title: Sedative and analgesic effects of buprenorphine, combined with either acepromazine or dexmedetomidine, for premedication prior to elective surgery in cats and dogs. Combination of dexmedetomidine with buprenorphine enhances the antinociceptive effect to a thermal stimulus in the cat compared with either agent alone. Evaluation of client-specific outcome measures and activity monitoring to measure pain relief in cats with osteoarthritis. Subjective and objective measurements of postoperative pain in cats. Clinical efficacy and safety of dexmedetomidine used as a preanesthetic prior to general anesthesia in cats. Comparison of injectable robenacoxib versus meloxicam for peri-operative use in cats: results of a randomised clinical trial. Comparison of oral robenacoxib and ketoprofen for the treatment of acute pain and inflammation associated with musculoskeletal disorders in cats: a randomised clinical trial. Adverse effects of EMLA (lidocaine/prilocaine) cream and efficacy for the placement of jugular catheters in hospitalized cats Changes in thermal threshold response in eight cats after administration of buprenorphine, butorphanol and morphine Use of a transdermal matrix patch of buprenorphine in cats: preliminary pharmacokinetic and pharmacodynamic data Relationship of orthopedic examination, goniometric measurements, and radiographic signs of degenerative joint disease in cats Evaluation of a ketamine-propofol drug combination with or without dexmedetomidine for intravenous anesthesia in cats undergoing ovariectomy. Comparison of oral and subcutaneous administration of buprenorphine and meloxicam for preemptive analgesia in cats undergoing ovariohysterectomy. Effects of meperidine or saline on thermal, mechanical and electrical nociceptive thresholds in cats. Dose range finding study for the efficacy of meloxicam administered prior to sodium urate-induced synovitis in cats. Comparison of transdermal administration of fentanyl versus intramuscular administration of butorphanol for analgesia after onychectomy in cats. Evaluation of signs of postoperative pain and complications after forelimb onychectomy in cats receiving buprenorphine alone or with bupivacaine administered as a four-point regional nerve block. Feline osteoarthritis: a prospective study of 28 cases. Vedaprofen therapy in cats with upper respiratory tract infection or following ovariohysterectomy. Comparison of preoperative carprofen and postoperative butorphanol as postsurgical analgesics in cats undergoing ovariohysterectomy. Postoperative analgesic efficacy of meloxicam compared to tolfenamic acid in cats undergoing orthopaedic surgery. Use of thermal threshold response to evaluate the antinociceptive effects of butorphanol in cats. Assessment of the influence of surgical technique on postoperative pain and wound tenderness in cats following ovariohysterectomy Clinical evaluation of meloxicam versus ketoprofen in cats suffering from painful acute locomotor disorders. Evaluation of short-term limb function following unilateral carbon dioxide laser or scalpel onychectomy in cats. Use of carbon dioxide laser for onychectomy in cats. Comparison of perioperative racemic methadone, levo-methadone and dextromoramide in cats using indicators of post-operative pain. Antinociceptive effects of epidural administration of hydromorphone in conscious cats. Methadone in combination with acepromazine as premedication prior to neutering in the cat. Dose-related thermal antinociceptive effects of intravenous hydromorphone in cats. Anti-nociceptive efficacy of carprofen, levomethadone and buprenorphine for pain relief in cats following major orthopaedic surgery. Evaluation of a therapeutic diet for feline degenerative joint disease. Dose-related antinociceptive effects of intravenous buprenorphine in cats. Owner-assessed indices of quality of life in cats and the relationship to the presence of degenerative joint disease Postoperative pain control in cats: clinical trials with medetomidine and butorphanol. A preliminary investigation comparing pre-operative morphine and buprenorphine for postoperative analgesia and sedation in cats. Analgesic efficacy of preoperative administration of meloxicam or butorphanol in onychectomized cats. Efficacy of non-acaricidal containing otic preparations in the treatment of otoacariasis in dogs and cats Relationship between plasma concentrations and analgesia after intravenous fentanyl and disposition after other routes of administration in cats. Analgesic efficacy of perioperative use of vedaprofen, tramadol or their combination in cats undergoing ovariohysterectomy⋆ Effect of amantadine on oxymorphone-induced thermal antinociception in cats. Prevalence of spondylosis deformans in the feline spine and correlation with owner-perceived behavioural changes. Item generation and design testing of a questionnaire to assess degenerative joint disease-associated pain in cats. Development of a pressure nociceptive threshold testing device for evaluation of analgesics in cats. Comparison between meloxicam and carprofen for postoperative analgesia after feline ovariohysterectomy. Evaluation of the clinical efficacy of meloxicam in cats with painful locomotor disorders. Postoperative analgesia in the cat after ovariohysterectomy by use of carprofen, ketoprofen, meloxicam or tolfenamic acid. A prospective multi-centre clinical trial to compare buprenorphine and butorphanol for postoperative analgesia in cats Effects of tramadol hydrochloride on the thermal threshold in cats. Analgesic effect of the transdermal fentanyl patch during and after feline ovariohysterectomy. Pharmacokinetic and pharmacodynamic modelling of intravenous, intramuscular and subcutaneous buprenorphine in conscious cats. Evaluation of orally administered robenacoxib versus ketoprofen for treatment of acute pain and inflammation associated with musculoskeletal disorders in cats. Evaluation of transdermal fentanyl patches for analgesia in cats undergoing onychectomy. Feline musculoskeletal pain index: responsiveness and testing of criterion validity. Postoperative analgesic effects of intravenous, intramuscular, subcutaneous or oral transmucosal buprenorphine administered to cats undergoing ovariohysterectomy. Long-term safety, efficacy and palatability of oral meloxicam at 0.01–0.03 mg/kg for treatment of osteoarthritic pain in cats Comparison of the effects of buprenorphine, oxymorphone hydrochloride, and ketoprofen for postoperative analgesia after onychectomy or onychectomy and sterilization in cats. Efficacy of tolfenamic acid and meloxicam in the control of postoperative pain following ovariohysterectomy in the cat. The faces pain scale for the self-assessment of the severity of pain experienced by children: Development, initial validation, and preliminary investigation for ratio scale properties Characterization of osteoarthritis in cats and meloxicam efficacy using objective chronic pain evaluation tools. Comparison of the analgesic effects of robenacoxib, buprenorphine and their combination in cats after ovariohysterectomy. Analgesia after feline ovariohysterectomy under midazolam-medetomidine-ketamine anaesthesia with buprenorphine or butorphanol, and carprofen or meloxicam: a prospective, randomised clinical trial
abstract: OBJECTIVE To evaluate the sedative and analgesic effects of intramuscular buprenorphine with either dexmedetomidine or acepromazine , administered as premedication to cats and dogs undergoing elective surgery . STUDY DESIGN Prospect i ve , r and omized , blinded clinical study . ANIMALS Forty dogs and 48 cats . METHODS Animals were assigned to one of four groups , according to anaesthetic premedication and induction agent : buprenorphine 20 μg kg(-1 ) with either dexmedetomidine ( dex ) 250 μg m(-2 ) or acepromazine ( acp ) 0.03 mg kg(-1 ) , followed by alfaxalone ( ALF ) or propofol ( PRO ) . Meloxicam was administered preoperatively to all animals and anaesthesia was always maintained using isoflurane . Physiological measures and assessment s of pain , sedation and mechanical nociceptive threshold ( MNT ) were made before and after premedication , intraoperatively , and for up to 24 hours after premedication . Data were analyzed with one-way , two-way and mixed between-within subjects anova , Kruskall-Wallis analyses and Chi squared tests . Results were deemed significant if p ≤ 0.05 , except where multiple comparisons were performed ( p ≤ 0.005 ) . RESULTS Cats premedicated with dex were more se date d than cats premedicated with acp ( p < 0.001 ) and ALF doses were lower in dex cats ( 1.2 ± 1.0 mg kg(-1 ) ) than acp cats ( 2.5 ± 1.9 mg kg(-1 ) ) ( p = 0.041 ) . There were no differences in sedation in dogs however PRO doses were lower in dex dogs ( 1.5 ± 0.8 mg kg(-1 ) ) compared to acp dogs ( 3.3 ± 1.1 mg kg(-1 ) ) ( p < 0.001 ) . There were no differences between groups with respect to pain scores or MNT for cats or dogs . CONCLUSION Choice of dex or acp , when given with buprenorphine , caused minor , clinical ly detectable , differences in various characteristics of anaesthesia , but not in the level of analgesia . CLINICAL RELEVANCE A combination of buprenorphine with either acp or dex , followed by either PRO or ALF , and then isoflurane , accompanied by an NSAID , was suitable for anaesthesia in dogs and cats undergoing elective surgery . Choice of sedative agent may influence dose of anaesthetic induction agent OBJECTIVE To evaluate the sedative and antinociceptive effects of combinations of dexmedetomidine and buprenorphine in cats . STUDY DESIGN Experimental r and omized study . ANIMALS Twelve purpose -bred neutered domestic short-hair cats ( 4 male and 8 female ) weighing 4.6 kg ( range 3.7 - 5.5 kg ) aged from 2 to 5 years . METHODS Six cats per group were administered buprenorphine ( B ) at 10 ( B10 ) or 20 microg kg(-1 ) ( B20 ) or dexmedetomidine ( D ) at 20 ( D20 ) or 40 microg kg(-1 ) ( D40 ) or a combination of B10/D20 . A feline thermal nociceptive threshold testing device was used to evaluate the antinociceptive effects of the drugs before and up to 24 hours after drug treatment . Sedation was scored using a 100 mm visual analogue scale ( VAS ) . RESULTS Thermal thresholds increased significantly after administration of all but D20 . Area under the curve ( AUC , hours degrees C ) for the first 6 hours ( mean + /- SD ) for B20 ( 281 + /- 17.8 ) was significantly greater than B10 ( 260 + /- 11.4 ) , D20 ( 250 + /- 7.9 ) and D40 ( 255 + /- 11.4 ) . The AUC for B10/D20 ( 273 + /- 12.2 ) was significantly greater than D20 but not the other treatments . No sedation was seen after administration of B10 or B20 and maximal sedation was seen for all animals in the D40 and B10/D20 groups and most animals in the D20 group . CONCLUSIONS D20 alone had the smallest analgesic effect ; B10 alone provided no sedation but their combination gave good sedation with analgesia comparable with B20 . CLINICAL RELEVANCE This combination could be a useful multimodal sedative/analgesic regimen in cats BACKGROUND There are no vali date d systems for measuring pain from osteoarthritis in cats . HYPOTHESIS Owner subjective assessment s and an activity monitor ( AM ) can be used to detect pain in cats with osteoarthritis and to assess efficacy of treatments . ANIMALS Thirteen cats older than 10 years old , with owner-assessed decreases in activity , painful arthritic joints , and clinical ly normal blood work were included and evaluated for 3 weeks . METHODS A collar-mounted AM measured activity and a client-specific outcome measure ( CSOM ) question naire characterized the severity of impairment . Overall global quality of life was also evaluated for each treatment . In weeks 2 and 3 , meloxicam ( 0.1 mg/kg , day 1 ; 0.05 mg/kg , days 2 - 5 ) or a placebo was administered in a blinded , r and omized , cross-over manner to test the assessment systems . RESULTS The cats had a median of 4 arthritic appendicular joints .  Activity counts for the week when cats ( complete data on activity ; n=9 ) were administered meloxicam were significantly higher than at baseline ( P = .02 ) but not after placebo ( P = .06 ) . Baseline activity counts were not significantly different from placebo ( P = .6 ) . The CSOM data ( n=13 ) showed that owners considered their cats to be more active on meloxicam compared with baseline ( P = .001 ) and placebo ( P < .004 ) , and more active on placebo than at baseline ( P < .01 ) . Global quality of life improved significantly with meloxicam ( P < .042 ) . CONCLUSIONS AND CLINICAL IMPORTANCE Both an AM and a CSOM system can detect behavior associated with pain relief in cats that are arthritic . Objective activity data might allow subjective assessment systems to be vali date d for use in clinical studies OBJECTIVE To evaluate the ability of various subjective and objective measurements to determine the presence and degree of postoperative pain in cats . DESIGN R and omized controlled prospect i ve clinical study . ANIMALS 18 healthy client-owned cats . PROCEDURE Cats were r and omly assigned to 3 groups of 6 : control , tenectomy , and onychectomy . Jugular catheters were placed the day prior to surgery . All surgeries were performed by the same surgeon , and all observations were made by the same blinded trained observer . One hour prior to surgery and at assigned intervals for 36 hours after surgery , heart rate , respiratory rate , and rectal temperature were measured . Scores were assigned for 3 interaction responses , including response to palpation , by use of simple descriptive scales , and to 2 pain assessment s by use of visual analogue scales . Blood was collected to measure plasma beta-endorphin and cortisol concentrations .  