You may have heard of the term ‘neuropathic pain’ and wondered what it means. It’s a difficult phenomena to understand. The signs of pain in your pet is not always obvious which makes it tricky to diagnose. As animals can’t verbally communicate with us about their pain, it is essential that you can identify the warning signs so treatment can start as soon as possible.
Below we give you an understanding of neuropathic pain in your pet, the symptoms to watch for, and talk through the different ways to treat the pain in your pet.
What is neuropathic pain?
Neuropathic pain is caused by damage, injury or disease in the somatosensory system, which is the body’s network of nerves that detect touch, pain and temperature.
According to Sarah Moore, a neurologist from The Ohio State University, neuropathic pain is a ‘maladaptive phenomenon caused by pathologic neuroplasticity, and can become a disease of the neurologic system in its own right by persisting beyond resolution of an inciting cause’ (Moore 2016).
When someone is experiencing neuropathic pain, it is not typically triggered by a specific event or injury – for example, the breaking a bone or burning the skin. Instead with neuropathic pain, the body just sends pain signals to your brain unprompted.
People with this pain condition may experience shooting, burning pain. The pain may be constant, or may occur intermittently. A feeling of numbness or a loss of sensation is common, too. Neuropathic pain also tends to get worse over time.
Neuropathic pain is common in people with chronic neurologic and musculoskeletal diseases, yet ‘these conditions remain an under-appreciated morbidity in veterinary patients’.
This is largely due to the fact that pets are unable to ‘self-report’ – meaning they cannot use words to communicate their symptoms.
How to identify neuropathic pain in your pets
‘The first, and perhaps most important step, in the management of neuropathic pain is identification and treatment (whenever possible) of the underlying disease affecting the somatosensory system.’ (Moore 2016).
Some behavioural symptoms include:
- Constant chewing
- Biting or scratching the same spot
- Spontaneous vocalisation (whining/meowing)
- Defensive reaction to touch without any visible pathology
‘Manifestations of neuropathic pain include both evoked pain (stimulus dependent hypersensitivity) and spontaneous pain. These signs may be either continuous or intermittent in nature.’ (Moore 2016).
What medical treatments do vets have for neuropathic pain in pets?
The Neuropathic Pain Special Interest Group of the International Association for the Study of Pain conducted a meta-analysis of human neuropathic pain literature (Finnerup et al. 2015) and makes strong recommendations for the use of drugs such as those below, which are also commonly used in veterinary contexts.
- Tricyclic antidepressants
In the same paper, weaker recommendations were made for:
- Strong opioids such as morphine
- Topical lidocaine or capsaicin
These are not recommended as front-line options because of side-effects. Also, in order to enhance analgesia and reduce side effects, neuropathic pain is often treated with a combination of therapies.
Can CBD be used to treat neuropathic pain in pets?
CBD can be used as a supplementary or adjunct therapy to support your pet’s treatment.
CBD is well suited to the combinational nature of neuropathic pain treatment, can operate as an adjunct to conventional forms of medication or treatment, and offers an additional route where conventional methods have failed.
The Pain Management Research Institute from The University of Sydney has inquired into the potential of CBD and found that ‘pan-cannabinoid receptor agonists may have efficacy in neuropathic pain states and that this might be enhanced by co-administration with opioids.’ (Kazantzis et al. 2015).
As mentioned previously, current first-line treatments for neuropathic pain are often used in combination. This is to ‘enhance analgesic efficacy and the therapeutic window. If the therapeutic window of cannabinoids can be improved through combinational therapy they may represent useful adjuvants for neuropathic pain.’ (Atwal et al. 2019).
Is your pet in pain? Interested to know more a about how CBD may help their pain?
Talk to your local vet and direct them to CBD Vets Australia to learn more.