Breakthrough pain – what is it and should we be worried about it? The simple answer is yes.

There is little in the literature regarding how prevalent it is in dogs, but in humans 16-95% of persistent pain conditions experience breakthrough pain which is severe or even excruciating, rapid in onset and can disable the patient. In this two-part live, Hannah and Gwen chat about breakthrough pain, starting with the three recognised subtypes in human literature: Incident, idiopathic and end of dose failure.

(September 2021 FULL VIDEO: You can find the full video in the Member Zone https://caninearthritis.co.uk/member-zone)

Guest info:

Gwen Covey-Crump qualified from the Royal Veterinary College in 2001 and worked in small animal practice before completing a residency in Veterinary Anaesthesia at the University of Bristol in 2004. She later joined the Queen's Veterinary Hospital at the University of Cambridge and returned to Bristol Vet School in 2009 as the lead Clinical Anaesthetist for Langford Veterinary Services. Gwen earned her European Diploma in Veterinary Anaesthesia and Analgesia in 2012 and now specializes in chronic pain management at Langford Vets, focusing on pharmacological therapies, environmental impacts on pain, and the connection between pain and behavior.

Key Takeaways:

1. Breakthrough Pain is Serious: It's a significant concern, often severe and rapid in onset, making it potentially disabling for patients, including dogs. Breakthrough pain, also known as acute flares, is a common but often overlooked aspect of osteoarthritis (OA) management in dogs, requiring better owner education.

2. Incident Pain: This subtype occurs due to trauma from activities like inappropriate exercise, highlighting the need for modified lifestyles and environments.

3. Idiopathic Pain: Diagnosed when no clear cause is found after excluding other conditions, stressing the importance of thorough reassessment when breakthrough pain is suspected.

4. End of Dose Failure: Occurs when pain relief isn't sustained due to incorrect dosing, underscoring the need for proper education on pain management and dosing. Proper dosing and timing of medications like gabapentin are crucial in managing chronic pain and preventing breakthrough pain in dogs.

5. Proactive Management: Understanding and identifying triggers for acute pain episodes, such as certain activities or dosing issues, can help prevent these painful flares. Adjusting the dog’s environment, like adding more rugs, can be as important as medication in managing pain and preventing flares.

6. Owner Vigilance: Pet owners need to be proactive and reflective, linking recent activities to pain episodes, as dogs won’t necessarily connect the two themselves.

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Stay tuned to learn how early detection can make a significant difference in managing OA in younger dogs.