Butorphanol was administered to all cats before surgery and to any cat subjectively assessed to be experiencing pain after surgery . RESULTS Only visual analogue scale scores and response to palpation scores differed significantly between control and surgical groups . CONCLUSIONS AND CLINICAL RELEVANCE Determination of the presence of pain in cats can be made on the basis of observation and interaction by a trained observer . Physiologic measurements , including plasma cortisol and beta-endorphin concentrations , did not differentiate between control cats and cats that underwent surgery OBJECTIVE To evaluate the clinical efficacy of dexmedetomidine as a preanesthetic medication administered prior to anesthetic induction with ketamine or propofol and with or without isoflurane for maintenance of anesthesia . DESIGN R and omized , blinded , controlled clinical trial . ANIMALS 184 client-owned cats . PROCEDURES Cats requiring general anesthesia for short or long procedures were assigned to receive 1 of 4 preanesthetic and induction drug combinations ( dexmedetomidine and ketamine , placebo [ saline { 0.9 % NaCl } solution ] and ketamine , dexmedetomidine and propofol , or placebo and propofol ) . Cats undergoing long procedures received isoflurane for maintenance of anesthesia . RESULTS Administration of dexmedetomidine prior to anesthetic induction with ketamine significantly increased the intubation success rate ( 57/64 [ 89 % ] ) , compared with the success rate for the placebo ( 4/37 [ 11 % ] ) ; significantly reduced the median induction dose of propofol ( ≤ 5.1 mg/kg [ 2.32 mg/lb ] ) , compared with that for the placebo ( ≤ 10.5 mg/kg [ 4.77 mg/lb ] ) ; and significantly reduced the isoflurane concentration ( 1.5 % ) required for anesthesia maintenance , compared with that for the placebo ( 3.0 % ) . Postoperatively , fewer cats receiving dexmedetomidine  required rescue analgesia , and cats had lower pain scores for at least 2 hours after surgery , compared with results for cats receiving the  placebo . Heart rate was lower during the procedure and respiratory rate and rectal temperature were lower during and after the procedure for cats receiving dexmedetomidine . More cats that received dexmedetomidine  had emesis and pale mucous membranes , compared with the number of cats with those signs that received placebo . CONCLUSIONS AND CLINICAL RELEVANCE Dexmedetomidine as a preanesthetic was efficacious for clinical use in cats requiring general anesthesia The objective of this study was to evaluate the efficacy and tolerability of robenacoxib , a selective cyclooxygenase-2 inhibitor , for the treatment of post-operative pain and inflammation in cats . The study was a prospect i ve , multi-centre , r and omised , blinded , non-inferiority design clinical study to compare robenacoxib to meloxicam .  Ninety-six cats undergoing surgery at eight centres in Japan were allocated r and omly to receive a single s.c . injection of robenacoxib ( 2 mg/kg , n=67 ) or meloxicam ( 0.3 mg/kg , n=29 ) shortly before induction of anaesthesia . Most cats underwent soft tissue surgery ( n=87 ) , mainly  ovariectomy  ( n=68 ) . Post-operative pain and inflammation were assessed at 3 , 8 and 22 h after recovery from anaesthesia using numerical rating scales . For the primary efficacy endpoint ( total clinician score ) , robenacoxib had significantly better efficacy than meloxicam , the relative efficacy ratio being 1.47 ( 95 % confidence interval 1.19 - 1.78 , P=0.0003 ) . For the secondary efficacy endpoints , robenacoxib was superior to meloxicam when assessed on the basis of posture , behaviour , pain on palpation and overall pain control , while meloxicam was superior with respect to wound heat . No cat in either group required rescue analgesia therapy . In tolerability assessment s , pain during injection and pain and inflammation at the injection site 22 h after recovery from anaesthesia were rated significantly less with robenacoxib compared to meloxicam . Both treatments were well tolerated on the basis of clinical observations and blood tests , with no significant differences between groups . In conclusion , single pre-operative administration of robenacoxib was well tolerated and had superior efficacy to meloxicam in reducing post-operative pain in cats The objective of the study was to evaluate the efficacy and tolerability of robenacoxib , a selective cyclooxygenase-2 inhibitor , for the treatment of acute pain and inflammation associated with musculoskeletal disorders in cats . The study was a prospect i ve , multi-centre , r and omised , blinded , non-inferiority design clinical trial comparing robenacoxib to ketoprofen . A total of 68 cats presenting with pain and inflammation associated with acute musculoskeletal disorders were recruited and allocated r and omly to receive , orally once daily for 5 - 6 days , either 1.0 - 2.4 mg/kg robenacoxib ( n=47 ) or 1mg/kg ketoprofen ( n=21 ) . The primary efficacy endpoint was the total clinician score , which was the sum of clinician numerical rating scale scores for pain , inflammation and mobility . Assessment s were made at baseline , on day 2 , and day 4 or 5 . For the total clinician score , non-inferior efficacy of robenacoxib was demonstrated with a relative efficacy of 1.151 ( 95 % confidence interval 0.872 - 1.494 ) . Non-inferior efficacy of robenacoxib was also demonstrated for the secondary endpoint of the total owner score .  Robenacoxib was superior ( P<0.05 ) to ketoprofen for the owner 's assessment of activity and human/animal relationship . The tolerability of both treatments was good as assessed by monitoring adverse events , clinical signs and haematology and serum biochemistry variables EMLA is a lidocaine/prilocaine cream used for topical analgesia in human pediatric patients . The purpose of this study was to establish the safety of EMLA in clinical ly ill cats , to measure systemic absorption and to determine whether EMLA reduced the need for sedation for the placement of jugular catheters . Thirty-one cats were r and omized to either a placebo or EMLA cream group . Cream was applied to a 10 cm2 area over the jugular vein , with 1 h of occlusive dressing . Neither anesthetic was systemically absorbed in any cat , and no adverse clinical signs were observed . Struggling during catheter placement was less in the EMLA-treated cats compared to placebo , but did not reach significance ( P=0.06 ) . Jugular catheters were successfully placed in 60 % of EMLA-treated cats and 38 % of placebo cats ; this difference was not statistically significant and may not justify the added steps of EMLA cream administration for this purpose . However , EMLA does appear to be safe in clinical ly ill cats , and may be useful for other applications such as for skin mass removal or repeated venepuncture Thermal  thresholds  were measured in eight cats after the intramuscular administration of morphine ( 0.2 mg/kg ) , buprenorphine ( 0.01 mg/kg ) or butorphanol ( 0.2 mg/kg ) , doses commonly used in clinical practice ; 0.9 per cent saline ( 0.3 ml ) was injected as a control . Groups of six cats were used and each cat participated in at least two treatments , according to a r and omised design . The investigator was blinded to the treatments . The thermal thresholds were measured with a testing device developed specifically for cats , and measurements were made before and five , 30 , 45 and 60 minutes and two , four , six , 12 and 24 hours after the injections . There was no significant change in thermal threshold after the injection of saline . With butorphanol , the threshold was increased only at five minutes after the injection and was decreased two hours after the injection ; with morphine it was increased from between four and six hours after the injection , and with buprenorphine it was increased from between four and 12 hours after the injection Six domestic shorthair cats , aged three to four years and weighing 5·1 to 7·4 kg , were used to assess the thermal antinociceptive effect of a transdermal buprenorphine patch , design ed to supply 35 μg buprenorphine/hour , which was applied to the shaved thorax . The cats ' thermal thresholds were tested before the patch was applied and two , four , six , eight , 10 , 12 , 14 and 16 hours after it had been applied , and then every six hours until it was removed after 72 hours , and for a further 24 hours afterwards . Blood was collected at each time to measure the plasma concentration of buprenorphine . The patches did not produce a significant change in the thermal thresholds of the cats throughout the testing period . The mean ( sd ) peak plasma buprenorphine concentration was 10 ( 0·81 ) ng/ml Background Available information suggests a mismatch between radiographic and orthopedic examination findings in cats with DJD . However , the extent of the discrepancy between clinical and radiographic signs of OA in companion animals has not been described in detail . This study aim ed to evaluate the relationship between orthopedic examination findings , joint goniometry  , and radiographic signs of DJD in 100 cats , in a prospect i ve observational design . Cat temperament , pain response to palpation , joint crepitus , effusion and thickening were grade d. Radiographs of appendicular joints and the axial skeleton were made under sedation . Joint motion was measured by use of a plastic goniometer before and after sedation . Associations between radiographic degenerative joint disease ( DJD ) and examination findings were assessed to determine sensitivity , specificity and likelihood estimations . Results Pain response to palpation was elicited in 0 - 67 % of the joints with DJD , with a specificity ranging from 62 - 99 % ; crepitus was detected in 0 - 56 % of the joints and its specificity varied between 87 and 99 % ; for effusion , values ranged between 6 and 38 % ( specificity , 82 - 100 % ) , and thickening , 0 - 59 % ( specificity , 74 - 99 % ) . Joints with DJD tended to have a decreased range of motion . The presence of pain increased the odds of having DJD in the elbow ( right : 5.5 ; left : 4.5 ) ; the presence of pain in the lower back increased the odds of spinal DJD being present ( 2.97 for lumbar ; 4.67 for lumbo-sacral ) . Conclusions Radiographic DJD can not be diagnosed with certainty using palpation or goniometry . However , negative findings tend to predict radiographically normal joints . Palpation and goniometry may be used as a tool to help to screen cats , mostly to rule out DJD OBJECTIVE To evaluate the use of a ketamine-propofol combination , with or without dexmedetomidine , in cats undergoing ovariectomy and to assess Heinz body formation following administration of these drugs . DESIGN R and omized clinical trial . ANIMALS 15 client-owned female cats . PROCEDURES Anesthesia was induced with a ketamine ( 2.0 mg/kg [ 0.91 mg/lb])-propofol ( 2.0 mg/kg ) combination with ( n = 7 ) or without ( 8) dexmedetomidine ( 0.003 mg/kg [ 0.0013 mg/lb ] ) and was maintained via continuous IV infusion of a 1:1 ketamine-propofol combination ( administration rate for each drug , 10.0 mg/kg/h [ 4.54 mg/lb/h ] ) . Cats underwent ovariectomy ;  duration of infusion was 25 minutes . Physiologic variables were measured at predetermined time points . Heinz bodies were quantified via examination of blood smears . Numeric scales were used to assess quality of recovery , degree of sedation , and signs of pain after surgery . RESULTS The ketamine-propofol group had a significantly higher mean heart rate at several time points during drug infusion , a significantly shorter time from the end of infusion to extubation ( 7 vs 29 minutes ) , and significantly lower sedation scores for the first hour after surgery than did the ketamine-propofol-dexmedetomidine group . Other variables were similar between groups ; recovery was smooth , and anesthesia and postoperative analgesia were deemed adequate for all cats . The number of RBCs with Heinz bodies was not increased after surgery , compared with values immediately after anesthetic induction . CONCLUSIONS AND CLINICAL RELEVANCE Total IV anesthesia with a ketamine-propofol combination , with or without dexmedetomidine , appeared to be effective in healthy cats . These short-term infusions produced smooth recovery and adequate analgesia during the postoperative period OBJECTIVE To compare the effectiveness of preoperative PO and SC administration of buprenorphine and meloxicam for prevention of postoperative pain-associated behaviors in cats undergoing ovariohysterectomy . DESIGN R and omized controlled study . ANIMALS 51 female cats ( 4 to 60 months old ; weight range , 1.41 to 4.73 kg [ 3.1 to 10.4 lb ] ) . PROCEDURE Cats received 1 of 5 treatments at the time of anesthetic induction : buprenorphine PO ( 0.01 mg/kg [ 0.0045 mg/lb ] ; n = 10 ) , buprenorphine SC ( 0.01 mg/kg ; 10 ) , meloxicam SC ( 0.3 mg/kg 10.14 mg/lb ] ; 10 ) , meloxicam PO ( 0.3 mg/kg ; 10 ) , or 0.3 mL of sterile saline ( 0.9 % NaCI ) solution SC ( control group ; 11 ) . Sedation scores and visual analog scale and interactive visual analog scale ( IVAS ) pain-associated behavior scores were assigned to each cat 2 hours before and at intervals until 20 hours after surgery . RESULTS Cats receiving meloxicam PO or SC had significantly lower IVAS scores ( 2.91 and 2.02 , respectively ) , compared with IVAS scores for cats receiving buprenorphine PO ( 755 ) . Pain-associated behavior scores for cats administered buprenorphine or meloxicam PO or SC preoperatively did not differ significantly from control group scores . Rescue analgesia was not required by any of the cats receiving meloxicam , whereas 3 of 10 cats receiving buprenorphine PO , 2 of 10 cats receiving buprenorphine SC , and 1 of 11 cats receiving the control treatment required rescue analgesia . CONCLUSIONS AND CLINICAL RELEVANCE On the basis of pain-associated behavior scores , cats receiving meloxicam PO or SC before ovariohysterectomy appeared to have less pain after surgery than those receiving buprenorphine PO preoperatively OBJECTIVE To measure cutaneous electrical nociceptive thresholds in relation to known thermal and mechanical stimulation for nociceptive threshold detection in cats . STUDY DESIGN Prospect i ve , blinded , r and omized cross-over study with 1-week washout interval . ANIMALS Eight adult cats [ bodyweight 5.1 + /- 1.8 kg ( mean + SD ) ] . METHODS Mechanical nociceptive thresholds were tested using a step-wise manual inflation of a modified blood pressure bladder attached to the cat 's thoracic limb .  