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Pain Control For Animals During Disaster Situations NDMS 2007 Part 4 NSAIDs and Beyond

Pain Control For Animals During Disaster Situations NDMS 2007 Part 4 NSAIDs and Beyond. James S. Gaynor, DVM, MS, DACVA, DAAPM Colorado Springs, CO 719-266-6400 www.nopetpain.com. Etodolac Carprofen Deracoxib Meloxicam Tepoxalin Firocoxib. Aspirin Piroxicam Phenylbutazone* Flunixin*

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Pain Control For Animals During Disaster Situations NDMS 2007 Part 4 NSAIDs and Beyond

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  1. Pain Control For Animals During Disaster SituationsNDMS 2007Part 4NSAIDs and Beyond James S. Gaynor, DVM, MS, DACVA, DAAPM Colorado Springs, CO 719-266-6400 www.nopetpain.com

  2. Etodolac Carprofen Deracoxib Meloxicam Tepoxalin Firocoxib Aspirin Piroxicam Phenylbutazone* Flunixin* Ketoprofen* NSAIDs *Commonly used in large animals Acetaminophen ©AAPMC2007

  3. Important Pathways Arachadonic Acid COX-3 Non Cox / Non Lox COX-2 LOX COX-1 Prostacyclins Leukotrienes Prostaglandins GI Protection Renal Blood Flow Platelet Function Prostaglandins Inflammation & Pain Renal Blood Flow GI Protection Vasodilation Platelet Autonomy Inflammation GI Ulceration ©AAPMC2007

  4. ASPIRIN 100% GI Hemorrhage With 1 Dose Arachadonic Acid COX-2 COX-1 Prostaglandins GI Protection Renal Blood Flow Platelet Function Prostaglandins Inflammation & Pain Renal Blood Flow GI Protection ©AAPMC2007

  5. Phenylbutazone, Flunixin, Ketoprofen Arachadonic Acid COX-2 COX-1 Prostaglandins GI Protection Renal Blood Flow Platelet Function Prostaglandins Inflammation & Pain Renal Blood Flow GI Protection ©AAPMC2007

  6. Etodolac (Etogesic®) Arachadonic Acid COX-2 COX-1 Prostaglandins GI Protection Renal Blood Flow Platelet Function Prostaglandins Inflammation & Pain Renal Blood Flow GI Protection ©AAPMC2007

  7. Carprofen (Rimadyl®) Arachadonic Acid Injectable & Oral Non Cox / Non Lox (NFKB) COX-2 COX-1 Prostaglandins GI Protection Renal Blood Flow Platelet Function Prostaglandins Inflammation & Pain Renal Blood Flow GI Protection ©AAPMC2007

  8. Deracoxib (Deramaxx®) Arachadonic Acid COX-2 COX-1 Prostacyclins Prostaglandins GI Protection Renal Blood Flow Platelet Function Prostaglandins Inflammation & Pain Renal Blood Flow GI Protection Vasodilation Platelet Autonomy ©AAPMC2007

  9. Meloxicam (Metacam®) Arachadonic Acid Injectable & Oral COX-2 COX-1 Prostaglandins GI Protection Renal Blood Flow Platelet Function Prostaglandins Inflammation & Pain Renal Blood Flow GI Protection ©AAPMC2007

  10. Tepoxalin (Zubrin®) Arachadonic Acid Tepoxalin x 1 hr Tepoxalin Metabolite COX-2 LOX COX-1 Leukotrienes Prostaglandins GI Protection Renal Blood Flow Platelet Function Prostaglandins Inflammation & Pain Renal Blood Flow GI Protection Inflammation GI Ulceration ©AAPMC2007

  11. Firocoxib (Previcox®) Arachadonic Acid COX-2 COX-1 Prostacyclins Prostaglandins GI Protection Renal Blood Flow Platelet Function Prostaglandins Inflammation & Pain Renal Blood Flow GI Protection Vasodilation Platelet Autonomy ©AAPMC2007

  12. Acetaminophen COX-3 ©AAPMC2007

  13. NSAIDs • More efficacious than placebo • A few comparisons • Little difference in pain relief ©AAPMC2007

  14. NSAIDs • Individuals will respond better to one NSAID than another • Pain relief • Adverse responses ©AAPMC2007

  15. ©AAPMC2007

  16. NSAIDs & Cats • Single Rimadyl SQ dose 1-2 mg/kg • No repeat dosing injectable or oral ©AAPMC2007

  17. Meloxicam in Cats for Acute Pain • 0.2 mg/kg SQ • 0.05 mg/kg PO daily for 4 days • Do NOT use bottle injectable dose and follow with oral ©AAPMC2007

