title: Pain and analgesia following onychectomy in cats: a systematic review.
abstract: OBJECTIVE
  To systematically review published studies evaluating pain associated with onychectomy in cats, and to assess the efficacy of the analgesic therapies applied.
  
  
  METHODS
  Four sources were used to identify manuscripts for review. Databases searched were those of the National Library of Medicine, EMBASE and CAB International. In addition, pertinent references in the bibliographies of included articles were retrieved.
  
  
  RESULTS
  Twenty manuscripts published in refereed journals were reviewed. These included papers reporting 18 clinical trials and two studies conducted in conditioned research cats. Twelve analgesics were evaluated, including seven opioids, four non-steroidal anti-inflammatory drugs and one local anesthetic. Nine studies involved a direct comparison of analgesic agents. Limb use was abnormal when measured at 2 and 12 days following onychectomy, and neither fentanyl patch nor butorphanol administration resulted in normal use of the surgical limb. In another study, cats evaluated at 6 months after this surgery were not lame. Differing surgical techniques were compared in six studies; the results indicated that pain scores were lower after laser surgery than after scalpel surgery. The difficulties associated with assessing pain in cats and the lack of sensitivity of the evaluation systems utilized were highlighted in many of the studies. Huge variations in dose and dosing strategies had significant impacts on drug efficacy. Statistically significant differences among treatments were found in most studies; however, no clearly superior analgesic treatment was identified. A combination of meloxicam or robenacoxib with an opioid may provide more effective analgesia and should be evaluated.
authors.affiliation: Department of Large Animal Clinical Sciences, Michigan State University College of Veterinary Medicine, East Lansing, MI, USA.
authors.forename: Deborah V
authors.initials: DV
authors.lastname: Wilson
authors.affiliation: Department of Surgical and Radiological Sciences, University of California, Davis, Davis, CA, USA.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Pascoe
mesh_terms: D000700:Analgesics / Q000627:therapeutic use*; D000818:Animals; D002415:Cats / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009919:Orchiectomy / Q000662:veterinary*; D010052:Ovariectomy / Q000662:veterinary*; D010147:Pain Measurement / Q000662:veterinary; D010149:Postoperative Pain / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic
chemical_list: D000700:Analgesics
keywords: analgesic; cat; onychectomy; pain assessment