Thermal nociceptive thresholds were measured by increasing the temperature of a probe placed on the thorax . The electrical nociceptive threshold was tested using an escalating current from a constant current generator passed between electrodes placed on the thoracic region . A positive response ( threshold ) was recorded when cats displayed any or all of the following behaviors : leg shake , head turn , avoidance , or vocalization . Four baseline readings were performed before intramuscular injection of meperidine ( 5 mg kg(-1 ) ) or an equal volume of saline . Threshold recordings with each modality were made at 15 , 30 , 45 , 60 , 90 , and 120 minutes post-injection . Data were analyzed using ANOVA and paired t-tests ( significance at p < 0.05 ) . RESULTS There were no significant changes in thermal , mechanical , or electrical thresholds after saline . Thermal thresholds increased at 15 - 60 minutes ( p < 0.01 ) and mechanical threshold increased at 30 and 45 minutes after meperidine ( p < 0.05 ) . Maximum thermal threshold was + 4.1 + /- 0.3 degrees C above baseline at 15 minutes while maximum mechanical threshold was 296 + /- 265 mmHg above baseline at 30 minutes after meperidine . Electrical thresholds following meperidine were not significantly different than baseline ( p > 0.05 ) . Thermal and electrical thresholds after meperidine were significantly higher than saline at 30 and 45 minutes ( p < 0.05 ) , and at 120 minutes ( p < 0.05 ) , respectively . Mechanical thresholds were significantly higher than saline treatment at 30 minutes ( p < or= 0.05 ) . CONCLUSION AND CLINICAL RELEVANCE Electrical stimulation did not detect meperidine analgesia whereas both thermal and mechanical thresholds changed after meperidine administration in cats OBJECTIVE To determine the lowest efficacious dose of oral meloxicam for relieving pain in cats with a sodium urate (SU)-induced acute inflammatory synovitis . STUDY DESIGN R and omized , blinded , controlled , and four-way crossover study . ANIMALS Eight surgically neutered cats ( four males , four females ) paired according to sex . METHODS Each pair of cats was treated with 0 ( placebo ) , 0.025 , 0.05 , or 0.075 mg kg(-1 ) oral meloxicam once daily for 4 days prior to injection , into alternating stifles , of 1 mL of 20 mg mL(-1 ) SU crystals , beginning with the right stifle . Each cat received each of the four treatments , separated by at least 21 days . Analgesic efficacy was evaluated based on objective ( e.g. , pressure mat data total force , contact pressure , and contact area ) and subjective ( e.g. , scores for Analgesia Scale [ AS ] , Lameness Scale [ LS ] , and Visual Analog Scale [ VAS ] ) outcome measures for pain assessment . All outcome measures were recorded before and during 30 hours after SU injection . The pre-defined primary outcome measure was the area under the response-time curve ( AUC(0 - 30 ) hours ) of the total force of the injected limb . Data were analyzed by analysis of variance . A sequential test procedure was applied and the test sequence stopped in case of a nonsignificant result . RESULTS Meloxicam at doses of 0.05 and 0.075 mg kg(-1 ) day(-1 ) PO was significantly different from placebo for the pre-defined primary outcome measure ( i.e. , AUC(0 - 30 ) hours of total force ) . All tested meloxicam doses were lower than placebo for the subjective outcome measures ( i.e. , AUC(0 - 30 ) hours of AS , LS , and VAS ) . CONCLUSIONS AND CLINICAL RELEVANCE The lowest efficacious dose of meloxicam for relieving pain in cats with an SU-induced synovitis was 0.05 mg kg(-1 ) day(-1 ) PO according to the pre-defined primary outcome measure . However , lower doses may also be effective as seen in the subjective outcome measures OBJECTIVE To compare postoperative discomfort assessed by subjective pain score and plasma cortisol concentrations in cats undergoing onychectomy that received analgesia by use of transdermal fentanyl ( TDF ) patches or an i.m . injection of butorphanol . DESIGN R and omized prospect i ve clinical trial . ANIMALS 22 client-owned cats weighing 2.2 to 5 kg ( 4.84 to 11 lb ) undergoing onychectomy .  PROCEDURE Research ers were blinded to which cats received a TDF patch ( 25 microg/h ) 18 to 24 hours prior to surgery or an i.m . injection of butorphanol ( 0.2 mg/kg ( 0.09 mg/lb ] ) at the time of sedation , immediately following extubation , and at 4-hour intervals thereafter for 12 hours . Clinical variables , plasma cortisol concentration , and pain scores were evaluated and recorded 24 hours prior to surgery , at extubation , and 2 , 4 , 8 , 12 , 24 , 36 , and 48 hours after surgery . RESULTS The TDF group had a lower pain score than the butorphanol group only at 8 hours after surgery . Both groups had significantly lower mean plasma cortisol concentrations 0 , 24 , 36 , and 48 hours after surgery , compared with mean plasma cortisol concentrations prior to surgery . No significant differences in appetite or response to h and ling the feet were observed between the 2 groups . CONCLUSIONS AND CLINICAL RELEVANCE Our data did not reveal a difference in pain relief between administration of TDF and butorphanol .  Plasma cortisol concentrations were not different between groups . Fentanyl appeared to provide equivalent analgesia to butorphanol in cats undergoing onychectomy . The primary advantage of using a TDF patch is that repeated injections are not required OBJECTIVE To evaluate signs of postoperative pain and complications after forelimb onychectomy in cats receiving buprenorphine alone or with bupivacaine administered as a 4-point regional nerve block . DESIGN Prospect i ve , r and omized , double-blind clinical trial . ANIMALS 20 cats . PROCEDURE All cats received buprenorphine ( 0.01 mg/kg [ 0.004 mg/lb ] , IM ) preoperatively . One forelimb of each cat also received bupivacaine ( 1 mg/kg [ 0.45 mg/lb ] of a 0.75 % solution ) administered as a 4-point regional nerve block . After onychectomy , discomfort ( lameness , foot reaction , and pain ) scores were evaluated by 2 experienced observers 2 , 4 , 6 , 8 , 24 , and 168 hours postoperatively . Complication ( hemorrhage , swelling , and infection ) scores were evaluated 24 and 168 hours postoperatively . Surgeries were performed by 1 experienced veterinary surgeon . Rescue analgesia was provided if needed . RESULTS 6 cats required rescue analgesia postoperatively . There was no difference in discomfort or complication scores between control limbs and limbs in which a nerve block was administered . Additionally , there was no difference in discomfort and complication scores between cats that did or did not require rescue analgesia . CONCLUSIONS AND CLINICAL RELEVANCE Bupivacaine administered as a 4-point regional nerve block in addition to a systemic analgesic did not decrease discomfort or complication scores in cats undergoing forelimb onychectomy OBJECTIVES To identify a cohort of cats with clinical osteoarthritis and to report on the clinical signs , the frequency of joints affected and the possible aetiopathogenesis within this population . METHODS Inclusion criteria for this prospect i ve study were presence of historical evidence and /or clinical signs of osteoarthritis , together with radiographic evidence of osteoarthritis . Patients showed clinical improvement within four weeks of analgesic administration and were free from other disease processes , which might explain the clinical signs and /or their response to analgesia . RESULTS Twenty-eight cases were included in the cohort . The elbow ( 45 per cent ) and the hip ( 38 per cent ) were the most frequently affected joints . Seventy-one per cent of cases had primary /idiopathic aetiology . Alterations in both the ability to jump ( 71 per cent ) and the height ( 67 per cent ) of jump ( lifestyle changes ) were the most frequent signs of disease . Sixty-one per cent of owners felt that their pet had made a marked improvement following administration of an analgesic/anti-inflammatory drug . There were statistically significant improvements in the ability to jump ( P < 0.001 ) , the height of jump ( P < 0.001 ) , lameness ( P = 0.03 ) , stiff gait ( P = 0.04 ) and the activity level ( P = 0.02 ) when compared with the start and the end of the study period . CLINICAL SIGNIFICANCE Osteoarthritis is a clinical problem in cats , but overt lameness is not the most common clinical feature OBJECTIVES The antipyretic and analgesic efficacy of vedaprofen ( at a dose of 0.5 mg/kg ) was evaluated after repeated once-daily administration ( for three or five days ) to 80 cats with upper respiratory tract disease or 302 cats undergoing ovariohysterectomy .  METHODS Both clinical trials were r and omised , double blinded and placebo controlled . RESULTS In the upper respiratory tract disease trial , vedaprofen produced a significant reduction in rectal temperature when compared with cats administered antimicrobial treatment only . This antipyretic activity lasted at least four hours after administration on the first day of treatment ( day 0 ) and at least eight hours on day 1 and day 2 . Significantly more cats in the treatment group were classified as having returned to normal on day 5 , day 6 and day 7 compared with the placebo group . In the ovariohysterectomy trial , scores for behaviour ( on day 1 , day 2 and day 3 ) and appetite ( on day 1 and day 2 ) were significantly better in the vedaprofen group than in the placebo-treated cats . CLINICAL SIGNIFICANCE Vedaprofen produced a clinical ly relevant reduction in body temperature and a more rapid return to normality in cats with upper respiratory tract disease . Vedaprofen treatment also result ed in more rapid recovery , presumably through the relief of pain and inflammation , in cats that had undergone soft tissue surgery OBJECTIVE To compare carprofen to butorphanol , with regard to postsurgical analgesic effects , duration of analgesia , and adverse side effects . STUDY DESIGN Blinded , r and omized clinical study . ANIMALS Seventy-one cats , 0.5 - 5 years of age , weighing 3.24 + /- 0.61 kg , undergoing ovariohysterectomy ( OHE ) . METHODS Cats were premedicated with subcutaneous atropine ( 0.04 mg kg(-1 ) ) , acepromazine ( 0.02 mg kg(-1 ) ) , and ketamine ( 5 mg kg(-1 ) ) . Anesthesia was induced with ketamine ( 5 mg kg(-1 ) ) and diazepam ( 0.25 mg kg(-1 ) ) given intravenously , and maintained with isoflurane . There were three treatment groups : group C ( 4 mg kg(-1 ) carprofen SC at induction ) , group B ( 0.4 mg kg(-1 ) butorphanol SC at end of surgery ) , and group S ( 0.08 mL kg(-1 ) of sterile saline SC at induction and end of surgery ) . Behavioral data were collected using a composite pain scale ( CPS ) , prior to surgery ( baseline ) and 1 , 2 , 3 , 4 , 8 , 12 , 16 , 20 , and 24 hours post-surgery . Interaction scores were analyzed separately . Cats with CPS scores > 12 received rescue analgesia ( meperidine , 4 mg kg(-1 ) , intramuscular ) . RESULTS Sixty cats completed the study . The CPS scores did not differ significantly between groups C and B at any time period . CPS scores for groups B and C were significantly increased for 12 hours post-surgery , and in group S for 20 hours . Both group C and B CPS scores were significantly lower than group S in this 20-hour postoperative period , except at 4 hours ( B and C ) and at 3 and 8 hours ( B alone ) . Interaction scores for group C returned to preoperative baseline 4 hours after surgery , while both groups B and S remained increased for at least 24 hours post-surgery . Nine cats required meperidine . CONCLUSION In this study , carprofen provided better postsurgical analgesia than butorphanol . Clinical relevance Neither drug completely abolished pain , however preoperative carprofen provided better pain control compared with postoperative butorphanol in the 24-hour period following OHE surgery in cats OBJECTIVES