Today's Veterinary Practice

JAN-FEB 2016

Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.

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Today's VeTerinary PracTice | January/February 2016 | tvpjournal.com elemenTs oF oncology Peer reviewed 52 Table 1. analgesic agents & other nonpharmaceutical techniques Commonly Used for Cancer Pain Management a Pain CategorY aPProPriate analgeSiCS DoSe Mild NSAIDs b Carprofen (dogs only) 4.4 mg/kg PO or SC Q 24 H or 2 mg/kg PO or SC Q 12 H Deracoxib (dogs only) 3–4 mg/kg PO Q 24 H Firocoxib (dogs only) 5 mg/kg PO Q 24 H Meloxicam Dogs: 0.2 mg/kg PO, SC, or IV Q 12 H Cats: 0.1 mg/kg PO Q 24 H every 2–4 days Piroxicam Dogs: 0.3 mg/kg PO Q 24 H Cats: Up to 0.3 mg/kg PO Q 24 H Robenacoxib (cats only) 1 mg/kg PO Q 24 H Steroids b p rednisone 0.5–1 mg/kg PO Q 24 H; taper to lowest dose that controls clinical signs p rednisolone (cats only) 0.5–1 mg/kg PO Q 24 H; taper to lowest dose that controls clinical signs Opioids Tramadol (dogs only) 5–10 mg/kg PO Q 8–12 H Moderate Opioids Codeine 1–2 mg/kg PO Q 8–12 H Hydrocodone 0.5 mg/kg PO Q 8–12 H Morphine 0.5–2 mg/kg PO Q 6–8 H Hydromorphone 0.2–0.4 mg/kg PO Q 8–12 H Buprenorphine c Dogs: 80–120 mcg/kg OTM Q 12–24 H Cats: 80–240 mcg/kg OTM Q 12–24 H Transdermal fentanyl patch 25, 50, 75, or 100 mcg/H patch Transdermal fentanyl liquid (dogs only) 1.3 mg/kg Q 4–7 days on dorsal scapular area Severe Opioids d Morphine (dogs and cats) Same as above Hydromorphone Same as above Buprenorphine Same as above Transdermal fentanyl patch Same as above Transdermal fentanyl liquid (dogs only) 2.7 mg/kg Q 4–7 days on dorsal scapular area Can be combined with any other analgesics in different pain categories Adjuvants Amantadine 2–5 mg/kg PO Q 12 H Gabapentin 5–10 mg/kg PO Q 8–12 H Oxcarbazepine 30–60 mg/kg PO 8–24 H Amitriptyline 1–5 mg/kg PO Q 12–24 H Lidocaine patches 1–3 patches depending on size of wound and size of animal, 1 application on the superfcial painful site for 5–7 days Can be combined with analgesic agents in different pain categories Nonpharmaceutical Modalities Acupuncture Physical rehabilitation Nutraceutical and nutritional supplemental therapies a. Modalities are appropriate for dogs and cats unless otherwise specifed. b. Do not administer NSAIDs and corticosteroids concurrently; only administer one NSAID at a time, and provide an appropriate washout period (approximately 5–7 days) when switching from one NSAID to another or to a corticosteroid (and vice versa). Use with caution in cats. c. Highly concentrated formulations, such as Simbadol (zoetisus.com), may be used to help make the volume administered more manageable; however, these products should not be sent home with clients due to safety and abuse concerns unless no other options are available for adequate pain control. d. Combine the opioids with an NSAID and adjuvants for treating severe pain.

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