Hospice: Symptom Management - ON DEMAND

Course overview

The program overview is broken down into each individual lecture. The first session will review new additions to the feline and canine pain management toolbox. This includes a new assessment tool for acute pain in cats, drugs for acute pain management in cats and monoclonal antibodies for alleviation of pain related to osteoarthritis in dogs and cats. The next session will discuss ketamine's role as a perioperative agent and its potential role for treating chronic (maladaptive) pain. Many clinicians are giving low doses subcutaneously to animals with long term pain and the evidence for this practice will be discussed. Next will be a session to describe the differences between nausea, vomiting and retching and describe pharmacologic and non-pharmacologic approaches to treatment. There are multiple causes of inappetence in dogs and cats and this session will review these and discuss the rational approach to incorporating capromorelin into a treatment plan. Key acupuncture points used to prevent vomiting and to stimulate appetite will be discussed. Afterwards we will focus on GOLPP - Geriatric Onset Laryngeal Paralysis and Polyneuropathy, which affects a large population of dogs but sadly many go undiagnosed, or if diagnosed, do not have access to optimal treatment options. Owners require education on the treatment options so they can make informed decisions and regardless of what they choose (surgical or non-surgical). We as veterinarians should be familiar with the course of clinical disease, how to discuss options with owners, deliver appropriate interventions or where to refer these patients. The next session will focus on the many environmental management tips that can help improve mobility as well as quality of life, but owners are often unaware of the products and strategies available to them. Being aware of the many options to provide to owners is important in improving quality of life in these hospice patients. Osteoarthritis (or degenerative joint disease) is the most common cause of chronic (maladaptive) pain in cats but is underrecognized by owners and therefore many cats go untreated. Screening and assessment tools have been developed and validated for cats and should be used to help diagnose the disease and monitor the response to treatment. Treatment is multimodal and includes drug and non-drug therapies in combination with environmental changes and ensuring that stress in the affected cat's household is addressed. Long term pain and mobility impairment are often seen in ageing dogs. Common causes include osteoarthritis (OA) and intervertebral disc disease (IVDD) which are painful and affect mobility and degenerative myelopathy (DM) and geriatric onset laryngeal paralysis polyneuropathy (GOLPP) which are not painful but cause significant mobility impairment. Helping patients afflicted with any of these conditions is very rewarding and requires an integrative approach. Mobility aids (e.g. harnesses) and physical therapy are often part of the treatment plan as well as ensuring a safe home environment that can be navigated. Some pets, especially those with one or more chronic medical conditions, are prescribed medication which is often given orally and sometimes more than once per day. Cat owners reported the following alarming statistics: 77% of cats tried to scratch or bite while being medicates, 78% spat out tablets, 72% refused food if medications were hidden in it and 52% of owners said medicating their cat negatively impacted their relationship with their cats. The final session will review tips and tricks for overcoming some of the challenges of medicating dogs and cats and will also explore alternatives such as transdermal drugs