To investigate the efficacy of meloxicam or tolfenamic acid administered preoperatively and postoperatively ( five days in total ) to cats undergoing surgical fracture repair . METHODS Eighty-eight otherwise healthy cats were matched according to fracture site and then r and omly allocated to one of two groups , receiving 0·2 mg/kg meloxicam by subcutaneous injection ( group M ) or 1·5 to 3 mg/kg tolfenamic acid orally ( group T ) before anaesthesia . Analgesia was continued with 0.05 mg/kg oral meloxicam once daily or 1·5 to 3 mg/kg oral tolfenamic acid twice daily for four days postoperatively . Pain was assessed by a blinded observer using visual analogue scales and a functional limb score . The drug administrator assessed feed intake and palatability of the treatment . RESULTS Data from 66 cats were analysed . Visual analogue scale pain scores and functional limb scores decreased over time in both groups but were not significantly different between treatments . Feed intake was similar in both groups . Meloxicam was significantly more palatable  than tolfenamic acid on all treatment days . CLINICAL SIGNIFICANCE Meloxicam and tolfenamic acid demonstrated comparable analgesia , without clinical ly observable side effects . Meloxicam may be associated with superior compliance in clinical practice due to the higher palatability and once daily treatment result ing in better ease of administration OBJECTIVE To characterize the antinociceptive actions of several doses of butorphanol by use of a thermal threshold testing device specifically design ed for cats . ANIMALS 6 domestic shorthair cats . PROCEDURE The study was a masked , r and omized , crossover design . Thermal thresholds were measured by use of a thermal threshold-testing device specifically developed for cats . A small probe containing a heater element and temperature sensor was held with consistent contact against a shaved area of the cat 's skin with an elasticized b and . Skin temperature was recorded before each test , prior to activation of the heater . On detection of a response ( eg , the cat flinched , turned , or jumped ) , the stimulus was terminated and the threshold temperature recorded . Three baseline measurements were recorded before IV injection of 0.1 , 0.2 , 0.4 , or 0.8 mg of butorphanol/kg . Each cat received all doses in a r and omized order at least 1 week apart . The investigator was unaware of the treatment received . Thermal thresholds were measured every 15 minutes for 6 hours . RESULTS Mean+/-SD pretreatment threshold temperature for all cats was 40.8+/-2.2 degrees C. There were no dose-related differences among treatments . There was a significant increase in threshold values for all treatments from 15 to 90 minutes after injection . Mydriasis was detected in all cats after treatment with butorphanol and dysphoric behavior was frequently exhibited . CONCLUSIONS AND CLINICAL RELEVANCE Results obtained by use of a thermal stimulus indicated that the duration of antinociceptive action of butorphanol was 90 minutes and there was no dose-response relationship in cats Elective ovariohysterectomy was performed on 66 cats . Surgical approach was flank ( group F ) or midline ( group M ) allocated by block r and omisation . Pre-anaesthetic medication was acepromazine ( 0.1 mg/kg ) via intramuscular injection . Anaesthesia was induced with intravenous thiopentone , and maintained with halothane in 100 % oxygen . Carprofen ( 4 mg/kg ) was administered by the subcutaneous route immediately after induction of anaesthesia . Postoperative pain and wound tenderness were assessed at 1 , 3 , 6 , 9 , 11–12 and 20–24 h after the end of surgery , and the assessment outcome marked on visual analogue scales ( VAS ) . Intervention analgesia ( if  pain VAS was > 40 mm ) was pethidine 4 mg/kg via intramuscular injection . Area under the curve ( AUC ) for VAS for pain and VAS for wound tenderness for each cat were calculated . AUC for wound tenderness was significantly greater for group F ( P=0.007 ) . There was no significant difference for AUC for pain between the groups . In conclusion , wounds after flank ovariohysterectomy are significantly more tender than after midline ovariohysterectomy in the cat . This indicates that interactive methods , including wound palpation , must be used to assess postoperative pain and the findings should be appropriately weighted in the overall assessment The aim of this study was to evaluate the efficacy and palatability of meloxicam 0.5mg/ml oral suspension , compared to ketoprofen tablets in cats suffering from painful acute locomotor disorders . This single blinded , positively-controlled , r and omised , multicentre trial involved 121 client owned cats . Cats received either meloxicam ( 0.5mg/ml oral suspension ) at 0.1mg/kg on day 1 followed by 0.05mg/kg q 24h on days 2 - 5 , or ketoprofen 5 mg tablets at 1.0mg/kg q 24h for 5 days . The efficacy of the two treatments was assessed subjectively by clinicians on day 6 using a clinical sum score ( CSS ) . Palatability and accuracy of dosing were also assessed . The baseline CSS was not significantly different between the groups , and after 5 days of treatment the CSS had decreased to a similar extent , reflecting a reduction in pain . There were no significant differences between the CSS of each group at day 6 . Both treatments were well tolerated .  Meloxicam was significantly more palatable than ketoprofen , and allowed for more accurate dosing .  Meloxicam and ketoprofen are a safe and efficacious treatment for acute locomotor disorders in cats .  Meloxicam ( Metacam ) may be associated with superior compliance in clinical practice due to the higher palatability , which results in better ease of administration OBJECTIVE To evaluate short-term postoperative forelimb function after scalpel and laser onychectomy  in cats . DESIGN R and omized , prospect i ve study . ANIMALS 20 healthy adult cats . PROCEDURES Cats were r and omly assigned to the  laser ( n = 10 ) or scalpel ( 10 ) onychectomy group . Unilateral left forelimb onychectomy was performed . In the scalpel group , a tourniquet was used during surgery and a b and age was applied after surgery .  Pressure platform gait analysis was performed prior to and 1 , 2 , 3 , and 12 days after onychectomy .  Peak vertical force ( PVF ) , vertical impulse , and the ratio of the PVF of the left forelimb to the sum of the remaining limbs ( PVF ratio ) were used as outcome measures . RESULTS The laser onychectomy group had significantly higher ground reaction forces on days 1 and 2 and significantly higher PVF ratio on day 12 , compared with the scalpel group . Similarly , significant differences were found in change in ground reaction forces on days 1 and 2 and the PVF ratio on day 12 , compared with day -1 . No cats required rescue analgesia during the course of the study . One cat in the laser group had signs of depression and was reluctant to walk on day 2 after surgery , had physical examination findings consistent with cardiac insufficiency , and was euthanized . CONCLUSIONS AND CLINICAL RELEVANCE Cats had improved limb function immediately after unilateral laser onychectomy , compared with onychectomy with a scalpel , tourniquet , and b and age . This improved limb function may result from decreased pain during the 48 hours following unilateral laser onychectomy OBJECTIVE To compare postoperative signs of discomfort and complications associated with use of CO2 laser for onychectomy with those of the scalpel technique in cats . DESIGN Prospect i ve , r and omized , masked clinical trial . ANIMALS 20 client-owned cats . PROCEDURE Forelimb feet ( right , left ) were r and omly assigned to laser and scalpel treatment groups . Signs of discomfort ( lameness and signs of pain ) and complications ( hemorrhage , swelling , and discharge ) were assessed on days 0 , 1 , and 7 . Surgeries were performed by 1 experienced surgeon . Evaluations were performed by 2 individuals without knowledge of treatment group . Signs of discomfort and complications were scored on scales of 0 to 8 and 0 to 9 , respectively . RESULTS Onychectomy did not result in high discomfort or complication scores 1 day after surgery , regardless of technique used , although the laser-treated group had significantly lower scores for signs of discomfort and complications . Seven days after surgery , significant differences were not detected between groups for signs of discomfort or complications . CONCLUSIONS AND CLINICAL RELEVANCE The CO2 laser can be an excellent tool for onychectomy in cats , with excellent hemostasis and minimal postoperative discomfort and complications . Differences in discomfort and complications between groups treated via scalpel versus CO2 laser were not clinical ly relevant and were only observed 1 day after surgery OBJECTIVE To compare three opioid agonist drugs for perioperative analgesia in cats . STUDY DESIGN Prospect i ve , blind , controlled , r and omised trial . ANIMALS Ninety client-owned cats , weighing 3.1 ( 2.1 - 4.5 ) kg , aged 14.6 ( 6.0 - 84.0 ) months , were studied . METHODS Seventy-six cats , scheduled for ovariectomy , received either 0.6 mg kg(-1 ) racemic methadone , 0.3 mg kg(-1 ) levo-methadone , 0.05 mg kg(-1 ) dextromoramide or a saline placebo IM . Behaviour and body position were assessed and scored 20 minutes later by a single ' blinded ' observer . Anaesthesia was induced with propofol and maintained with halothane .  Heart rate ( HR ) , respiratory rate ( RR ) , Fe'CO2 and SpO2 were recorded during anaesthesia . Post-operatively , pain was categorised as absent , moderate or severe , on the basis of appearance , behaviour and response to palpation of the surgical wound ( pain score ) . Appearance , pain scores and physiological variables were monitored every 30 minutes , for a duration of 4 hours . Differences between time-dependent continuous variables were analysed using mixed models for repeated measurements . Differences in categorical , time-dependent variables were analysed using chi2-tests . Significance was set at p < or = 0.05 . RESULTS There were no significant changes in appearance after pre-anaesthetic medication . After surgery , there was no association between appearance and pain score with HR or RR . The assessment of pain depended on comparison with the placebo group , by comparing animals ' reactions to wound palpation . Sixteen of the 18 cats in the placebo group and 14 of the 19 cats in the dextromoramide group showed signs of moderate-to-severe pain after surgery . In the levo-methadone group ( n = 20 ) , one animal showed pain after 60 minutes and two after 120 minutes . One cat in the racemic methadone group ( n = 19 ) showed pain signs and behavioural changes at 60 minutes . Compared to the two methadone groups , ' rescue ' analgesia was required more often in cats treated with dextromoramide or saline . CONCLUSION AND CLINICAL RELEVANCE Dextromoramide ( 0.05 mg kg(-1 ) ) was ineffective , while racemic methadone ( 0.6 mg kg(-1 ) ) and levo-methadone ( 0.3 mg kg(-1 ) ) provided effective analgesia in cats following ovariectomy , without behavioural , respiratory or cardiovascular side effects OBJECTIVE To evaluate the antinociceptive effects of epidurally administered hydromorphone in conscious , healthy cats . ANIMALS 7 healthy adult cats . PROCEDURES An epidural catheter was implanted in each cat . Thermal threshold ( TT ) was measured by increasing the temperature of a probe placed on the thorax and monitoring the cat 's response . Mechanical threshold ( MT ) was measured by manually inflating a modified blood-pressure bladder affixed to a thoracic limb and monitoring the response . After the baseline TT and MT values were determined , hydromorphone ( 0.05 mg/kg ) or an equal volume of saline ( 0.9 % NaCl ) solution was epidurally injected . The TT and MT were again measured at 15 , 30 , 45 , 60 , 120 , 180 , 240 , 300 , 360 , and 480 minutes after injection . RESULTS TT and MT did not change significantly from baseline values at any point after saline solution was administered . The MT and TT values were significantly higher than the baseline value at 15 minutes and at 120 and 180 minutes after hydromorphone administration , respectively . The MT and TT values after hydromorphone administration were also significantly different from those obtained at 30 minutes and at 15 minutes and 120 to 300 minutes , respectively , after administration of saline solution . No significant changes in skin temperature were detected after either treatment . CONCLUSIONS AND CLINICAL RELEVANCE Epidural administration of hydromorphone at a dosage of 0.05 mg/kg yielded thermal and some mechanical antinociceptive effects in cats , and no hyperthermia was detected . Additional studies of the antinociceptive effectiveness and duration of epidurally administered hydromorphone in clinical situations are required OBJECTIVE To investigate the safety , sedative and analgesic properties of methadone in combination with acepromazine  prior to neutering in cats . STUDY DESIGN Controlled clinical , block r and omized , prospect i ve , blinded study design ed for regulatory purpose s. ANIMALS 24 female and 21 male healthy cats . METHODS Cats received one of three opioids combined with acepromazine ( 0.05 mg kg(-1 ) ) intramuscularly ( IM ) for premedication : Group 1 : buprenorphine ( 0.02 mg kg(-1 ) ) , group 