Georgiou S.G. DVM, MSc in Algology, PhD in Veterinary Anaesthesia, Volos Veterinary Specialists, Volos | Papagiorgou E. DVM, GPCert Emergency Medicine and Surgery (candidate), Volos Veterinary Specialists, Volos | Diamantis F. DVM, MSc Surgery, SASTS (SCIVAC), Volos Veterinary Specialists, Volos | Milini T.K. DVM, GPCert Internal Medicine (candidate), Volos Veterinary Specialists, Volos | Lafioniatis S. DVM, GPCertSAS (candidate), mGRSK, Small Animal Practice Savvas Lafioniatis | Karra K.E. DVM, GPCertDI ISVPS, Plakentia Veterinary Clinic, Athens
Introduction
Neuropathic pain (NP) is caused by a lesion or disease affecting the somatosensory system and is associated with persistent postoperative pain (PPP). Central sensitization is a feature of PPP, caused by peripheral nerve injury during surgery or inadequate perioperative analgesia, and is often characterized by abnormal sensation (allodynia, hyperaesthesia). History, sensory examination and response to appropriate treatment remain the key factors in NP diagnosis, while pregabalin is the mainstay of its treatment in humans.
Clinical cases
We present a case of presumed NP in a cat. A 3-legged cat was referred with unusual behavior since adoption, but injury history was deficient.
Clinical and orthopedic examination, blood and urine analysis, radiographs and CT scan revealed no abnormalities, whereas neurological evaluation revealed mechanoallodynia on the stump and throughout the thoracolumbar region, which elicited marked agitation in the cat. NP was suspected, according to history and signs of hyperaesthesia and allodynia. Treatment consisted of meloxicam 0.1 mg/kg SID and tramadol 2 mg/kg BID for 5 days and pregabalin 1.5 mg/kg BID for 3 months. Pain assessments were performed (FGS, CSOMf) for evaluation of treatment response throughout the next 3 months.
Results
A rapid improvement was observed and the quality of life was notably enhanced throughout the treatment period.
Conclusions
No adverse effects were noticed during the 3-month treatment and no rebound hyperalgesia was noticed after pregabalin gradual cessation.