Managing Chronic Non-osteoarthritic Pain | Part 3a (Chronic, Active inflammatory pain)

What is chronic pain?

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Chronic pain is an unpleasant sense of discomfort that persists or progresses over a long period. In contrast to acute pain that arises suddenly in response to a specific injury and is usually treatable, chronic pain persists over time and is often resistant to medical treatments.

The following are scenarios whose rate of occurrence is closer to that of osteoarthritis:-

1. Chronic, Active inflammatory pain

2. Maladaptive chronic pain

3. Cancer pain.

The therapeutic rationale of these pain phenomena is from the understanding of the disease pathophysiology.

Chronic, Active Inflammatory Pain

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Examples of Chronic, Active Inflammatory Pain include the following:-

1. Chronic periodontal disease (Dental disease)

2. Feline lymphocytic—plasmacytic stomatitis (Inflammation of the mucous membranes of the mouth)

3. Idiopathic feline lower urinary tract disease (Kidney disease)

4. Inflammatory bowel disease (Inflammation/infection of the Digestive Tract)

5. Meningoencephalitides (Inflammation/infection of the brain)

6. Otitis external (Inflammation/infection of the outer ear)

7. Pancreatitis (Inflammation/Infection of the pancreas)

8. Feline interstitial cystitis (Inflammation / Infection of the urinary bladder)

Chronic Periodontal Disease

Feline Plasmacytic Stomatitis

Lower Urinary Tract Disease

Inflammatory Bowel Disease

Meningoencephalitides

Otitis Externa

Pancreatitis

Feline Interstitial Cystitis

Treatment

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The treatment order for this category of chronic pain should be in the following order:

1. Anti-inflammatory medications: non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids

2. Treatment of underlying disease or aggravating comorbidities

3. Neuromodulatory analgesic drugs, such as gabapentin, tramadol, and amitriptyline

4. Weight optimization.

Further reading

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1. Chronic pain management in cats & dogs I Part -1(Overview)

2. Chronic pain management in cats & dogs I Part-2 (Osteoarthritis)

3. Managing chronic non-osteoarthritic pain I Part-3b (Maladaptive chronic pain)

4. Managing Chronic Non-osteoarthritic Pain I Part-3c (Cancer-pain)

References

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