Drug management in chronic pain: when basics are not enough

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: This session considers analgesic management for pain beyond the licensed options. Our current licensed options for pain management are NSAIDs, paracetamol (as Pardale V), tramadol and grapiprant in dogs and NSAIDs in cats. Starting with those options we will briefly address which one to choose as a first line for pain. We will cover how to work out when to add a second analgesic and what that analgesic should be. Consideration should be given to the type of pain we are treating and an assessment of the impact of the pain on the pet.

: This session considers new and emerging approaches to the pharmacological management of chronic pain conditions. This is an exciting field with an expanding range of options including recently licenced novel classes of NSAIDs (grapiprant), cannabidiol (CBD) compounds, anti-nerve growth factor monoclonal antibody treatment, and even the use of more traditional agents such as ketamine to ‘break the pain cycle’ and effectively reset the pain baseline. It takes an evidence-based approach, where it exists, and tries to assist in making logical pain management plans where the more traditional agents and methods have proven insufficient to effectively treat a particular case. It also emphasise sthat it is very unlikely that any of the novel therapies used as the sole analgesic will sufficiently control pain, and that a holistic approach is essential to ensure the best outcome for our patients.

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