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NSAIDs

Non-steroidal anti-inflammatory drugs (NSAIDs) are the mainstay of treatment of chronic pain. This is an appropriate choice since most forms of chronic pain do have an inflammatory component and NSAIDs allow us to provide analgesia AND to treat pain at its source (inflammation). Controlling the pathology of the pain leads to better pain relief. NSAIDs are the only drugs that have statistically shown consistent relief of chronic pain. There are several FDA approved NSAIDs for control of chronic pain in dogs, although not all are approved for treatment of chronic pain. An NSAID that is FDA-approved for treatment of chronic pain should be the first choice for long-term therapy. Two NSAIDs are approved for treatment of acute pain in cats but there are no NSAIDs approved in the US for long-term pain relief. However, NSAIDs are used for chronic pain in cats and published data are available from other countries.

Multimodal therapy

What options are available when the patient is unable to take NSAIDS or, more commonly, when the pain advances to a pain state that is uncontrollable by NSAIDs used alone? In that instance, opioids, N-methyl-D-aspartate (NMDA) antagonists, and novel drugs like gabapentin should all be considered as potential therapies. In addition, non-pharmacologic therapies (eg, acupuncture, massage, physical therapy, TENS, etc…) should be strongly considered. Dosages for drugs used to treat chronic pain, along with [...]

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