Episode 161 - Parenteral Pain Modifying Analgesics in Veterinary Medicine

🔗 Unlock the Secrets to Pain Management – Yours Forever! Take your knowledge to the next level with lifetime access to the full online course on pain management! Go to http://ivdi.org/pain and use promo code "pain" to start learning instantly! ---------------------------------------------------------------------------- 🎧 Host: Dr. Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM In this episode, veterinary pain management expert Dr. Mark Epstein explores the latest advancements in parenteral pain-modifying analgesics for chronic pain in dogs and cats. He breaks down the science behind ketamine, bisphosphonates, maropitant, and interventional pain therapies, providing practical dosing recommendations and real-world clinical insights. What You’ll Learn in This Episode: ✅ How ketamine can be used beyond perioperative settings for chronic pain ✅ The role of bisphosphonates in managing osteosarcoma pain ✅ Maropitant’s potential as a pain-modifying agent ✅ The latest research on interventional pain therapies (steroids, PRP, hyaluronic acid) ✅ Practical dosing recommendations and safety considerations Key Takeaways: 🔹 Ketamine for Chronic Pain: Perioperative ketamine use is expanding into chronic pain management Administered every two weeks for three to four doses Research on subcutaneous infusion devices for continuous low-dose delivery Anecdotal reports on monthly low-dose SC ketamine (0.5 mg/kg), but more studies needed 🔹 Bisphosphonates for Osteosarcoma Pain: Zoledronate (Zoledronic Acid) is preferred over pamidronate—stronger, safer, and quicker Standard dose: 0.1 mg/kg IV over 15 minutes (max 4 mg) Best when combined with NSAIDs and radiation therapy for enhanced pain relief 🔹 Maropitant (Cerenia) Beyond Anti-Nausea: May reduce central sensitization (wind-up pain) despite not being a direct analgesic Some studies show benefits for neuropathic pain, GI pain, and post-op discomfort New research into nanoparticle formulations for improved absorption 🔹 Interventional Therapies for Chronic Pain: Saline alone can provide joint pain relief by diluting inflammatory mediators Corticosteroids reduce inflammation but may harm cartilage—use cautiously Hyaluronic Acid (HA) may not outperform saline in osteoarthritis management PRP & stem cell therapy show promise, but protocols and effectiveness vary 📢 Have Questions or Comments? Drop them below! Don’t forget to like, subscribe, and turn on notifications for more expert veterinary pain management content. 🔗 Unlock the Secrets to Pain Management – Yours Forever! Loved today’s insights from Dr. Epstein? Take your knowledge to the next level with lifetime access to the full online course on pain management! Go to http://ivdi.org/pain and use promo code "pain" to start learning instantly!