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Guest Post by Bonnie Brown, CCRP, VMD from Gotham Veterinary Center

We have added an early lameness detection diagnostic tool, Stance Analyzer, at Gotham AH. It has been a very useful tool in our practice and helps with:

  • Early detection of lameness
  • Provides data to prove treatment efficacy
  • Follow progress of treatment
  • Use as a scale

It helps to diagnose more subtle lameness by demonstrating the distribution of weight on all four limbs of the patient. It has convinced several pet owners the importance of starting rehabilitation therapy when they saw the discrepancy in their pet’s weight bearing.

The objective data the Stance Analyzer provides is the baseline evaluation to determine if the therapy we are using is effective or if we need to alter the treatment modalities and exercises. The Stance Analyzer also provides the pet owners a visual representation of the data while it monitors their pet’s progress as the analysis is repeated every three weeks. It is very simple to use and space efficient and doubles as a scale.

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Guest Post by Bonnie Brown, CCRP, VMD from Gotham Veterinary Center

At Gotham AH, we certainly do use our laser for the treatment of Osteoarthritis but we have also discovered so many other very successful uses for the laser.  This includes post-surgical incisions and surgical dental extractions for pain relief and faster healing. However, the following 3 conditions respond very well with laser therapy:

  • Lacerations
  • Bite wounds
  • Skin tears

The response has been nothing short of miraculous! Previously when any laceration or bite wound came into the hospital it would almost always end up in surgery with full anesthesia.

My first experience with a significant laceration on a dog that was bitten by another dog in the park and had suffered an ~ 8cm laceration that extended deep into the muscle. The dogs owner did not feel comfortable agreeing to anesthesia and surgery and so I spoke to her about laser therapy. She was thrilled to have another option that was less invasive. I explained that we would laser three times weekly and that full healing might take 4-6 weeks because of the depth of the wound.  The owners were thrilled we had an option other than surgery.  We began a 3x per week treatment protocol and would show them the progress at each visit and by the 9th session (3 weeks later) the laceration had filled in and was much more superficial and was about one-third of it’s initial size.  By the end of week four it had completely healed. We now routinely offer laser as the first option for many wounds and lacerations

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8 Ways to Treat Pain in Cats

Guest Blog by Jeff Smith, DVM, CCRP, Middletown Animal Hospital, Middletown, CA

 

8 ways to treat pain in cats

The new AAHA/AAFP Pain Management Guideline state that pain management should include pharmaceutical as well as non-pharmaceutical modalities.  MultiModal Pain Management is the new Standard of Care for painful patients
First, check laboratory values (CBC/Chem/UA), BP, and imaging.  This is not an exhaustive review of the subject, just a quick summary to act as a checklist of items to study and consider.
DJD is rarely evident on radiographs of cats.  Look for muscle atrophy, lack of jumping and lack of activity as the main indicators of joint pain.
1.  NSAIDs (COX Inhibitor):  Meloxicam is our drug of choice for safety, ease of use, and the ability to titrate or adjust the dose (0.02-0.03 mk/kg SID).  This is an off-label use in the US, but an approved use in Europe and Australia.
2.  Laser Therapy (decrease pain, decrease inflammation):  With contact head administration—3X per week for 4 weeks then 1X week for 1 month then once every 2-4 weeks.  Treat at 10-15 J/cm2 depending on severity.
3.  Weight Loss—Hill’s Metabolic Diet:  Weight loss is equally effective as NSAIDs for pain relief in arthritic patients.  This is often an overlooked but important consideration for geriatric cats.
4.  Adequan: Twice weekly for 6-8 doses (0.5 to 2.5 mg/lb IM or SQ).  Then every 4 months administer twice weekly for 4 doses—this protocol stimulates up regulation of the chondrocytes that will not occur with once monthly injections.  This is a much preferred and more effective joint therapy than oral supplements.  This the only disease modifying drug we have to use.
5.  Gabapentin (Ca Channel): Amantadine (NMDA), Amitriptyline (NE/Serotonin RUI), Bupirnex (Opiod).  All 4 agents block the pain pathway at different and unique locations, so they can be used in combination for added effect as needed. Look into the dosages and combined use of these meds as a more advanced extension of this discussion.
6.  Omega 3 Fatty Acids/Fish Oil (reduce Arachidonic Acid):  High EPA content and high quality.  WelActin is our neutriceutical of choice in this category.  We give a double dose (640 mg EPA/day/10# Cat) for the first 30 days and then reduce to a maintenance dose (320 mg EPA/day/10# Cat).
7.  Environmental Modification:  Ramps, steps, lower litter box barriers, rug runners—all help painful kitties get where they want to go with less discomfort.
8.  Physical Rehabilitation:  Yes!  Cats are candidates for rehab, too.  Underwater Treadmill, Massage, Passive Range of Motion, Strengthening Exercises, Core Exercises.  This is a rewarding and exciting aspect of veterinary medicine to develop.  Clients LOVE bringing their pets to rehab!
Consider advanced training such as the CCRP certification offered by the University of Tennessee or consult Darryl Millis’ Canine Rehabilitation Textbook.

 

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