Posts in pain relief
Paracetamol for the management of pain in dogs

Paracetamol is one of the most commonly-used drugs worldwide. It is available to buy over the counter for humans, and for dogs (as Pardale-V tablets, which contain paracetamol together with codeine). However, there is a lot of confusion about the efficacy and safety of paracetamol in dogs. For example, is paracetamol a non-steroidal anti-inflammatory drug (NSAID)? Is it safe to use with NSAIDs in dogs as it is in people? This module summarises the published evidence on the use of paracetamol in dogs and relates it to the treatment of acute and chronic pain in practice. It is important to note that paracetamol should never be used in cats.

By doing this module you will:

  • understand the current knowledge on the pharmacology of paracetamol

  • know the clinical evidence on the safety and efficacy of paracetamol in dogs

  • find out how the information provided with veterinary licensed forms of paracetamol relates to the evidence

  • understand how the evidence informs the practical use of paracetamol.

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CBD for canine arthritis. What do we know?

It is clear from online forum discussions among dog owners that there is interest in the perceived benefits of cannabidiol (CBD). Some dog owners either already give CBD to their dogs, or are interested in trying it, to relieve arthritis pain. Consequently veterinary professionals may be asked for advice about CBD or be asked to prescribe it. By doing this module you will:

  • understand what is known about the physiological effects of CBD in dogs;

  • know the legal status of CBD products, including whether they can be prescribed;

  • be aware of the published evidence on the clinical efficacy of CBD in dogs with osteoarthritis; 

  • be aware of what is known about the safety of CBD in dogs.

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Grapiprant – a new drug for treating osteoarthritis in dogs

By doing this module you will:

  • understand the pharmacology of grapiprant;

  • know the clinical evidence on the efficacy and safety of grapiprant;

  • be aware of what is known about how grapiprant compares with NSAIDs;

  • understand what is meant by intention-to-treat and per-protocol analysis in clinical trials result analysis;

  • understand what is meant by the number needed to treat and its relevance to clinical practice.

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Which NSAID

By doing this module you will:

  • know what an NSAID is

  • understand the clinical pharmacology of NSAIDs

  • gain a broad understanding of the range of licensed uses of the different NSAIDs 

  • understand what is known about the comparative efficacy and safety of NSAIDs 

  • be able to make a rational choice.

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Tramadol for pain relief in dogs: what's its place? (Updated)

By doing this module you will:

  • understand the pharmacology of tramadol

  • know the evidence on its efficacy in acute and chronic pain

  • be aware of the adverse effects

  • know the place of tramadol in the management of pain in dogs.

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Amantadine in the management of chronic pain in dogs and cats

By doing this module you will:

  • Understand the pharmacology of amantadine and the rationale for using it in chronic pain.
  • Be aware of the published evidence on the use of amantadine in dogs and cats.
  • Find out what is known about the adverse effects of amantadine. 
  • Know the potential role of amantadine in the management of chronic pain and how to monitor its effects.
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Lidocaine/prilocaine topical anaesthetic cream in small animals

Lidocaine (25mg/g) plus prilocaine (25mg/g) cream is a topical anaesthetic licensed for use in humans but not in animals. However, it is used in veterinary practice – for example, during venepuncture at the jugular or cephalic vein for blood sampling, especially in cats, or the ear veins in rabbits; and when inserting an intravenous cannula preoperatively in cats, dogs and rabbits. This module summarises the published evidence on the efficacy and safety of lidocaine/prilocaine cream in small animals, gives practical guidance on its use, and highlights the gaps in the evidence.

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NSAIDs in horses

Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly-used categories of drugs in horses. Here, we review the efficacy and safety of NSAIDs when used for relieving inflammation and pain from musculoskeletal problems. We also offer practical advice on choosing an NSAID from among the eight authorised in the UK for horses, and on what to tell clients when their horses start NSAID therapy.

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Post-operative pain in cats – meloxicam or robenacoxib?

A recent advert for the injectable NSAID, robenacoxib (Onsior – Novartis) says the drug gives “superior pain relief”, going on to say that “In a recent study Onsior injection demonstrated superior efficacy to meloxicam in reducing post-operative pain in cats”. The advert gives a web link to more information, including the claim that robenacoxib is “tissue selective” and “persists at the source of inflammation but exits the bloodstream quickly, sparing vulnerable organs from prolonged exposure”. Here, we look at the evidence behind these claims.

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