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INTRODUCTION RESULTS
l Periodontal disease (PD) is common and produces pain with potential impact l Demographic data, prevalence and frequency of rescue analgesia and results
on nutritional status and quality of life of cats.1,2 of CMPS-F are shown in Tables 1 and 2, and Figure 3, respectively.
l This study aimed to evaluate pain scores, analgesic requirements and food l CMPS-F scores were positively correlated with number of tooth extractions,
intake between cats with minimal or severe PD before and after treatment. gingival index, and calculus index (r = 0.80, 0.70 and 0.48, respectively).8
l The hypotheses were: 1) cats with severe PD would have higher pain scores l The severe disease group had lower wet food intake during 3 minutes at 2
and analgesic requirements than those with minimal PD, 2) pain scores and 6 hours post-operative (day 1), evening of day 3 and morning and
would correlate with dental parameters and 3) cats with severe PD would evening of days 4 and 5 when compared to the minimal group (p ≤ 0.0004,
have less food intake than those with minimal PD. respectively). Wet food intake was higher in the minimal group at 6 hours
post-operative and lower in the severe group on the morning of day 4 (p =
0.001 and 0.0003, respectively) when compared with baseline.
MATERIALS & METHODS l Results of wet food intake during 3 minutes and 2 hours/day and dry food
intake during 3 minutes and 2 hours are shown in Figure 4.
l Ethics committee: 17-Rech-1890
Table 1 – Demographic data for cats with minimal or severe oral disease undergoing
l Study design: Prospective, blinded clinical trial treatment for oral disease
l Animals: Twenty-four cats (11 males and 13 females) from local shelters were Variable Minimal disease (n = 12) Severe disease (n =12) p value
divided into two groups (minimal or severe PD) based on a scoring system Median (range) dental score 1 (0-4) 17 (8-28) < 0.0001
Mean (SD) Age (years) 3.6 (2) 8.5 (2.2) < 0.0001
(Figure 1). Mean (SD) Body weight (Kg) 4.0 (0.6) 5.8 (1.9) 0.007
l Treatment of oral disease: Cats were admitted on day 0. They underwent Median (range) Body condition score (1-9) 5 (5-6) 6 (4-6) 0.078
general anesthesia (acepromazine, hydromorphone, propofol, isoflurane, Table 2 – Number of cats receiving rescue analgesia at each time point during the study
meloxicam and dental nerve blocks with bupivacaine) on day 1 for treatment Group
Day 1 (Postoperative)
Day 2 Day 3
Days
Total p value
4, 5, 6
of oral disease. Cats were discharged on day 6; meloxicam was administered 0.5h 1h 2h 3h 4h 6h 8h
Minimal disease 0 0 0 0 0 0 0 0 0 0 0 (0%)
up to day 4 (0.05 mg/kg PO at day 2-4). Severe disease 0 2 1 2 5 2 2 5 2 0 21 (91.7%)
< 0.0001
l Pain assessment: Pain assessment was performed by an observed who was Figure 3 – CMPS-F scores in cats with minimal and severe oral disease
5
blinded to disease severity using the Glasgow composite measure pain scale- before and after treatment
feline (CMPS-F)3 (Figure 2). Rescue analgesia was administered if scores ≥ *†
4
*† Minimal disease
5/20 using hydromorphone either at 0.05 mg/kg (IV) or 0.1 mg/kg (IM). *† Severe disease
l Food intake evaluation: Cats were fed drya and wetb food according to Figure 3 *† *†
CMPS-F
*† *† *†
2. Total amount (100%) of food/day was calculated based on the following *†
equation (kcal): 70 body weight (kg)0.75.4 Cats were offered 33.3% of their 2
* * *†
* *† *
daily total amount at each time point. Food intake (%) during 3 minutes and *
* * *
2 hours were calculated for each time point and each day/cat. Any remaining
1
*
food was removed after 2 hours. 0
100
Statistical analysis:
Evening
Evening
0.5 h
1 h
2 h
3 h
4 h
6 h
8 h
Morning
Noon
Morning
Noon
Evening
Morning
Noon
Morning
Noon
Evening
Morning
Baseline
l
80
u26 CMPS-F scores were compared between baseline and each time point and
Atlas of Normal Radiographic Anatomy and Anatomic Variants in the Dog and Cat Day 1 (Postoperative) Day 2 Day 3 Day 4 Day 5 Day 6
Time point
between groups at each time point using the Cochran-Mantel-Haenszel test for
Food intake (%)
Upper jaw Incisors Figure 4 – Food intake (%) in cats with minimal and severe oral disease
repeated measures. 101 201 60
103
102 202
203 before and after treatment
Right upper Left upper
Figure 4a – Wet food Figure 4b – Dry food
u Correlations
permanent
between 2CMPS-F scores on the morning of day 2 and dental
permanent Canine 104 204
*
1 40 *
parameters were evaluated using Spearman’s correlation.
