Zero Pain Philosophy

Our quick chat podcasts are snippet updates of recent literature. In this episode Matt reviews a recently reported abstract investigating subcutaneous ketamine.
References
Nielsen MB et al (2026) A randomized, double-blinded,placebo-controlled parallel-group pilot study evaluating the effect of low-dosesubcutaneous ketamine as an adjunctive analgesic in dogs with osteoarthritis.Proceedings of the Association of Vetereinary Anaesthetists meeting Liverpool.

Sam Lindley is one of the most well respected veterinary acupuncturists - both a practitioner and a teacher of what we consider to be a valuable addition to our analgesic practice.
In this episode Matt chats to Sam about her experience and approach to chronic pain cases. Sam also mentions the evidence for acupuncture in sepsis - the link below is a systematic review on the topic.

References
Yang L, Zhou D, Cao J, Shi F, Zeng J, Zhang S, Yan G, Chen Z, Chen B, Guo Y, Lin X. Revealing the biological mechanism of acupuncture in alleviating excessive inflammatory responses and organ damage in sepsis: a systematic review. Front Immunol. 2023 Sep 11;14:1242640. doi: 10.3389/fimmu.2023.1242640. PMID: 37753078; PMCID: PMC10518388.

Stem cells are an evolving and promising option for osteoarthritis management in dogs and cats. In this podcast we talk to Dr Russell Chandler from Greenside Referrals in Scotland with all the questions you may have about stem cells. We start from the view of the vet in the consulting room with an arthritic pet in front of them. 
What do we say to clients, how do stem cells work, which cases are suitable. Listen to our discussion now and understand if stem cells are the right option for your patients.
Links
Greenside Referrals
https://www.stemcellsscotland.co.uk/contact-us
Russell’s book
https://5mbooks.com/product/regenerative-medicine-in-small-animal-musculoskeletal-conditions
Andrew Armitage’s paper on stem cells
Efficacy of autologous mesenchymal stromal cell treatment for chronic degenerative musculoskeletal conditions in dogs: A retrospective study.
This represents the first study using “real-world” data to show that cell-based therapies, injected into multiple areas of musculoskeletal pathology in a targeted holistic approach, resulted in rapid and profound positive effects on the patient's pain state and quality of life which was maintained with repeat treatment for up to 2 years.
https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2022.1014687/full

How does CBD work?
Is CBD a first line option for the treatment of OA pain? 
And where in our second line options does CBD fit? 
In this episode of the Zero Pain Philosophy podcast we are joined by anaesthesia & pain specialist Dr Leon Warne to answer these questions.
If your clients are asking you about CBD, then you need to listen to this.
References
Here is the link to the CATRAS work discussed in today’s podcast:
Warne LN, Schug SA, Beths T, Brondani JT, Carter JE, Lascelles BDX, Raisis AL, Robertson SA, Steagall PVM, Taylor PM, Whittem T, Bauquier SH. Content validation of a Critical Appraisal Tool for Reviewing Analgesia Studies (CATRAS) involving subjects incapable of self-reporting pain. Pain Rep. 2018 Jul 25;3(4):e670. doi: 10.1097/PR9.0000000000000670. PMID: 30123860; PMCID: PMC6085143.
These are the COAST guidelines:
Cachon T, Frykman O, Innes JF, Lascelles BDX, Okumura M, Sousa P, Staffieri F, Steagall PV, Van Ryssen B. COAST Development Group's international consensus guidelines for the treatment of canine osteoarthritis. Front Vet Sci. 2023 Aug 3;10:1137888. doi: 10.3389/fvets.2023.1137888. PMID: 37601753; PMCID: PMC10436090.
This is a recent review of CBD in dogs and cats
Moreno-López N, Moreno-López C, Amariles P. Cannabis-based products for medicinal use in dogs and cats: a systematic review. J Small Anim Pract. 2025 Jul 14. doi: 10.1111/jsap.13913. Epub ahead of print. PMID: 40660612.

Our latest podcast discusses the newly launched DogMA app with researchers Dr Natasha Clark and Professor Eithne Comerford. 
Mobility issues from musculoskeletal diseases, like osteoarthritis, affect around 200,000 dogs annually, posing a significant challenge to their health and welfare. Although these diseases can affect dogs of any age, owners often miss early, subtle signs of gait abnormalities, leading to late diagnosis of osteoarthritis. 
The DogMA app was developed to address this by enabling early detection of mobility problems, including subtle signs of discomfort or decline often overlooked in routine care. 
DogMA is supported by scientific research led by Dr. Natasha Clark at the University of Liverpool, under the supervision of Professors Eithne Comerford and Karl Bates, in collaboration with Dogs Trust. 
By using the app for regular assessments, users can also contribute anonymized data to ongoing research at the University of Liverpool, helping to advance the understanding of canine mobility across the UK.
References
Here is the link to the paper discussed in today’s podcast:
Clark NL, Bates KT, Harris LK, Tomlinson AW, Murray JK, Comerford EJ. GenPup-M: A novel validated owner-reported clinical metrology instrument for detecting early mobility changes in dogs. PLoS One. 2023 Dec 27;18(12):e0291035. doi: 10.1371/journal.pone.0291035. PMID: 38150469; PMCID: PMC10752556.
University of Liverpool page launching DogMA
https://www.liverpool.ac.uk/life-course-and-medical-sciences/research/dogma/
Download the app for free from your app store:
Android: DogMA in the Google Play Store
iOS: DogMA in the Apple App Store
This is the paper documenting radiographic and clinical OA in 23% of dogs less than 4 years of age:
Enomoto M, de Castro N, Hash J, Thomson A, Nakanishi-Hester A, Perry E, Aker S, Haupt E, Opperman L, Roe S, Cole T, Thompson NA, Innes JF, Lascelles BDX. Prevalence of radiographic appendicular osteoarthritis and associated clinical signs in young dogs. Sci Rep. 2024 Feb 3;14(1):2827. doi: 10.1038/s41598-024-52324-9. PMID: 38310147; PMCID: PMC10838335. 
These are the COAST guidelines:
Cachon T, Frykman O, Innes JF, Lascelles BDX, Okumura M, Sousa P, Staffieri F, Steagall PV, Van Ryssen B. COAST Development Group's international consensus guidelines for the treatment of canine osteoarthritis. Front Vet Sci. 2023 Aug 3;10:1137888. doi: 10.3389/fvets.2023.1137888. PMID: 37601753; PMCID: PMC10436090.