinary case report
Pain relief results from palliative care in dogs with bone cancer
By Monteiro, Beatriz P et al.·Published in PloS one·2018·Department of biomedical sciences, Canada·View original on PubMed →
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Original publication title: Pain characterization and response to palliative care in dogs with naturally-occurring appendicular osteosarcoma: An open label clinical trial.
- Species:
- dog
Plain-English summary
A group of dogs with bone cancer (osteosarcoma) were experiencing significant pain and were given a combination of pain medications, including cimicoxib, amitriptyline, and gabapentin, to help manage their symptoms. Over the course of the treatment, the dogs showed some improvement in their activity levels and a reduction in restlessness at night. However, the overall pain management was challenging, and some symptoms worsened when gabapentin was added to the other medications. While the treatments provided some relief, the dogs still experienced severe pain that was difficult to control.
People also search for: dog bone cancer pain treatment · osteosarcoma pain management in dogs · cimicoxib for dogs with cancer
Abstract
This study aimed to characterize bone cancer pain (quantitative sensory testing (QST), stance asymmetry index, actimetry, scores of pain and quality of life (QoL)) in dogs with appendicular osteosarcoma (OSA), and to evaluate a stepwise palliative analgesic treatment. The pain profile of thirteen client-owned dogs with OSA was compared with seven healthy dogs. Dogs with OSA were then enrolled in a prospective, open-label, clinical trial. Outcome measures included: primary and secondary mechanical thresholds (MT), conditioned pain modulation (CPM), stance asymmetry index, actimetry (most and least active periods), visual analog scales and QoL. After baseline assessments, stepwise treatment comprised orally administered cimicoxib (2 mg/kg q 24h), amitriptyline (1-1.5 mg/kg q 24h) and gabapentin (10 mg/kg q 8h); re-evaluations were performed after 14 (D14), 21 (D21) and 28 (D28) days, respectively. Statistics used mixed linear models (α = 5%; one-sided). Centralized nociceptive sensitivity (primary and secondary MT, and dynamic allodynia) was recorded in OSA dogs. Healthy dogs had responsive CPM, but CPM was deficient in OSA dogs. Construct validity was observed for the QST protocol. Asymmetry index was significantly present in OSA dogs. The CPM improved significantly at D14. When compared with baseline (log mean ± SD: 4.1 ± 0.04), most active actimetry significantly improved at D14 (4.3 ± 0.04), D21 and D28 (4.2 ± 0.04 for both). When compared with baseline, least active actimetry significantly decreased after treatment at all time-points indicating improvement in night-time restlessness. No other significant treatment effect was observed. Except for tactile threshold and actimetry, all outcomes worsened when gabapentin was added to cimicoxib-amitriptyline. Dogs with bone cancer are affected by widespread somatosensory sensitivity characterized by peripheral and central sensitization and have a deficient inhibitory system. This severe pain is mostly refractory to palliative analgesic treatment, and the latter was only detected by specific and sensitive outcomes.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/30521538/