Dr Robert Trujanovic is an EBVS European Specialist in Veterinary Anaesthesia & Analgesia. In our latest podcast we talk to Robert to share his experience of using botulinum toxin A in pain management in dogs. Robert is leading the field on this subject and brings his experience of interventional pain management to our Zero Pain community. We exploreWhat is the mechanism of action of BT?What sort of pain cases is BT used for in human medicine?Can you please tell us about some cases where you have successfully used BT in dogs (any feline experience)Are there some practical considerations you would like to mention?References· Pioneering pain management with botulinum toxin type A: From anti-inflammation to regenerative therapies. Hamta Rahmatipour, Salar Mohammadi Shabestari, Soheila Zamanlui Benisi, Hamidreza Samadikhah · Botulinum toxin for the treatment of chronic pain. Review of the evidence. Roberto Carlo Rivera Día, Mario Andrés Arcila Lotero, María Victoria Avellaneda Suarez, Sara Echeverri Saldarriaga, Manuela Gómez Martínez · Botulinum Toxin in Chronic Lateral Epicondylitis, from Tendon to Muscle Approach—A Review · Transforaminal versus Intra-Articular Facet Corticosteroid Injections for the Treatment of Cervical Radiculopathy: A Randomized, Double-Blind, Controlled Study N.J. Bureau, T. Moser, J.H. Dagher, D. Shedid, M. Li, P. Brassard and B.E. Leduc · Retrodural space of Okada in the posterior ligamentous complex region: clinical and anatomical findings relevant to lumbar interlaminar epidural injection
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Let sleeping dogs (and cats) lie!
In the latest edition of The Zero Pain Philosophy podcast Matt talks to behaviour specialist Dr Carrie Tooley about sleep in dogs and cats. How many hours of sleep should dogs and cats be getting and how can sleep disturbance influence behaviour and emotional health? ShownotesWhy we sleep – Matthew WalkerLi et al review (2022): The Influence of Sleep Disturbance on Chronic Pain: https://link.springer.com/article/10.1007/s11916-022-01074-2Sleep questionnaires – only one validated for use in dogs SNoRE 3.0: https://www.nature.com/articles/s41598-023-40048-1https://www.pdsa.org.uk/what-we-do/pdsa-animal-wellbeing-report/paw-report-2024BSS (British Sleep Society)/ESRS (European Sleep Research Society) – memberships, webinars, conferencesBSS have a few podcast episodes “BSS bites”
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Tuning into pain and emotional health
Understand how to incorporate pre visit sedation protocols with your cat or dog friendly approach
This podcast complements the pre-visit medication protocols that we have on Zero Pain Philosophy
Learn how to interpret some of the behaviours that anxious dogs are showing in the hospital and how our interactions with those pets are 90% of the solution
Review the pre-visit and hospital sedation protocols created by Dr Matt Gurney & Dr Sarah Heath first, as you listen to this podcast
Find the sedation protocols at www.zeropainphilosophy.com. Please note access is limited to veterinary professionals and we are unable to answer advice queries from pet owners. Please contact your vet.
For information on behavioural medicine support from Behaviour Referrals Veterinary Practice please visit https://behaviouralreferrals.co.uk/
References
Mills, Daniel S et al. “Pain and Problem Behavior in Cats and Dogs.” Animals : an open access journal from MDPI vol. 10,2 318. 18 Feb. 2020, doi:10.3390/ani10020318
Tooley, Carrie, and Sarah E Heath. “Emotional Arousal Impacts Physical Health in Dogs: A Review of Factors Influencing Arousal, with Exemplary Case and Framework.” Animals : an open access journal from MDPI vol. 13,3 465. 28 Jan. 2023, doi:10.3390/ani13030465
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48:00
Modifying the Microbiome to Minimise Pain
In our latest podcast, Modifying the Microbiome to Minimise Pain, Matt talks to Dr Siobhain O’Mahony, a leading academic in microbiome research. Dr O’Mahony has published work within human medicine, examining the link between the microbiome and pain outcomes after surgery. And we ask, ‘How could this translate into our field of veterinary pain management?’
