Currently the only validated pain score system for cats is the UNESP-Botucatu ( http :// www . animalpain . com . br ).
Obesity leads to an increased risk of multiple health issues including orthopedic disease and pain . Maintaining an optimum body condition is an essential factor for pain management in cats . Bjornvad ( 2011 ) compared results of body condition scoring by use of a 9-point scale with body composition determined by dual -energy x-ray absorptiometry in neutered indoor-only domestic shorthair cats . Their results indicated that the 9-point scale is useful in determining a cat ’ s percent body fat and therefore is clinically relevant . A body condition score and current weight should be assessed at every office visit to determine if a weight loss program needs to be instituted and if the current program is effective .
Opioids are the most effective drug class for managing acute pain and can play a role in managing chronic pain . Full μ agonists elicit greater and more predictable analgesia than partial μ agonists or κ agonists . In a comparison study , buprenorphine administered before surgery and during wound closure provided adequate analgesia for 6 hours following ovariohysterectomy in cats , whereas butorphanol did not ( Warne 2014 ). In cats , IM and IV administration of opioids are recommended both pre- and postoperatively ( Giordano 2010 ). Transmucosal or buccal administration
of buprenorphine also has clinical efficacy ( Robertson 2003 , 2005 ).
Non-steroidal anti-inflammatory drugs are the hallmark for the treatment of chronic pain and perioperative pain management . A retrospective study found that longterm use of meloxicam did not reduce the lifespan of cats > 7 years of age with pre-existing , stable chronic kidney disease compared to cats without chronic kidney disease ( Gowan 2012 ). Low-dose meloxicam ( 0.01 – 0.03 mg / kg PO q 24 hr ) is effective in treating arthritic cats and is well-tolerated even in cats with chronic kidney disease as long as their condition is stable ( Gowan 2011 ). Oral administration and longterm use of meloxicam in cats is off label use in the US . Robenacoxib is a COX-2 selective NSAID FDA-approved for surgical pain in cats . A long-term safety study was done in young cats giving 5 times the recommended dosage of Robenacoxib for 6 months and 10 times the recommended dosage for 6 weeks , which revealed minimal side effects ( King 2012 ).
Local analgesics provide complete analgesia and should be used with every surgical procedure , if possible . Studies using both thermal threshold and surgical models demonstrated that Tramadol produces a painmodifying effect in cats via the production of the μ-agonist M1 metabolite ( Pypendop 2009 , Brondani 2009 ). Gabapentin is an anticonvulsant that produces analgesia by down-regulating calcium channels .