Summary
Veterinarians from 15 European countries attended a conference organised by Merial Animal Health from April 22 to 24 to consider better ways to manage pain during post-surgical recovery and in chronic conditions such as osteoarthritis and cancer.
Studies by veterinary scientists across Europe have indicated that pain in dogs and cats is often poorly controlled. There are many reasons for this; owners are often unable to recognise the subtle signs of chronic pain in their pets, while their vets may be worried about the potential ill-effects of long-term treatment with traditional pain-killing drugs.
Speakers at the meeting insisted that there is no reason why an animal should continue to suffer The latest generation of analgesic and anti-inflammatory agents, such as Merial’s firocoxib, are highly effective in treating both acute and chronic pain in dogs. And with a lower risk of the adverse effects on the stomach, kidneys and blood function associated with older medicines.
Dr Stephane Junot, senior lecturer in anaesthesia and analgesia at the Lyon veterinary school reminded colleagues that postoperative pain is not just an important welfare issue – it also causes a range of physiological effects which affect general health and can retard healing. There are plenty of treatment options for different types of pain but it is vital that the effects of treatment should be carefully monitored. He stressed that to achieve optimal control of postoperative pain, treatment should begin before, rather than during and after, surgery. Veterinarians in practice can use a number of pain assessment tools to evaluate the patient’s response to treatment, he pointed out.
Even in conditions like osteoarthritis which may not be curable, treatment can be effective in allowing the animal to regain function and a good quality of life, said Professor Jean-Pierre Genevois, head of the small animal surgery department at Lyon. Meanwhile, Toulon-based veterinary behaviourist Dr Claude Beata emphasised the vital role that can be played by veterinary nursing staff in explaining to clients how to identify pets that are in pain and explaining how to tackle the problem. Merial is currently producing a range of educational materials aimed at supporting nurses in this role.
One of the problems in delivering better care for pet animals is that their owners will often mistake the signs of pain associated with diseases like osteoarthritis and cancer, for part of the natural changes in behaviour associated with ageing. But veterinarians such as Professor Enrique Rodriguez Grau-Bassas from the University of Las Palmas and Dr Peter Vajdovitch from Szent Istvan University in Hungary were both able to show the beneficial effects of treatment with the new class of drugs like firocoxib as part of the strategy for alleviating the chronic pain caused by many cancers.
Firocoxib acts on the COX-2 enzyme that is a key component of the biochemical pathway leading to the pain response. A better understanding of how this enzyme is expressed in the cells of individual cancer patients may allow the development of even more precise treatments tailored to the needs of that individual, according to Dr Antonio Espinosa de los Monteros, also from the Las Palmas veterinary school.
Basic research is still continuing to try to better understand the mechanisms of action of these new agents. Professor John Innes from the University of Liverpool told the meeting about investigations on the effects of firocoxib on cartilage cells grown in culture as an in vitro model for studying osteoarthritis. Meanwhile, his colleague Peter-John Noble described another similar in vitro model for examining any effects on the gastric lining of any future developments in non-steroidal anti-inflammatory drugs.
As part of its commitment to advancing the science of analgesia, Merial sponsors a prize for veterinarians producing case studies or publications on pain control management in small animal practice. The winners of the 2008 pain management award, worth Euros 3000, were Stephan Mahler and Karine Menier, in practice in Acigne, near Rennes in Brittany. Their presentation described the use of the tricyclic antidepressant drug, amitriptyline in the treatment of two cats with severe neuropathic pain.
Applications are invited for the 2009 pain management award, to be received by December 13, 2009. Further details from Ms Agnes Vidal, Merial’s European marketing director for pet animal and equine pharmaceutical products (agnes.vidal@merial.com)