July 14, 2016

Tips on Analgesia in Pregnant and Lactating Dogs and Cats

Pregnant and nursing animals in pain need special consideration because clinical trials of analgesics usually exclude these populations and safety data are lacking.
By Amy Karon, DVM, MPH

NSAIDs in Pregnant & Nursing Cats & Dogs 

Nonsteroidal anti-inflammatories are potentially teratogenic and may adversely affect development. They should be avoided in pregnant animals, and should be used sparingly – if at all – in lactating animals, according to WSAVA. Dr. Mathews recommends no more than one dose of an NSAID after cesarean section.
 

Ketamine in Pregnant & Nursing Cats & Dogs 

Although ketamine is not known to be teratogenic, it increases uterine tone, and therefore should be avoided during pregnancy, according to WSAVA. Ketamine usually is not recommended for lactating animals because of the chances of its passing into milk.
 

Alpha2 Adrenoceptor Agonists in Pregnant & Nursing Cats & Dogs 

Xylazine inhibits uterine perfusion and should be avoided during pregnancy, while it is unclear how medetomidine and dexmedetomidine affect pregnant dogs and cats, WSAVA notes. The organization makes no recommendations about these drugs for nursing animals.
 

Herbal Analgesics in Pregnant & Nursing Cats & Dogs 

WSAVA recommends avoiding herbal analgesics in pregnant and lactating animals because of a lack of safety data.
 

Tips for Owners and Other Caregivers of Pregnant & Nursing Cats & Dogs 

Carefully monitor pregnant and nursing dogs and cats for adverse effects of analgesia. When in doubt, halt treatment and consult with the prescribing veterinarian. Complex cases may benefit from consultation with experienced specialist, such as a veterinary anesthesiologist or theriogenologist (veterinary reproductive specialist).
 
If pain relief medication is given for several days, the dose should gradually be tapered instead of stopping abruptly, unless there is concern about a serious adverse effect.
 
As always, avoid giving over-the-counter analgesics intended for humans, particularly without input from an experienced veterinarian. Acetaminophen (paracetamol, Tylenol), ibuprofen, naproxen, and acetylsalicylic acid have caused many fatal toxicities in dogs and cats.
 
In terms of nonpharmacologic relief, common-sense measures such as bandaging, gentle heat, and cold packs can help relieve discomfort, but are best used in consultation with a veterinarian or experienced veterinary technician.
 
Dr. Amy Karon earned her doctorate in veterinary medicine and master’s degrees in public health and journalism from the University of Wisconsin-Madison. She was an infectious disease epidemiologist and “disease detective” (EIS officer) with the Centers for Disease Control and Prevention before becoming a full-time medical writer. She lives in the San Francisco Bay area, where she volunteers for the local Humane Society.

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