2 : methadone ( 0.5 mg kg(-1 ) ) , group 3 butorphanol ( 0.4 mg kg(-1 ) ) . Sedation was assessed 30 minutes after premedication using a visual analogue scale ( VAS ) and simple descriptive scale . Anaesthesia was induced with alfaxalone and maintained with isoflurane in oxygen . Surgical ovariohysterectomy or castration was performed . Pain was assessed using an interactive VAS ( IVAS ) and mechanical nociceptive threshold ( MNT ) with a pressure rate onset device . Methadone ( 0.5 mg kg(-1 ) IM ) and meloxicam ( 0.2 mg kg(-1 ) subcutaneously ) were provided 6 and 8 hours after premedication respectively , or together as rescue analgesia ( IVAS above 50 ) . RESULTS Sedation scores , induction agent dose , pain scores at all time points and rescue analgesia were not statistically different between groups . In methadone treated cats there was no significant variation in MNT over time , suggesting a possible anti-hyperalgesic action , whereas in the other two groups lower thresholds were recorded at various time points after surgery compared to baseline . No cats required rescue analgesia after the second dose of methadone . No perioperative adverse effects occurred . CONCLUSION AND CLINICAL RELEVANCE Methadone provided comparable sedation and analgesia to both buprenorphine and butorphanol when combined with acepromazine . Differences in analgesic efficacy between opioids might have been undetectable because of the surgical model and surgeon competency . Nevertheless , methadone is an effective analgesic in cats and its administration prior to feline neutering may be advantageous OBJECTIVE To describe the dose-related thermal antinociceptive effects of intravenous ( i.v . ) hydromorphone  in cats . STUDY DESIGN R and omized , blinded , crossover design . ANIMALS Seven adult cats ( 3.5 - 7.4 kg ) , two spayed females , and five neutered males . METHODS Hydromorphone ( 0.025 , 0.05 , or 0.1 mg kg(-1 ) ) was administered i.v .. Skin temperature and thermal threshold were measured before and at selected time points to 720 minutes post-administration . Statistical analysis of mean thermal threshold and skin temperatures over time for each dose and between doses was by way of a split-plot model and post hoc Bonferroni t-tests . p < 0.05 was considered significant . RESULTS A significant difference from baseline for mean thermal threshold was identified for the 0.05 mg kg(-1 ) dose ( 5 - 80 minutes , peak thermal threshold 46.9 + /- 6.2 degrees C ) and 0.1 mg kg(-1 ) dose ( 5 - 200 minutes , peak thermal threshold 54.9 + /-0.2 degrees C ) . The thermal threshold was significantly greater after the 0.1 mg kg(-1 ) dose from 5 to 200 minutes compared to the 0.025 mg kg(-1 ) and 0.5 mg kg(-1 ) doses . The thermal threshold was significantly greater from 35 to 80 minutes for the 0.05 mg kg(-1 ) dose when compared with the 0.025 mg kg(-1 ) dose . Skin temperature was significantly increased from 35 to 140 minutes following the 0.1 mg kg(-1 ) dose . CONCLUSIONS A dose-related antinociceptive effect was demonstrated for i.v . hydromorphone  in cats . CLINICAL RELEVANCE Hydromorphone at doses less than 0.1 mg kg(-1 ) has a modest antinociceptive effect and a short duration of action . At a dose of 0.1 mg kg(-1 ) i.v . , onset of analgesia is rapid with a clinical ly useful duration of effect , but is associated with a rise in skin temperature A placebo-controlled , r and omized blind study was conducted in cats ( n = 60 ) after fracture repair to compare the analgesic effects as well as the side-effects of carprofen , buprenorphine and levomethadone during a 5-day treatment . Cats with severe shock symptoms or increases in blood urea nitrogen ( BUN ) and creatinine were excluded from the study . The cats were r and omly assigned to four groups ( n= 15 ) . In group 1 , carprofen was administered upon extubation at an initial dose of 4 mg/kg body weight , followed by one-third of that dose three times daily on days 2 to 5 . In group 2 , buprenorphine was administered in a single dose of 0.01 mg/kg body weight upon extubation and subsequently every 8 h. Levomethadone ( group 3 ) was applied according to the same scheme at a dosage of 0.3 mg/kg body weight each time . The placebo ( group 4 ) was given at the same time intervals as the opioids . Examinations were carried out prior to anaesthesia , between 30 min and 8 h after extubation , and on the following 4 days , 1 h after administration of the analgesics or the placebo as well as 1 h before the next administration . Pain and sedation evaluation was carried out with a visual analogue system ( VAS ) and with the aid of a numerical estimation scale ( NRS ) . Pain was also scored by measuring mechanical nociceptive threshold of traumatized tissue . Plasma glucose and cortisol concentration , heart rate , respiration rate , blood pressure and body temperature were measured . Furthermore , a complete blood count and clinical chemistry including BUN , creatinine , alanine aminotransferase ( ALT ) , glutamate dehydrogenase ( GLDH ) , arterial blood pressure ( AP ) , total protein and electrolytes of the cats were checked on the day of admission as well as on the last day of this study ( day 5 ) . Defaecation and urination as well as wound healing were monitored . On the basis of the mechanical nociceptive threshold of the traumatized tissue , concentrations of plasma glucose and cortisol and pain assessment using NRS and VAS , carprofen was found to have better anti-nociceptive efficacy when compared with the two opioid analgesics , while the analgesic effect of levomethadone was similar to that of buprenorphine . However , the carprofen group also showed comparably high median NRS and VAS pain scores in addition to occasional broad deviations from the group mean on the first post-operative treatment day . Sedative effects were detected for buprenorphine and levomethadone ; in addition , symptoms of central excitation were noted with levomethadone . There was no indication of any clinical ly relevant respiratory depressive or cardiovascular effects , nor of any undesired renal , gastrointestinal or hepatic effects of the analgesics applied . However , the somewhat insensitive examination methods did not permit sufficient evaluation of side-effects , particularly on the gastrointestinal tract and the kidneys . It was found that carprofen and buprenorphine were well-tolerated analgesics for a 5-day administration in the cat , whereas levomethadone caused central excitation in some cases in the dosage scheme used here . However , it was apparent that none of the tested analgesics induced sufficient analgesia in the post-operative phase . For this reason , suitable methods must be found to improve analgesia , particularly in the immediate post-operative phase BACKGROUND Feline degenerative joint disease ( DJD ) is common and there are no approved therapies for the alleviation of the associated pain . OBJECTIVE To test a diet high in eicosapentaenoic acid ( EPA ) , and docosahexaenoic acid ( DHA ) content and supplemented with green-lipped mussel extract and glucosamine/chondroitin sulfate ( test-diet ) for its pain-relieving and activity-enhancing effects in cats with painful , mobility-impairing DJD over a 9-week period . ANIMALS Forty client-owned cats . METHODS R and omized , controlled , blinded , parallel group , prospect i ve clinical study . Cats with no detectable systemic disease , and with at least 1 appendicular joint with radiographic evidence of DJD where manipulation elicited an aversive response were included . Cats were r and omly allocated to the test-diet or control diet ( C-diet ) . Outcome measures were subjective owner and veterinarian assessment s , and objective activity monitoring ( accelerometry ) . Nonparametric statistics were used to evaluate changes within and between groups for both subjective and objective data , and locally weighted scatterplot smoothing regression analysis was used to predict activity changes . RESULTS The primary objective outcome measures indicated that activity declined significantly ( P < .001 ) in the C-diet group , significantly increased ( P < .001 ) in the test-diet group and there was a significant difference between the groups ( P < .001 ) . CONCLUSION AND CLINICAL IMPORTANCE A diet high in EPA and DHA and supplemented with green-lipped mussel extract and glucosamine/chondroitin sulfate improved objective measures of mobility . Dietary modulation might be 1 method to use to improve mobility in cats with DJD-associated pain The dose-related antinociceptive effects of intravenous ( IV ) buprenorphine were evaluated in cats . Thermal ( TT ) and mechanical threshold ( MT ) devices were used for nociceptive stimulation . After baseline threshold recordings , buprenorphine was administered IV ( 0.01 , 0.02 or 0.04 mg/kg ; B1 , B2 and B4 , respectively ) in a r and omised , blinded and cross-over study . Data were analysed by ANOVA ( P<0.05 ) using 95 % confidence intervals ( CI ) . TT increased 15 , 30 , 45 min and 1 ( 5.2+/-2.7 degrees C ) , 2 , 3 and 4 h after B1 ; 15 , 30 , 45 min and 1 ( 5.1+/-3.9 degrees C ) and 2 h after B2 , and 15 , 30 , 45 min and 1 ( 5.4+/-3.3 degrees C ) , 2 , 3 , 6 and 8 h after B4 . MT increased 15 and 45 min after B2 ( 260+/-171 mmHg ) , and 30 ( 209+/-116 mmHg ) and 45 min and 1 and 2 h after B4 . At 45 min , MT values were significantly higher after B2 compared to B1 ( P<0.05 ) . With MT , B2 and B4 produced more antinociception and longer duration of action than B1 , respectively . No dose response to thermal stimulation was detected This study evaluated the types of items owners consider important to their cats ’ quality of life ( QoL ) . We hypothesized that items contributing to QoL in cats are predominantly items requiring mobility . The objectives of the study were to describe the types of items considered important by owners for their cats ’ QoL ; to describe the proportion of these items that involve mobility ; to evaluate what patient factors , including severity of degenerative joint disease ( DJD ) , affect this distribution ; and to evaluate whether the proportion of QoL items involving mobility chosen by owners is different in cats presenting for a DJD study compared with a r and omly selected population . A total of 830 client-generated items were evaluated . Regardless of DJD status , 40 % of items listed by owners involved  mobility  , while 60 % were ‘ inactive ’ items , rejecting our hypothesis . This highlights the need to assess non-active items that owners consider to constitute QoL to fully assess the impact of diseases like DJD and , therefore , the success of therapeutic interventions OBJECTIVE To evaluate the analgesic effects of medetomidine ( MED ) and butorphanol ( BTO ) in cats after ovariohysterectomy . STUDY DESIGN A placebo-controlled , blinded monocenter clinical study . ANIMALS Healthy adult female client-owned cats . METHODS Sixty-four cats weighing 3.15 + /- 0.6 kg , presented to the University of Helsinki 's Small Animal Teaching Hospital for routine elective ovariohysterectomy  , received MED at 15 microg/kg ( n = 18 ) , BTO at 0.1 mg/kg ( n = 23 ) , or saline ( PL ) ( n = 23 ) intramuscularly immediately after ovariohysterectomy . Level of pain perception , degree of restlessness , and extent of sedation were scored subjectively before and at 30 , 60 , 90 , and 120 minutes after test-drug administration . RESULTS BTO provided the best pain relief , followed by MED . Saline provided the least pain relief . Both MED and BTO effectively and identically prevented postoperative restlessness . MED and BTO produced an identical degree of sedation that was better than the PL . CONCLUSIONS Both MED ( at 15 microg/kg ) and BTO ( at 0.1 mg/kg ) prevent postoperative pain in cats after ovariohysterectomy . Clinical Relevance -MED and BTO are useful for preventing postoperative pain in cats OBJECTIVE To compare the postoperative analgesic and sedative properties of buprenorphine and morphine in cats . STUDY DESIGN Prospect i ve , r and omized , blinded study . ANIMALS Thirty-two domestic cats undergoing surgery . METHODS Cats received pre-anaesthetic medication with acepromazine ( 0.05 mg kg-1 ) given intramuscularly and were r and omly allocated to group M and given morphine ( 0.1 mg kg-1 ) intramuscularly ( IM ) or to group B and given buprenorphine ( 0.01 mg kg-1 ) IM . Anaesthesia was induced with propofol and maintained with halothane in oxygen and nitrous oxide .  