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Meet Prof Paulo Steagall. Hear about his career, where thefeline 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 onepart of the picture of enabling us to give optimal care to our feline patients.
Listen to Paulo’s reflections on burprenorphine and how theuse 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-BenjaminiY, Taylor S. 2022 ISFM Consensus Guidelines on the Management of Acute Pain inCats. J Feline Med Surg. 2022 Jan;24(1):4-30. doi: 10.1177/1098612X211066268.PMID: 34937455.
Steagall PV, Monteiro BP. Acute pain in cats: Recentadvances 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 acutepain behaviors in cats based on expert consensus. PLoS One. 2023 Sep28;18(9):e0292224. doi: 10.1371/journal.pone.0292224. PMID: 37768967; PMCID:PMC10538801.
Evangelista MC, Watanabe R, Leung VSY, Monteiro BP, O'TooleE, Pang DSJ, Steagall PV. Facial expressions of pain in cats: the developmentand 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 ofthe studies using buprenorphine in cats. J Vet Intern Med. 2014May-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 andafter 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 painin 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 caregiversreliably assess acute pain in cats using the Feline Grimace Scale? A largebilingual 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, SteagallPV, Luna SPL. Clinical validation of the short and long UNESP-Botucatu scalesfor 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 areunable to offer advice direct to pet owners.
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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.
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Eksik bölüm mü var?
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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
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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
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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.
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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.
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As a complementary supplement to Ian Self's webinar on CBD and our pain update, Matt has reviewed two of the papers on CBD in dogs. For people CBD comes with celebrity endorsement, but is this all there is to it? What does the evidence say?
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In this podcast we will review a recent study examining the use of lumbosacral epidural injection in dogs undergoing caesarian section, exploring the pros and cons of this technique.
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If you are thinking about intra-articular therapies, where do you start? In this episode Matt chats to the Vet Vault team about where he sees IA therapies fit with Oa management
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Continuing our OA series, the Zero Pain & Vet Vault teams chat about the role of NSAIDs and grapiprant in management of your OA cases.
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Matt joins Hugh and Gerardo from Vet Vault to discuss bedinvetmab, in one of three podcasts on OA management.
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Earlier this year Matt joined the guys from The Vet Vault to chat all things chronic pain management. In this episode we chat about the use of ketamine subcutaneously for chronic pain.
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Always a popular topic, we decided to go back to the literature to guide your use of tramadol for post operative pain control.
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In this Vet Vault chat, Matt talks to Hubert and Gerardo about our second line options in OA. We cover amantadine and discuss is there room for tramadol?
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NMDA antagonists are excellent additions to chronic pain management. Why would you choose either? How do they work and what evidence do we have? In this edition of our member podcast, Matt reviews the use of these drugs and how they can help your patients.
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Recently Matt joined the team at Vet Vault to discuss analgesic management of Caesarean sections - amongst other things! You'll enjoy this lively discussion!
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This month we review two studies comparing different methods to confirm correct epidural injection placement in dogs in sternal and lateral recumbency.
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Our December podcast presents the results of our latest Zero Pain Insight looking at grapiprant prescribing considerations.
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Our November podcast explores the use of fentanyl transdermal patches in dogs and cats.