Medical (non-surgical) pain

WSAVA guideline

Key findings

• Perceived-pain anchors: necrotizing pancreatitis/cholecystitis, thrombosis/ischaemia = severe-to-excruciating; peritonitis/pleuritis, hollow-organ distension, torsions, capsular organomegaly = moderate-to-severe; cystitis = moderate (Table 11).
• Severe (Table 26): titratable µ-agonist infusions (avoid vomiting opioids: morphine, hydromorphone); NSAIDs if stable (combinable with opioids); locoregional techniques; ketamine/lidocaine CRI; intrapleural (somatic) / intraperitoneal (visceral) blocks; lidocaine ⚠️ cat caution.
• Moderate: µ-agonist via IV catheter (frequent IM/SC injections painful/stressful — avoid); NSAID if stable; ketamine/lidocaine CRI; buprenorphine in multimodal regimens (Table 26).
• Mild–moderate: NSAID ± buprenorphine (OTM suits home use); gabapentin 10 mg/kg PO q8 h (dog)/q12 h (cat) — little acute-pain evidence; gabapentinoids better for chronic neuropathic medical pain; renal adjustment (Table 26).
• Oral mucositis: viscous lidocaine 2% mixed 1:1:1 with Mg/Al hydroxide + diphenhydramine, max 0.4 mL/kg q8 h; green tea flushes for mouth or wounds (Table 26).
• Adjuncts at all levels: antiemetics/anti-nausea drugs; acupuncture (pain, GI/urinary, vomiting); massage, cold/warm therapy; enrichment; feline pheromones (Table 26).

Drugs named in WSAVA’s own guideline text

As printed in WSAVA’s document, not this app’s own extracted data — see “Related drugs in this reference” below for that.

• µ-agonist opioid (fentanyl) (Dog)

• (Cat)

• Ketamine (Dog & Cat)

• Lidocaine (Dog)

• Buprenorphine (Dog)

• (Cat)

• Gabapentin (Dog)

• (Cat)

• NSAID of choice (Dog & Cat)

• Intrapleural / intraperitoneal LA (Dog & Cat)

• Viscous lidocaine mouthwash (Dog & Cat)

Recommendations

• Treat the underlying disease; analgese before/during diagnostics

  Expert consensus (GPC, §3.9)

• Opioids first-choice in emergency/critically ill; titratable µ-agonist infusions for severe pain

  Expert consensus (GPC)

• Avoid vomiting opioids (morphine, hydromorphone); IV catheter over frequent IM/SC

  Expert consensus (GPC)

• NSAIDs only when haemodynamically stable, no contraindications; opioid-combinable

  Expert consensus (GPC)

• Ketamine and/or lidocaine CRI in severe/moderate tiers; lidocaine cat caution

  Expert consensus (GPC)

• Intrapleural/intraperitoneal blocks for somatic/visceral pain respectively

  Expert consensus (GPC)

• Mild–moderate: NSAID ± OTM buprenorphine; gabapentin 10 mg/kg q8 h (dog)/q12 h (cat), renal adjustment

  Expert consensus, low evidence (Table 26)

• Mucositis mouthwash max 0.4 mL/kg q8 h; green tea flushes

  Expert consensus (Table 26)

• Adjuncts at all levels: antiemetics, acupuncture, massage, thermal therapy, enrichment, pheromones

  Expert consensus (GPC)

Related drugs in this reference (0)

No indication text currently matches this condition by name. Try a broader condition or search the drug reference directly. Absence of a match does not establish that treatment is unavailable.