September is Pain in Animals Awareness Month!
One of the most common species whose pain is UNDERdiagnosed is the domestic cat. Besides cats being masters at hiding pain, as owners, we interact with them on a much different level than a dog or other species in our homes. Cats tend to be sedentary, so a limp may go undetected. Some cats don't appreciate being picked up, so pain won't be noted when being handled on a routine basis. Thankfully our team at Boca Park Animal Hosptial has an excessive amount of experience in how to treat felines!
A recent article was published in the July 2018 issue of the Journal of Feline Medicine and Surgey. They reviewed practitioners' approach to addressing degenerative joint disease pain in cats.
The purpose of this study was to determine the prescribing practices of veterinarians for treatment of degenerative joint disease (i.e. a chronic pain condition) in cats. The study was designed as an online survey emailed to veterinarian members of an online veterinary community.
According to the article: the survey was sent to 36,676 clinicians, of which 1056 completed the survey (2.9% response rate). Two clinicians had never prescribed pain control for arthritis in cats, for a total of 1054 datasets. 77% of respondents were female and 90.6 % were from the USA or Canada.
The article highlights three key items to note. First - Of all the numerous therapies available, only three therapies have undergone rigorous scientific trials to show efficacy; one joint diet, one NSAID (Meloxicam) and a monoclonal antibody (Frunevetmab).
Based on the survey, the most widely prescribed treatment (Gabapentin) was NOT one with robust scientific support. Yet for the lack of research on this medication in the cat, Gabapentin has been shown to be generally regarded as safe and effective. A lack of scientific evidence may prevent a veterinarian from offering a patient appropriate care.
The article also goes on to break down the use of medication based on years in practice, delineating a generational difference in how veterinarians approach pain in cats. Veterinarians in practice less than one year, were the LEAST likely to prescribe any medication. Those in practice 6- 20 years were open to prescribing therapy of any kind. Those in practice more than 20 years were most likely to prescribe corticosteroids.
This brings to light the second and third items to note. Clinical experience is instrumental in diagnosing, and successfully treating pain in the feline patient. Veterinarians in the 6 – 20 year range of experience were most likely to identify and TREAT the pain. The third item is UNDERSTANDING the pathogenesis of degenerative joint disease and pain in the cat. Corticosteroids to relieve inflammation. But they don’t address the multitude of other factors in the pain response. And there are definite adverse effects to watch for, as corticosteroids alter glucose metabolism, can promote fluid retention, and can suppress the immune system. Better options exist.
The team of veterinarians at Boca Park Animal Hospital are committed to understanding pain in your cat, and developing acceptable and often multimodal approaches to treating pain in them. This includes medicine as well as integrative options that promote self-healing. Have your cat examined and help prevent silent suffering!