Pain and sedation scores using visual analogue scales , and heart and respiratory rates , were measured immediately before , and 30 , 60 , 120 , 180 , 300 and 420 minutes after anaesthesia . RESULTS Pain scores were significantly lower at 60 , 120 and 180 minutes after anaesthesia in group B. Group B also had higher heart rates at 30 minutes . There were no other statistically significant differences between the groups . CLINICAL RELEVANCE Buprenorphine ( 0.01 mg kg-1 ) appeared to provide better postoperative analgesia than morphine ( 0.1 mg kg-1 ) and may also have a longer duration of action OBJECTIVE To determine analgesic efficacy and adverse effects of preemptive administration of meloxicam or butorphanol in cats undergoing onychectomy or onychectomy and neutering . DESIGN R and omized controlled study . ANIMALS 64 female and 74 male cats that were 4 to 192 months old and weighed 1.09 to 705 kg ( 2.4 to 15.5 lb ) . PROCEDURE Cats received meloxicam ( 0.3 mg/kg [ 0.14 mg/lb ] , s.c . ) or butorphanol ( 0.4 mg/kg [ 0.18 mg/lb ] , s.c . ) 15 minutes after premedication and prior to anesthesia . A single blinded observer measured physiologic variables , assigned analgesia and lameness scores , and withdrew blood sample s for each cat at baseline and throughout the 24 hours after surgery . Rescue analgesia ( butorphanol , 0.4 mg/kg , i.v . or s.c . ) or administration of acepromazine ( 0.025 to 0.05 mg/kg [ 0.011 to 0.023 mg/lb ] , i.v . ) was allowed . RESULTS Meloxicam-treated cats were less lame and had lower pain scores . Cortisol concentration was higher at extubation and lower at 1 , 5 , and 12 hours in the meloxicam-treated cats . Fewer meloxicam-treated cats required rescue analgesia at 3 , 5 , 12 , and 24 hours after extubation . General impression scores were excellent or good in 75 % of meloxicam-treated cats and 44 % of butorphanol-treated cats . There was no treatment effect on buccal bleeding time ; PCV and BUN concentration decreased in both groups , and glucose concentration decreased in meloxicam-treated cats . CONCLUSIONS AND CLINICAL RELEVANCE Preoperative administration of meloxicam improved analgesia for 24 hours without clinical ly relevant adverse effects in cats that underwent onychectomy or onychectomy and neutering and provided safe , extended analgesia , compared with butorphanol Eighty-nine cats and 38 dogs naturally infested with the ear mite Otodectes cynotis were r and omly allocated into two treatment groups . One group was treated with a product containing miconazole nitrate , polymyxin B sulphate and prednisolone acetate , the other with a combination of diethanolamine fusi date , framycetin sulphate , nystatin and prednisolone . The treatment ( five drops in each ear ) was applied twice daily for 14 days , and its efficacy was evaluated on days 7 , 14 and 21 on the basis of an otoscopic examination of the external ear canal , a microscopical examination of scrapings for the presence of ear mites and clinical signs of pruritus , pain , erythema and /or exu date . Both treatments were highly effective , and there were no significant differences between the two products , either in efficacy or in the clinical improvements observed . Apart from an allergic reaction in one cat treated with the second product , no adverse effects were observed Data allowing rational use of analgesics in cats are limited . Pharmacokinetics and pharmacodynamics of fentanyl were studied in cats .  Plasma fentanyl concentrations were measured using radioimmunoassay in a crossover study in six cats after 10 microg/kg ( i.v . ) or by application of fentanyl in pluronic lecithin organogel ( PLO ) to the inner ear pinna . On a separate occasion thermal thresholds were measured after i.v . fentanyl ( 10 microg/kg ) or saline . Plasma fentanyl concentrations reached 4.7 - 8.31 ng/mL 2 min after i.v . administration and were undetectable after 95 min . Fentanyl was not detected in plasma at any time after PLO use . Thermal thresholds did not change following saline administration but were increased above baseline from 5 to 110 min after i.v . fentanyl . In this model a plasma concentration of > 1.07 ng/mL was required to provide analgesia . Plasma concentrations were measured in additional cats after intranasal or oral dosing ( 2 microg/kg ) and after 30 microg/kg in PLO gel . After oral and nasal dosing , Cmax values were 0.96 and 1.48 ng/mL at 5 and 2 min , respectively . Plasma fentanyl was not detected after application of the higher dose of fentanyl in PLO The analgesic efficacy of tramadol and /or vedaprofen was evaluated in cats su bmi tted for elective ovariohysterectomy , using a r and omised double blind placebo controlled design . Forty adult female cats ( 3.0±0.32 kg ; 1.8±0.7 years ) were distributed into four groups . Vedaprofen PO ( 0.5 mg/kg ) , tramadol SC ( 2 mg/kg ) , both , or placebo was administered 1 h before surgery and every 24 and 8 h , respectively , for 72 h after surgery . Pain score evaluated by interactive visual analogue and composite pain score and hyperalgesia by the von Frey filament test were recorded at 1 , 2 , 4 , 6 , 8 , 12 , 24 , 28 , 32 , 48 , 52 , 56 , 72 , 96 h and on the 7th day after surgery . Animals treated with combined vedaprofen and tramadol treatment did not need rescue analgesia , did not develop hyperalgesia , and their serum cortisol concentrations and pain scores were lower than placebo until 24 and 72 h after surgery , respectively . Combined vedaprofen and tramadol treatment provided more effective postoperative analgesia and prevented hyperalgesia than when used on their own . Multimodal technique is a superior method of treating pain after feline ovariohysterectomy . This work also provides evidence for the benefits of analgesia for up to 3 days following ovariohysterectomy This study examined the effect of amantadine , an N-methyl-d-aspartate receptor antagonist , on the thermal antinociceptive effect of oxymorphone in cats . Six adult healthy cats were used . After baseline thermal threshold determinations , oxymorphone was administered intravenously to maintain plasma oxymorphone concentrations of 10 , 20 , 50 , 100 , 200 , and 400 ng/mL. In addition , amantadine , or an equivalent volume of saline , was administered intravenously to maintain a plasma amantadine concentration of 1100 ng/mL. Thermal threshold and plasma oxymorphone  and amantadine concentrations were determined at each target plasma oxymorphone concentration . Effect maximum models were fitted to the oxymorphone concentration-thermal threshold data , after transformation in % maximum response . Oxymorphone increased skin temperature , thermal threshold , and thermal excursion ( i.e. , the difference between thermal threshold and skin temperature ) in a concentration-dependent manner . No significant difference was found between the amantadine and saline treatments . Mean ± SE oxymorphone EC(50 ) were 14.2 ± 1.2 and 24.2 ± 7.4 ng/mL in the amantadine and saline groups , respectively . These values were not significantly different . Large differences in oxymorphone EC(50 ) in the saline and amantadine treatment groups were observed in two cats . These results suggest that amantadine may decrease the antinociceptive dose of oxymorphone in some , but not all , cats OBJECTIVES The primary objective was to determine the prevalence , spinal distribution , and association with the signalment of cats suffering from different grade s of feline spondylosis deformans ( spondylosis ) . The secondary objective was to document behavioural changes associated with spondylosis by owner observation . METHODS A cross-sectional study was performed to determine the prevalence of feline spondylosis ( group 1 ) . A prospect i ve study was performed to determine the association between radiographic abnormalities of the lumbosacral region ( L3-S1 ) and owner perceived behavioural changes based on a completed question naire ( group 2 ) . The radiographs were review ed using a grading system ( 0 - 3 ) for spondylosis . RESULTS The prevalence of spondylosis in group 1 was 39.4 % ( 158/402 ) . Cats with spondylosis were significantly older than cats without spondylosis ( p < 0.001 ) . The thoracic ( T ) vertebrae T4-T10 were most often affected by spondylosis , but spondylosis was most severe in the T10-S1 vertebrae . In group 2 , spondylosis of the lumbosacral region was significantly correlated with owner-reported behavioural changes , such as a decreased willingness to greet people and to being petted , increased aggressiveness , and a poor perceived quality of life ( p = 0.037 ) . CLINICAL SIGNIFICANCE This study found that feline spondylosis is common and that spondylosis of the lumbosacral region may be accompanied by behavioural changes OBJECTIVE To determine the items ( question topics ) for a subjective instrument to assess degenerative joint disease (DJD)-associated chronic pain in cats and determine the instrument design most appropriate for use by cat owners . ANIMALS 100 r and omly selected client-owned cats from 6 months to 20 years old . PROCEDURES Cats were evaluated to determine degree of radiographic DJD and signs of pain throughout the skeletal system . Two groups were identified : high DJD pain and low DJD pain . Owner-answered questions about activity and signs of pain were compared between the 2 groups to define items relating to chronic DJD pain . Interviews with 45 cat owners were performed to generate items . Fifty-three cat owners who had not been involved in any other part of the study , 19 veterinarians , and 2 statisticians assessed 6 preliminary instrument design s. RESULTS 22 cats were selected for each group ; 19 important items were identified , result ing in 12 potential items for the instrument ; and 3 additional items were identified from owner interviews . Owners and veterinarians selected a 5-point descriptive instrument design over 11-point or visual analogue scale formats . CONCLUSIONS AND CLINICAL RELEVANCE Behaviors relating to activity were substantially different between healthy cats and cats with signs of DJD-associated pain . Fifteen items were identified as being potentially useful , and the preferred instrument design was identified . This information could be used to construct an owner-based question naire to assess feline DJD-associated pain . Once vali date d , such a question naire would assist in evaluating potential analgesic treatments for these patients A pressure analgesiometric device was developed for unrestrained cats . Eleven cats were studied . Stimulation was via three rounded pins within a bracelet on the forearm . The pins were advanced by manual bladder inflation .  Bladder pressure was measured using a strain gauge pressure transducer . The threshold was recorded at the behavioural end point . Thresholds were measured at 5 and 15min intervals for 2 - 4h , after removal/replacement of the cuff , for 120min after SC butorphanol ( 0.4mg/kg ) , and with mild skin inflammation at the testing site . Data were analysed using ANOVA . Pressure thresholds in untreated cats were around 150mmHg . The minimum interval for testing was established as 15min . Data were reproducible over 4h and beyond 24h . Thresholds in 5 cats increased ( P<0.05 ) above baseline for 45min after butorphanol with a maximum increase of 270+/-182mmHg at 10min . Thresholds decreased with inflammation . The method appears suitable for feline analgesia investigations Eighty female cats presented for ovariohysterectomy were r and omly allocated to one of two treatment groups in this assessor-blinded trial . After pre-anaesthetic assessment , the cats were premedicated with acepromazine ( 0.1 mg/kg ) . Anaesthesia was induced with thiopentone and maintained with halothane in oxygen .  Forty cats received carprofen ( 4 mg/kg subcutaneously ) and 40 received meloxicam ( 0.3 mg/kg subcutaneously ) after anaesthetic induction . Following routine flank ovariohysterectomy the cats were assessed using visual analogue scale scores for pain and sedation over a 20-hour study period . Blood sample s were taken before sedation and at 20 hours for serum biochemistry ( urea , creatinine , alanine aminotransferase and aspartate aminotransferase ) . There were no significant differences between the groups for pain and sedation scores . Serum biochemistry values were similar between the groups , with some differences within groups between the pre-sedation and 20-hour values . One cat in the carprofen group and two cats in the meloxicam group required rescue analgesia with intramuscular morphine ( 0.2 mg/kg ) The ability of two non-steroidal anti-inflammatory drugs to modify the clinical manifestations of pain associated with locomotor disease was assessed . Sixty-nine cats with acute or chronic locomotor disorders were recruited from 14 first opinion UK veterinary practice s and r and omly allocated to one of two treatment groups . Group A received meloxicam drops ( 0.3 mg/kg orally on day 1 followed by 0.1 mg/kg daily for four more consecutive days ) and group B received ketoprofen tablets ( 1.0 mg/kg orally once daily for five days ) . Each cat underwent a full clinical examination before treatment , 24 hours after initiation of treatment and 24 hours after completion of treatment . General clinical parameters ( demeanour and feed intake ) and specific locomotor parameters ( weightbearing , lameness , local inflammation and pain on palpation ) were scored using a discontinuous scale scoring system . The two groups did not differ in terms of age , weight , gender distribution or duration of clinical signs ; nor did they differ in terms of general clinical or specific locomotor scores pretreatment . Both treatment regimens result ed in a significant improvement in demeanour , feed intake and weightbearing , and a significant reduction in lameness , pain on palpation and inflammation . No significant difference was observed between the two treatment groups with respect to any of the parameters measured and both treatments were associated with minimal observed side effects .  Meloxicam and ketoprofen were found to be effective analgesics and well tolerated in cats with acute or chronic locomotor disorders when administered for short-term treatment ( five days ) in such cases . However , meloxicam was assessed to be significantly more palatable than ketoprofen The adequacy of postoperative analgesia was assessed in 40 cats following ovariohysterectomy .  