Content continues after advertisement

Recognizing Pain in Cats After Dental Extractions

Kendall Taney, DVM, DAVDC, FAVD, Center for Veterinary Dentistry & Oral Surgery, Gaithersburg, Maryland

Dentistry & Periodontology

|November/December 2020|Web-Exclusive

Sign in to Print/View PDF

In the literature

Watanabe R, Frank D, Steagall PV. Pain behaviors before and after treatment of oral disease in cats using video assessment: a prospective, blinded, randomized clinical trial. BMC Vet Res. 2020;16:100.


FROM THE PAGE …

Dental disease can be overlooked as a source of patient morbidity when patients are eating and drinking normally. Education in identifying behaviors specific to oral pain could lead to more prompt treatment of dental disease and help pet owners evaluate their pets in the postoperative period.

In this prospective, blinded, randomized clinical trial,* 24 cats were divided into minimal (group 1, minimal dental treatment) or severe (group 2, multiple dental extractions) oral disease groups. Both groups underwent oral examination, radiography, scaling, and dental extractions while under general anesthesia. Cats were filmed remotely for 10 minutes before surgery (baseline) and throughout the study at different time points over a 36-hour period. The videos consisted of 4 groups of behaviors, including general demeanor, playing, feeding, and postfeeding. A board-certified behaviorist evaluated the duration and frequency of different behaviors.

All cats received premedication with acepromazine and hydromorphone and local anesthetic blocks using bupivacaine. Meloxicam was administered SC at the end of the dental procedure, and 3 subsequent doses were administered PO at 24, 48, and 72 hours after the first dose. Cats received rescue analgesia (ie, hydromorphone) when Glasgow Feline Composite Measure Pain Scale scores were ≥5 out of 20 at any time during the study. Based on the duration of action of hydromorphone in cats, videos obtained within 2 hours of rescue analgesia were excluded from statistical analysis to avoid bias.

Results showed that cats in group 2 exhibited more signs consistent with pain than did cats in group 1. Group 2 cats were generally less active both before and after surgery and exhibited fewer play behaviors. Group 2 cats also had more difficulty grasping dry food postoperatively, although no significant difference in feeding behaviors for soft food was found between the groups. Frequency of postfeeding headshaking was significantly higher in both groups at day 6 as compared with baseline. The study concluded that cats with oral pain require longer periods of time to eat both dry and soft food than those with minimal pain. Despite some study limitations, including the need to extrapolate the Glasgow Feline Composite Measure Pain Scale scores for evaluation of oral pain, the authors also concluded this study identified some pain-induced behaviors in cats undergoing treatment of oral disease and these behaviors may be used to differentiate painful versus pain-free cats in clinical practice.


…TO YOUR PATIENTS

Key pearls to put into practice:

1

Cats that were determined to have significant dental disease were noted to be less active in the pre- and postoperative observation periods; these cats were also less playful. These observations support that dental disease can cause patient morbidity; however, these behaviors may be subtle and challenging for owners to recognize.1-3

2

Grasping of dry food in the postoperative period was more difficult for patients that had multiple extractions. It is generally recommended to feed patients that have had extractions a soft diet for patient comfort.2

3

Cats that had more extractions required rescue analgesia more frequently in this study. Appropriate multimodal pain management is essential for patient comfort after dental extractions.2-5

4

Recognition of specific behavioral signs of oral pain in cats could be useful to owners and clinicians in identifying the need for dental treatment. These signs could also be useful for evaluation of pain in the postoperative period after dental treatment.6-8

* This study was funded by Hill’s Pet Nutrition.

References

For global readers, a calculator to convert laboratory values, dosages, and other measurements to SI units can be found here.

All Clinician's Brief content is reviewed for accuracy at the time of publication. Previously published content may not reflect recent developments in research and practice.

Material from Clinician's Brief may not be reproduced, distributed, or used in whole or in part without prior permission of Educational Concepts, LLC. For questions or inquiries please contact us.

Podcasts

Clinician's Brief:
The Podcast
Listen as host Alyssa Watson, DVM, talks with the authors of your favorite Clinician’s Brief articles. Dig deeper and explore the conversations behind the content here.
Clinician's Brief provides relevant diagnostic and treatment information for small animal practitioners. It has been ranked the #1 most essential publication by small animal veterinarians for 9 years.*

*2007-2017 PERQ and Essential Media Studies

© 2023 Educational Concepts, L.L.C. dba Brief Media ™ All Rights Reserved. Terms & Conditions | DMCA Copyright | Privacy Policy | Acceptable Use Policy