Canine
neuropathic pain (NeuP) has been poorly investigated. This study aimed to evaluate the
pain burden, sensory profile and inflammatory
cytokines in dogs with naturally-occurring NeuP. Twenty-nine client-owned dogs with NeuP were included in a prospective, partially masked, randomized crossover clinical trial, and treated with
gabapentin/placebo/
gabapentin-
meloxicam or
gabapentin-
meloxicam/placebo/
gabapentin (each treatment block of 7 days; total 21 days).
Pain scores, mechanical (MNT) and electrical (ENT) nociceptive thresholds and descending noxious inhibitory controls (DNIC) were assessed at baseline, days 7, 14, and 21. DNIC was evaluated using ΔMNT (after-before conditioning stimulus). Positive or negative ΔMNT corresponded to inhibitory or facilitatory
pain profiles, respectively.
Pain scores were recorded using the Client Specific Outcome Measures (CSOM), Canine Brief
Pain Inventory (CBPI), and short-form Glasgow Composite Measure
Pain Scale (CMPS-SF). Data from baseline were compared to those of sixteen healthy controls. ΔMNT, but not MNT and ENT, was significantly larger in controls (2.3 ± 0.9 N) than in NeuP (-0.2 ± 0.7 N). The percentage of dogs with facilitatory sensory profile was similar at baseline and after placebo (61.5-63%), and between controls and after
gabapentin (33.3-34.6%). The CBPI scores were significantly different between
gabapentin (CBPI
pain and CBPI overall impression) and/or
gabapentin-
meloxicam (CBPI
pain and interference) when compared with baseline, but not placebo. The CBPI scores were not significantly different between placebo and baseline. The concentration of
cytokines was not different between groups or treatments. Dogs with NeuP have deficient inhibitory
pain mechanisms.
Pain burden was reduced after
gabapentin and/or
gabapentin-
meloxicam when compared with baseline using CBPI and CMPS-SF scores. However, these scores were not superior than placebo, nor placebo was superior to baseline evaluations. A caregiver placebo effect may have biased the results.