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The Global Pain Council of the WSAVA utilizes ketamine extensively in the recommendations for countries where opioid analgesics, and safe non-steroidal analgesics are limited. Recent human papers evaluating safety in:
· Intensive care and cerebral perfusion in the ICU (not increasing ICP)
· Reduced neurotoxicity and improved perfusion in neuro-anesthesia
· Improved hemodynamics for sedations in ICU
· Modification of neuropathic pain and anxiety disor-
· Replacement for opioid drugs in acute pain in opi- oid-free and reduced opioid procedures
Veterinary uses: Two primary considerations: Anesthesia and sedation:
Acute Analgesia: NMDA antagonism reduces requirement for opioids, reduced post-operative pain, reduced wind-up at the level of the spinal cord and glia.
The Global Pain Council of the WSAVA utilizes ketamine extensively in the recommendations for countries where opioid analgesics, and safe non-steroidal analgesics are limited.
Chronic Analgesia: NMDA antagonism mitigates glial hyper-activity and neuropathic pai
· Spinal cord injury, brain injury peripheral nerve injury
· Chronic OA
Low cost and high margin of safety at sub-anesthetic doses
Systemic and peripheral applications
Other (oral) NMDA antagonists:
· Amantadine 2-5 mg/kg q 12-24 hours
· Memantine 0.3-0.5 mg/kg q 12-24 hours
M. Chandler1, M. Rinkinen2
1Vets Now Referrals, Nutrition, Glasgow, United Kingdom
2Helsinki University of Veterinary Medicine-, Medicine, Helsinki, Finland
Care for chronic enteropathy cases: medicine and nutritional therapies
Drs Minna Rinkinen and Marge Chandler
Diet and Chronic enteropathy
The gastrointestinal tract (GIT) is impacted directly by the diet more than any other part of the body. It is affected by the nutrients, the frequency and timing of meals,
and the effect on the microbiome. The diet may contain toxins, allergens, nutritional excesses or deficiencies. The diet also has a direct effect on GI physiology, affecting motility, cell renewal rate, enzyme production, immune functions, ammonia production, and volatile fatty acid content. Nutrition plays a key role in the management of many GI diseases, and many cases may be managed by dietary therapy alone.
Nutritional Assessment
Nutritional assessment is part of the routine history taking and physical examination. Nutritional assessment has two parts: a screening evaluation and an extended evaluation if areas of concern are found. The screening evaluation should be performed at every veterinary visit and includes a diet history, body weight, body condition score (BCS), muscle condition, and evaluation of the coat and teeth.
A complete dietary history is especially crucial for patients with GI disease. Often the pet has access to treats, foods provided to give medications, or outside food sources (e.g., scavenging or hunting) which the owner may not consider part of the “diet”, so the questioning must be done carefully.
Chronic diarrhoea
Chronic diarrhoea is diarrhoea which has lasted longer than 2 weeks. It has many potential aetiologies, including adverse reactions to food, inflammatory bowel disease/ chronic enteropathy, parasites, infectious agents, neoplasia, and systemic disorders such as pancreatitis, pancreatic insufficiency, kidney or liver disease, and hypoadrenocorticism.
Large vs small intestinal diarrhoea
One of the first diagnostic steps is to determine if
the diarrhoea is large or small intestinal in origin or both. Many patients exhibit signs which fall into “both”
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