We also touch upon what we should eat ourselves and ask whether we are feeding our pets correctly.
References for shownotes
The gut microbiota as a key regulator of visceral pain (2017)
The gut microbiota in persistent post-operative pain following breast cancer surgery
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11137075/
Stevens, Christina et al. “Gut Microbiome and Osteoarthritis: Insights From the Naturally Occurring Canine Model of Osteoarthritis.” Arthritis & rheumatology (Hoboken, N.J.), 10.1002/art.42956. 19 Jul. 2024, doi:10.1002/art.42956
Stewart, H L et al. “Differences in the equine faecal microbiota between horses presenting to a tertiary referral hospital for colic compared with an elective surgical procedure.” Equine veterinary journal vol. 51,3 (2019): 336-342. doi:10.1111/evj.13010
Stewart, Holly L et al. “Changes in the faecal bacterial microbiota during hospitalisation of horses with colic and the effect of different causes of colic.” Equine veterinary journal vol. 53,6 (2021): 1119-1131. doi:10.1111/evj.13389
Jan S Suchodolski
https://pubmed.ncbi.nlm.nih.gov/34514619/
The Dysbiosis Index (DI) is a validated quantitative PCR assay for canine fecal samples that measures the abundance of seven important bacterial taxa and summarizes the results as one single number.
The DI can be used to assess the microbiome in clinical patients over time and in response to therapy (eg, fecal microbiota transplantation).
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Is subcutaneous methadone a thing?
Spoiler alert - you need to listen to this podcast to understand if there is a place for subcutaneous methadone in veterinary clinical practice!
In this edition, Matt reviews the first paper that investigated pharmacokinetics of subcutaneous methadone and first raised the question of using this route in dogs. Matt then chats to anaesthesia specialist Aoife Ryan about a study they performed together to attempt to enhance our understanding around this topic. With Carl, we then chat through a recent publication examining this route of administration in dogs.
For more on methadone, please see our pain update 'Methadone, the most versatile opioid' here
https://www.zeropainphilosophy.com/post/methadone-the-most-versatile-opioid
Need more detail? You can watch this webinar on methadone
https://www.zeropainphilosophy.com/members-webinars
References discussed in this podcast
Bini G, Vettorato E, De Gennaro C, Corletto F. A retrospective comparison of two analgesic strategies after uncomplicated tibial plateau levelling osteotomy in dogs. Vet Anaesth Analg. 2018 Jul;45(4):557-565. doi: 10.1016/j.vaa.2017.11.005.
Ingvast-Larsson C, Holgersson A, Bondesson U, Lagerstedt AS, Olsson K. Clinical pharmacology of methadone in dogs. Vet Anaesth Analg. 2010 Jan;37(1):48-56. doi: 10.1111/j.1467-2995.2009.00476.x.
Ryan AC, Murrell JC, Gurney MA. Post-operative nausea and vomiting (PONV) observed in a clinical study designed to assess the analgesic effects of intravenous and subcutaneous methadone in dogs. Vet J. 2022 Sep;287:105876. doi: 10.1016/j.tvjl.2022.105876.
Upchurch D, Lin KTT, KuKanich B. Two doses of subcutaneous methadone for postoperative analgesia in dogs undergoing tibial plateau levelling osteotomies. J Small Anim Pract. 2024 Jun;65(6):368-375. doi: 10.1111/jsap.13728.
Zero Pain Philosophy is here to help veterinary professionals worldwide achieve Analgesic Excellence in your clinic. Established by vet specialists Matt Gurney & Carl Bradbrook, we offer a variety of educational resources to help spread pain management know how including both free and paid content including podcasts, pain updates, webinars and a telemedicine service. Our content is delivered by European & American Specialists in Veterinary Anaesthesia & Analgesia.
Resources are for vet professionals: pet owners - ask your vet to use our telemedicine service to seek case advice.
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