At extubation , cats were given one dose of carprofen , ketoprofen , meloxicam or tolfenamic acid . Postoperative analgesia was assessed using visual analogue scale ( VAS ) scoring for pain and sedation ; measurement of mechanical nociceptive thresholds at the wound ; recognition of the requirement for rescue intervention analgesia ; and an overall clinical assessment score at 18 hours . VAS pain scores were low throughout the trial , with no significant differences found between the groups . Postoperative mechanical nociceptive thresholds decreased significantly from baseline in all four groups , with no significant differences between the groups . One cat in each of the tolfenamic acid , ketoprofen and meloxicam groups required rescue intervention analgesia . Nine out of 10 cats in all four groups were classified as having desirable overall clinical assessment scores . In summary , all four drugs provided good postoperative analgesia , although none was able to prevent postoperative wound tenderness One hundred and fifty-three cats undergoing surgery in seven veterinary practice s in Great Britain were studied . They were r and omly allocated to receive either 10–20 μg/kg buprenorphine or 0.4 mg/kg butorphanol with acepromazine before anaesthesia with propofol , Saffan or thiopentone and isoflurane or halothane . Routine monitoring was undertaken . Pain and sedation were assessed blind using a four point ( 0–3 ) simple descriptive scale ( SDS ) at 1 , 2 , 4 , 8 and 24 h. Pain and sedation data were compared using non-parametric statistical tests and continuous data using t tests or analysis of variance ( ANOVA ) . Anaesthesia and surgery were uneventful , and cardiorespiratory data were within normal limits . After surgery , overall , more cats had pain score 0 after buprenorphine and more had pain score 3 after butorphanol ( P=0.0465 ) . At individual time points , more cats had lower pain scores  after buprenorphine at 2 ( P=0.040 ) and 24 ( P=0.036 ) h. At 24 h 83 % after buprenorphine and 63 % after butorphanol  had pain score 0 ( P<0.04 ) . Buprenorphine provided better and longer lasting postoperative analgesia  than butorphanol OBJECTIVE -To determine the thermal antinociceptive effect of oral administration of tramadol hydrochloride at doses between 0.5 and 4 mg/kg in cats . ANIMALS-6 healthy adult domestic shorthair cats . PROCEDURES -Baseline ( before drug administration ; time 0 ) thermal threshold was determined by applying a thermal probe to the thorax of each cat . Tramadol ( 0.5 , 1 , 2 , 3 , or 4 mg/kg ) or a placebo was then administered orally in accordance with a Latin square design . Thermal threshold was determined by an observer who was unaware of treatment at various times until thermal threshold returned to baseline values or 6 hours had elapsed . Plasma tramadol and O-desmethyl-tramadol concentrations were measured prior to drug administration and at 1-hour intervals thereafter . Effect-concentration data were fitted to effect maximum models . RESULTS -Highest plasma tramadol and O-desmethyl-tramadol concentrations increased with increasing tramadol dose . Significant effects of dose and time on thermal threshold were detected . Thermal threshold was significantly higher than the baseline value at 80 and 120 minutes for the 0.5 mg/kg dose , at 80 and from 120 to 360 minutes for the 2 mg/kg dose , from 40 to 360 minutes for the 3 mg/kg dose , and from 60 to 360 minutes for the 4 mg/kg dose . CONCLUSIONS AND CLINICAL RELEVANCE -Tramadol induced thermal antinociception in cats . Doses of 2 to 4 mg/kg appeared necessary for induction of significant and sustained analgesic effects . Simulations predicted that 4 mg/kg every 6 hours would maintain analgesia close to the maximum effect of tramadol OBJECTIVE To evaluate the efficacy of the transdermal fentanyl patch in relieving perioperative pain and stress associated with ovariohysterectomy in cats . STUDY DESIGN Prospect i ve laboratory trial . ANIMALS Twenty-four female , purpose -bred cats . METHODS Each cat was r and omly assigned to groups 1 - 3 . Group 1 received a 25-microg/h transdermal fentanyl patch only . Group 2 received the patch and anesthesia . Group 3 received anesthesia only . Patches were left in place for 72 hours . Rectal temperature , heart rate , respiratory rate , indirect blood pressure , blood glucose , serum cortisol concentration , plasma fentanyl concentration , pain score , and excitement/sedation score were monitored at prescribed intervals over an 81-hour period . Cats from groups 1 - 3 were reassigned to groups 4 and 5 . Group 4 received the patch , anesthesia , and an ovariohysterectomy . Group 5 received anesthesia and an ovariohysterectomy only . The study period and monitored parameters were the same as for groups 1 - 3 . RESULTS Serum cortisol concentrations were significantly lower in group 4 than group 5 during the surgical and early postsurgical time periods . A similar effect was noted in blood glucose concentrations during the surgical period . Rectal temperature was significantly higher in group 2 when comparing all anesthetized groups during the early postsurgical period . Pain scores were significantly higher in groups 4 and 5 than in groups 2 and 3 during the early postsurgical period . There was no significant difference in pain scores between groups 4 and 5 during this period , however . CONCLUSIONS The transdermal fentanyl patch affects biochemical markers of perioperative pain and stress associated with ovariohysterectomy in cats , attenuating rises in serum cortisol and blood glucose concentrations during the surgical and early postsurgical periods . CLINICAL RELEVANCE The transdermal fentanyl patch is effective in alleviating perioperative pain and stress associated with ovariohysterectomy in cats as evidence d by attenuated rises in cortisol and blood glucose concentrations in cats that were operated on and treated with the patch OBJECTIVE To describe simultaneous pharmacokinetics ( PK ) and thermal antinociception after intravenous ( i.v . ) , intramuscular ( i.m . ) and subcutaneous ( SC ) buprenorphine in cats . STUDY DESIGN R and omized , prospect i ve , blinded , three period crossover experiment . ANIMALS Six healthy adult cats weighing 4.1±0.5 kg . METHODS Buprenorphine ( 0.02 mg kg(-1 ) ) was administered i.v . , i.m . or s.c .. Thermal threshold ( TT ) testing  and  blood collection  were conducted simultaneously at baseline and at predetermined time points up to 24 hours after administration . Buprenorphine plasma concentrations were determined by liquid chromatography t and em mass spectrometry . TT was analyzed using anova ( p<0.05 ) . A pharmacokinetic-pharmacodynamic ( PK-PD ) model of the i.v . data was described using a model combining biophase equilibration and receptor association-dissociation kinetics . RESULTS TT increased above baseline from 15 to 480 minutes and at 30 and 60 minutes after i.v . and i.m . administration , respectively ( p<0.05 ) . Maximum increase in TT ( mean±SD ) was 9.3±4.9 ° C at 60 minutes ( i.v . ) , 4.6±2.8 ° C at 45 minutes ( i.m . ) and 1.9±1.9 ° C at 60 minutes ( s.c . ) . TT was significantly higher at 15 , 60 , 120 and 180 minutes , and at 15 , 30 , 45 , 60 and 120 minutes after i.v . administration compared to i.m . and s.c . , respectively . I.v . and i.m . buprenorphine concentration-time data decreased curvilinearly . S.c . PK could not be modeled due to erratic absorption and disposition . I.v . buprenorphine disposition was similar to published data . The PK-PD model showed an onset delay mainly attributable to slow biophase equilibration ( t(1/2 ) k(e0)=47.4 minutes ) and receptor binding ( k(on)=0.011 mL ng(-1 ) minute(-1 ) ) . Persistence of thermal antinociception was due to slow receptor dissociation ( t(1/2 ) k(off)=18.2 minutes ) . CONCLUSIONS AND CLINICAL RELEVANCE I.v . and i.m . data followed classical disposition and elimination in most cats . Plasma concentrations after i.v . administration were associated with antinociceptive effect in a PK-PD model including negative hysteresis . At the doses administered , the i.v . route should be preferred over the i.m . and s.c . routes when buprenorphine is administered to cats OBJECTIVE To evaluate the efficacy and tolerability of oral administration of robenacoxib for treatment of acute pain and inflammation associated with musculoskeletal disorders in cats . ANIMALS 155 cats requiring relief of signs of pain and inflammation associated with acute musculoskeletal disorders . PROCEDURES The study was a multicenter , prospect i ve , r and omized , masked , noninferiority field trial . Cats were allocated r and omly to 1 of 3 treatment groups : group 1 ( 1.0 to 2.4 mg of robenacoxib/kg , q 24 h ) , group 2 ( 1.0 to 2.4 mg of robenacoxib/kg , q 12 h [ daily dosage , 2.0 to 4.8 mg/kg ] ) , and group 3 ( ketoprofen [ mean dosage , 1 mg/kg , q 24 h ] ) . All cats were administered tablets PO for 5 or 6 days . The primary efficacy endpoint was the investigator global assessment score , which was the sum of scores of signs of pain , inflammation , and mobility assessed in a masked manner by veterinary investigators at baseline , day 2 , and day 4 or 5 . Cat owners monitored in a nonmasked manner secondary responses by observation of cats ' activity , behavior , appetite , and interactions . Safety was assessed by monitoring adverse events , clinical signs , and hematologic and plasma biochemical variables ( before and after treatment ) . RESULTS No significant differences were detected among the 3 treatment groups for any primary or secondary efficacy endpoints or for tolerability variables .  Robenacoxib tablets administered once daily were significantly more palatable than ketoprofen tablets . CONCLUSIONS AND CLINICAL RELEVANCE Robenacoxib tablets administered once daily had noninferior efficacy and tolerability , and superior palatability , compared with the active control drug , ketoprofen , for the treatment of signs of acute pain and inflammation associated with musculoskeletal disorders in cats OBJECTIVE To evaluate efficacy and safety of using transdermal fentanyl patches ( TFP ) for analgesia in cats undergoing onychectomy . DESIGN R and omized controlled clinical trial . ANIMALS 45 client-owned cats weighing > or = 2.7 kg ( 5.9 lb ) undergoing onychectomy , onychectomy and ovariohysterectomy , or onychectomy and castration .  PROCEDURE Cats were r and omly assigned to be treated with a TFP ( 25 micrograms/h ) or butorphanol ; TFP were applied a minimum of 4 hours before surgery ( approx 8 hours prior to extubation ) . Rectal temperature , heart rate , respiratory rate , force applied by the forelimbs , and serum fentanyl concentration were measured , and temperament , recovery , degree of sedation , severity of pain , severity of lameness , and appetite were scored before and periodically for up to 40 hours after surgery . RESULTS Cats treated with a TFP had better recovery scores at 2 of 4 evaluation times , lower sedation scores at 2 of 8 evaluation times , and lower pain scores at 6 of 8 evaluation times , compared with cats treated with butorphanol . Use of a pressure-sensitive mat to evaluate force applied by the forelimbs did not reveal any differences between groups but did reveal a significant difference between preoperative and postoperative values . Mean + /- SD serum fentanyl concentrations were 1.56 + /- 1.08 , 4.85 + /- 2.38 , 4.87 + /- 1.56 , and 4.35 + /- 2.97 ng/ml approximately 8 , 24 , 32 , and 48 hours , respectively , after TFP placement . CONCLUSIONS AND CLINICAL RELEVANCE Results suggest that use of a TFP ( 25 micrograms/h ) for postoperative analgesia in cats undergoing onychectomy with or without surgical sterilization is safe and effective BACKGROUND Progress in establishing if therapies provide relief to cats with degenerative joint disease (DJD)-associated pain is hampered by a lack of vali date d owner-administered assessment methods . HYPOTHESIS That an appropriately developed subjective owner-completed instrument ( Feline Musculoskeletal Pain Index-FMPI ) to assess DJD-associated impairment would have responsiveness and criterion validity . ANIMALS Twenty-five client-owned cats with DJD-associated pain . METHODS FMPI responsiveness ( ability to detect the effect of an analgesic treatment ) and validity ( correlation with an objective measure ) were explored through a stratified , r and omized , double blinded , placebo-controlled , crossover 10-week clinical study . Meloxicam was administered to effect pain relief . A linear mixed model , backward stepwise regression , and Pearson correlations were used to assess responsiveness and criterion validity with the assumption that the NSAID would increase activity . RESULTS Positive responses of cats to placebo ( P = .0001 ) and meloxicam treatment ( P = .0004 ) were detected ; however , the instrument did not detect any difference between placebo and meloxicam ( linear mixed model ) , even for the high impairment cases . Percent meloxicam target dose administered , temperament , and total baseline FMPI score were covariates that most affected FMPI scores . Controlling for significant covariates , most positive effects were seen for placebo treatment . Positive treatment effects on activity were detected , but only for the cases design ated as most highly impaired . CONCLUSIONS AND CLINICAL IMPORTANCE Neither responsiveness nor criterion validity were detected by the inclusion criteria for cases in this study . The data suggest that further work is indicated to underst and factors affecting activity in cats to optimize inclusion criteria OBJECTIVE To compare the postoperative analgesic effects of intravenous ( IV ) , intramuscular ( IM ) , subcutaneous ( SC ) or oral transmucosal ( OTM ) buprenorphine administered to cats undergoing ovariohysterectomy . STUDY DESIGN R and omized , prospect i ve and blinded clinical trial . ANIMALS 100 female cats . METHODS Cats were assigned to receive 0.01 mg kg(-1 ) of buprenorphine administered by the IV , IM , SC or OTM route ( n = 25/group ) . Buprenorphine was made up to 0.3 mL with 0.9 % saline . DIVAS ( 0 - 100 mm ) and simple descriptive scale ( SDS ) ( from 0 to 4 ) pain and sedation scores were assigned to each cat before and 1 , 2 , 3 , 4 , 6 , 8 , 12 and 24 hours after ovariohysterectomy . Buprenorphine and carprofen were administered for rescue analgesia . Data were analyzed using anova and Fisher 's exact test ( p < 0.05 ) . RESULTS There were no significant differences between groups for breed , body weight , anesthetic time or surgery time ( p > 0.05 ) . There were no significant differences between groups for sedation scores at any time . SDS pain scores did not detect any differences between groups ( p > 0.05 ) . DIVAS pain scores after OTM administration were significantly higher than IV and IM administration at 1 hour and at 3 , 4 , 6 , 8 and 12 hours , respectively ( p < 0.05 ) . DIVAS pain scores after SC administration were significantly higher than IV and IM administration at 2 hours and at 2 , 3 , 4 , 8 , 12 and 24 hours ( p < 0.05 ) , respectively . Six , four , 13 and 17 cats that received IV , IM , SC and OTM buprenorphine required rescue analgesia , respectively . There was a significantly higher incidence of treatment failure in cats that received SC and OTM buprenorphine compared with cats that received IV and IM buprenorphine ( p < 0.05 ) . CONCLUSIONS AND CLINICAL RELEVANCE IV and IM administration of buprenorphine provided better postoperative analgesia than SC or OTM administration of the drug and these routes of administration should be preferred when buprenorphine is administered to cats Osteoarthritis is a chronic , painful condition that is now recognised as affecting a large proportion of cats .  Non-steroidal anti-inflammatory drugs ( NSAIDs ) have proven efficacy in dogs and humans but there are limited published data on the use of NSAIDs in the long-term management of this condition in cats . This prospect i ve study aim ed to assess the long-term safety and palatability of oral meloxicam and its efficacy in treating osteoarthritic pain in cats when given at a dose of 0.01–0.03 mg/kg once daily . Forty cats diagnosed with osteoarthritis completed the trial with a mean treatment duration of 5.8 months . Gastrointestinal upset in 2/46 ( 4 % ) cats was the only adverse effect noted . No deleterious effect on renal function was detected in cats studied . Owners subjectively assessed treatment efficacy as good or excellent in 34/40 ( 85 % ) of cases . The results of this study showed oral meloxicam to be safe and palatable long-term treatment for osteoarthritis in cats when given with food at a dose of 0.01–0.03 mg/kg In this prospect i ve , r and omized , blinded study , 68 clinical ly healthy cats that had onychectomy ( n = 20 ) , onychectomy and castration ( n = 20 ) , or onychectomy and ovariohysterectomy ( n = 28 ) were r and omly assigned to one of four postoperative analgesic treatment groups : buprenorphine ( 0.01 mg/kg body weight , intramuscularly [ IM ] ) , oxymorphone hydrochloride ( 0.05 mg/kg body weight , IM ) , ketoprofen ( 2 mg/kg body weight , IM ) , and placebo ( physiological saline ) . Sedation scores , visual analog pain scores , cumulative pain scores , serum cortisol concentration , and appetite were used to assess postoperative analgesic effect . Buprenorphine demonstrated the highest efficacy with the lowest cumulative pain scores and serum cortisol levels OBJECTIVE The hypothesis was that Visual Analog Scale ( VAS ) scores would be lower , and mechanical wound thresholds ( MWT ) higher , in cats receiving tolfenamic acid  compared to those receiving placebo in the postoperative period following elective ovariohysterectomy . ANIMALS Sixty-nine client-owned cats . METHODS A prospect i ve , r and omized , blinded and placebo-controlled study was performed in cats which underwent ovariohysterectomy following preoperative tolfenamic acid , meloxicam , or placebo . A second dose of the same analgesic was administered 24 hours postoperatively . Assessment s were made 1-hour before induction and 1 , 2 , 4 , 6 , 22 , and 25 hours postoperatively . Pain was assessed by a blinded observer using Numerical Rating ( NRS ) and VAS scales . The MWT were measured using a force-measuring device . Group comparison was performed by using one-way ANOVA and chi-squared test for qualitative and quantitative data , respectively , and a mixed model for repeated measurements ( p < 0.05 ) . RESULTS Sixty-five cats were included in the study . There were no differences between groups at baseline . There was a treatment effect on the NRS scores at 6 , 22 and 25 hours . The meloxicam group was less painful than controls at 6 and 22 hours ; both treatment groups were less painful than controls at 25 hours . There were no differences between groups in VAS for pain or sedation . The number of animals receiving rescue analgesia did not differ between groups . There was a treatment effect on MWT ; thresholds in both treatment groups were significantly higher than that observed in controls at all time points . CONCLUSIONS Preoperative tolfenamic acid or meloxicam reduced wound sensitivity following ovariohysterectomy in the cat . CLINICAL RELEVANCE Tolfenamic acid and meloxicam administered preoperatively provided a similar analgesic effect in the postoperative period lasting 24 hours . Mechanical thresholds may be a better way of evaluating postoperative analgesia provided by nonsteroidal anti-inflammatory drugs in cats & NA ; Altogether 553 children ( 195 first grade rs , mean age 6.8 years , and 358 third grade rs , mean age 8.7 years ) participated in the development of a self‐report measure to assess the intensity of children 's pain .  The first step was the derivation , from children 's drawings of facial expressions of pain , of 5 sets of 7 schematic faces depicting changes in severity of expressed pain from no pain to the most pain possible . With the set of faces that achieved the highest agreement in pain ordering , additional studies were conducted to determine whether the set had the properties of a scale . In one study , children rank‐ordered the faces on 2 occasions , separated by 1 week . All 7 faces were correctly ranked by 64 % ( retest 1 week later , 61 % ) of grade 1 children and by 86 % ( retest 89 % ) of grade 3 children . In a second study , the faces were presented in all possible paired combinations . All 7 faces were correctly placed by 62 % ( retest 86 % ) of the younger and by 75 % ( retest 71 % ) of the older subjects . A third study asked children to place faces along scale : a procedure allowing a check on the e quality of intervals . The fourth study checked on whether pain was acting as an underlying construct for ordering the faces in memory . We asked whether children perceived the set as a scale by asking if memory for an ordered set of faces was more accurate than for a r and om set . The final study checked , with 6‐year‐old children , the test‐retest reliability of ratings for recalled experiences of pain . Overall , the faces pain scale incorporates conventions used by children , has achieved strong agreement in the rank ordering of pain , has indications that the intervals are close to equal , and is treated by children as a scale . The test‐retest data suggest that it may prove to be a reliable index over time of self‐reported pain This study aim ed to characterize osteoarthritis (OA)-related chronic pain and disability in experimental cats with naturally occurring OA .  Peak vertical ground reaction force ( PVF ) , accelerometer-based motor activity ( MA ) and the von Frey anesthesiometer-induced paw withdrawal threshold were used to define OA and to test the efficacy of meloxicam . A diagnosis of OA was based on radiographic and orthopedic examinations . Cats with OA ( n=39 ) and classified as non-OA ( n=6 ) were used to assess the reliability and sensitivity of the parameters to assess OA over 3weeks while being administered placebo medication . A r and omised parallel design study was then used to investigate the effects on OA of daily oral meloxicam treatment for 4weeks at different dose rates ( 0.025mg/kg , n=10mg/kg ; 0.04mg/kg , n=10 ; 0.05mg/kg , n=9 ) , compared to cats administered a placebo ( n=10 ) . The test-retest repeatability for each tool was good ( intra-class correlation coefficient ⩾0.6 ) . The PVF and the von Frey anesthesiometer-induced paw withdrawal threshold discriminated OA ( P<0.05 ) . Meloxicam did not add to the PVF improvement observed in placebo-treated cats during the treatment period ( adj-P⩽0.01 ) . The 0.025 and the 0.05mg/kg meloxicam-treated cats experienced a higher night-time ( 17:00 - 06:58h ) MA intensity during the treatment period compared to the placebo period ( adj-P=0.04 , and 0.02 , respectively ) and this effect was not observed in the placebo group . The high allodynia rate observed in the 0.04mg/kg meloxicam-treated group may explain the lower responsiveness to the drug . The von Frey anesthesiometer-induced paw withdrawal threshold demonstrated no responsiveness to meloxicam . The results from this study indicated that daily oral meloxicam administration for 4weeks provided pain relief according to night-time MA The aim of this study was to compare the postoperative analgesic effects of robenacoxib and buprenorphine alone or in combination , in cats after ovariohysterectomy . Thirty healthy cats were r and omly assigned to receive buprenorphine ( 0.02 mg/kg , n=10 ; GB ) , robenacoxib ( 2mg/kg , n=10 ; GR ) or their combination at the same dosages ( n=10 ; GBR ) SC . After 30 min cats were se date d with an IM administration of medetomidine ( 0.02 mg/kg ) and ketamine ( 5mg/kg ) . General anaesthesia was induced with propofol and after intubation was maintained with isoflurane . Before premedication and at 1 , 2 , 3 , 4 , 6 , 8 , 12 and 24h after extubation , pain and sedation were assessed using a simple descriptive pain scale , ranging from 0 ( no pain/no sedation ) to 4 ( intense pain/ deep sedation ) . If the pain score was ≥ 3 , rescue analgesia was provided using buprenorphine ( 0.02 mg/kg ) administered IM . Pain score was higher in GB at 2 , 3 , 4 , 6 and 8h compared to baseline and compared to GBR at the same study times . Moreover , the pain score was also higher in GB compared to GR at 2 , 3 , 4 and 6h . Pain score was similar at all study times between GR and GBR . Sedation at 1 and 2h was higher than baseline values in all groups . Cats in GB received rescue analgesia more often than cats assigned to GR or GBR . Robenacoxib was an effective analgesic drug in cats up to 24h after ovariohysterectomy . The addition of buprenorphine did not provide any additional analgesic effects compared to robenacoxib alone One hundred female cats undergoing routine ovariohysterectomy under midazolam-medetomidine-ketamine anaesthesia  were included in a blinded , r and omised , prospect i ve clinical study to compare postoperative analgesia produced by four analgesic drug combinations given preoperatively ( n = 25 per group ) . A secondary aim was to assess the effects in kittens and pregnant animals . Buprenorphine 180 µg/m2 or butorphanol 6 mg/m2 were given with either carprofen 4 mg/kg ( groups BUPC and BUTC , respectively ) or meloxicam 0.3 mg/kg ( groups BUPM or BUTM , respectively ) . Medetomidine  was not antagonised . A simple , descriptive scale ( SDS ; 0–4 ) , a dynamic and interactive visual analogue scale ( DIVAS ; 0–100 mm ) and mechanical nociceptive thresholds ( MT ; 2.5-mm diameter probe ) were used to evaluate postoperative pain . All pain scores were low ( DIVAS < 10 mm , SDS < 2 and MT > 10 N ) and there were no significant differences between the groups . It was concluded that all protocol s provided adequate analgesia and when used with midazolam-medetomidine-ketamine are effective for routine feline ovariohysterectomy
target: Studies were primarily related to the assessment of pain in relation to surgical procedures , and no clear distinction was made concerning the onset of acute and chronic pain .
  The metrics used within the tools appeared to focus primarily on the sensory aspect of pain , with no study clearly discriminating between the sensory and affective components of pain .
background: Objectives The objectives were to review systematic ally the range of assessment tools used in cats to detect the behavioural expression of pain and the evidence of their quality ; and to examine behavioural metrics ( considering both the sensory and affective domains ) used to assess pain .