  18. Potent Opioid Treatment Strategy Mild-Opioid NSAID ©AAPMC2007

  19. Treatment Strategy • Get the patient comfortable quickly (IV is ideal) • Maintain the comfort • Prevent problem pain ©AAPMC2007

  20. Nonmedical Aspects of Maintaining Comfort ©AAPMC2007

  21. Non Drug Options • Pulsed electromagnetic field therapy • Acupuncture • Good nursing care!!!!! ©AAPMC2007

  22. ©AAPMC2007

  23. For Consultation Further Information 719-266-6400 800-791-2578 www.nopetpain.com ©AAPMC2007

  24. Useful Doses & Information ©AAPMC2007

  25. NSAID Doses in Small Animals ©AAPMC2007

  26. NSAID Doses in Dogs and Cats ©AAPMC2007

  27. NSAID Doses in Small Animals ©AAPMC2007

  28. NSAID Doses in Small Animals ©AAPMC2007

  29. Mu Agonist Opioid Doses in Small Animals ©AAPMC2007

  30. Transdermal Fentanyl Patch Dosing in Dogs and Cats ©AAPMC2007

  31. Other Opioid Doses in Small Animals ©AAPMC2007

  32. Tranquilizer /Sedative Doses in Small Animals ©AAPMC2007

  33. NSAID Doses in Horses & Cattle ©AAPMC2007

  34. Opioid Doses in Horses and Cattle ©AAPMC2007

  35. Tranquilizer / Sedstive Doses in Horses & Cattle ©AAPMC2007

  36. NSAID Doses in Swine & Small Ruminants ©AAPMC2007

  37. NSAID Doses in Swine & Small Ruminants ©AAPMC2007

  38. Mu Agonist Opioid Doses in Swine & Small Ruminants ©AAPMC2007

  39. Mu Agonist Opioid Doses in Swine & Small Ruminants ©AAPMC2007

  40. Other Opioid Doses in Swine & Small Ruminants ©AAPMC2007

  41. Tranquilizer / Sedative Doses in Swine & Small Ruminants ©AAPMC2007

  42. Analgesia Considerations in Horses • Opioids: may cause excitement in the pain free horse, can be prevented with concurrent administration of a tranquilizer • Alpha-2 agonists: well tolerated and accepted • NSAID's: well tolerated and accepted•local anesthesia, neurectomies: well tolerated and accepted • Epidural 2-adrenergic agonists - perineal analgesia ©AAPMC2007

  43. Analgesia Considerations in Food Animals • Little information on these species • Opioids: partial agonists appear to work well • NSAID's: seemly work well•local anesthesia: is a vital option • Food Residues ©AAPMC2007

  44. Analgesia Considerations in Cats • Opioids: produce excitement at high doses,however, these drugs can work well if use appropriate dose; if excitement occurs, a tranquilizer, such as acepromazine, will calm the animal • NSAID's (acetaminophen, aspirin): toxicity is a major problem • Local anesthesia: more sensitive than dogs to get overdose • Epidural opioids ± local anesthetics• • Transdermal fentanyl ©AAPMC2007

  45. Analgesia Considerations in Dogs • Opioids: work well, widely documented in the literature• • NSAID's: work well, widely used, some toxicity problems with some drugs • Local anesthesia: techniques established, may be an option • Epidural opioids ± local anesthetics • Transdermal fentanyl ©AAPMC2007

  46. Resources • Handbook of Veterinary Pain Management. Eds: Gaynor JS & Muir WW. Mosby, St. Louis, 2002 • University of Rochester Medical Center, Committee on Animal Resources http://www.urmc.rochester.edu/ucar/manual/table1.htm • Yale Animal Resource Center http://www.med.yale.edu/yarc/vcs/drugs.htm • Wake Forest University Animal Resources Program http://www1.wfubmc.edu/ARP/health/index.htm • Cornell University Center for Animal Resources and Education http://www.research.cornell.edu/care/documents/SOPs/CARE102.pdf • Small Animal Pain Management, Carroll GL. AAHA Press 1998 ©AAPMC2007

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