Right upper Left upper
100
105 205 100
*
106 206
Premolars
* *
u Prevalence and frequency of rescue analgesia were compared using the exact
Right upper
deciduous
Left upper
deciduous
107 207
80
* * *
*
*
20 80
5 6 108 208
chi-square test.
Food intake (%)
109 209 60 60
Food intake was compared using a linear mixed model with Benjamini-Hochberg
Molars
u 110 210
0
Right Left Baseline Day 1 Day 2 Day 3 Day 4 Day 5
sequential adjustment procedure for multiple comparisons (p < 0.05). Molars 410
411 311
310
40
Time point
40
CMPS-F scores and food intake obtained within 2 hours of IV and within 6 hours
Right lower Left lower
Minimal disease (3 min)
u permanent permanent
Right lower
409 309
Left lower 20
Severe disease (3 min)
20
4 3
of IM injection after rescue analgesia were excluded from the statistical 408
407
308
307
Minimal disease (2 h)
Severe disease (2 h)
analysis.5,6
Premolars 0 0
406 306 Baseline Day 1 Day 2 Day 3 Day 4 Day 5 Baseline Day 6
Right lower Left lower
deciduous deciduous 405 305 Time point Time point
8 7
Minimal disease (3 min)
Premolars
106
3 206 extracted, they were
counted as 2 points,
CONCLUSIONS
108
107
1 207
ACKNOWLEDGEMENTS
Molar 409 309
Cats were allocated to
l 2-7. The modified Triadan system of dental identification. In
Figure
Premolars
408 1 308 A, eachanatomy
(Atlas of normal radiographic
& anatomic variants in the dog and cat) the minimal (Figure 1-a)
quadrant of the mouth is designated by a number; this is the
first digit in identification. With respect to permanent teeth, the right
3
407 307
or severe (Figure 1-b)
maxilla is designated 1, the left maxilla 2, the left mandible 3, and the
Figure 2 – Time points for pain assessment and food intake evaluation
D
REFERENCES
W
Day 0 Admission
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W Dental procedure
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0.5h W Post-OP
3.0h W Post-OP
6.0h
2. Southerden P. In Pract 2010; 32: 2–7.
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06:00 09:00 12:00
Post-OP
1.0h
Post-OP
2.0h 15:00 Post-OP
4.0h 18:00 Post-OP
8.0h 21:00
3. Reid J et al. Vet Rec. 2017; 180: 449.
W W W 4. Chandler ML et al. Vet Clin North Am Small Anim Pract. 2014; 44: 645-66.
Day
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09:00 12:00 15:00 18:00 21:00
D
6. Lascelles BD et al. J Vet Intern Med. 2004; 18: 190-195.
Day 6 Discharge 7. Thrill DE et al. The skull In: Atlas of normal radiographic anatomy & anatomic variants in the dog and cat
06:00 09:00 12:00 15:00 18:00 21:00
a Hill’s Science Diet, Adult OpImal Care – Dry,
2nd ed. Missouri: ELSEVIER; 2016. P. 20-48.
CMPS-F + Feeding CMPS-F D Dry fooda W Wet foodb b Hill’s PrescripIon Diet a/d,
Hill’s Pet NutriIon Canada Inc., Mississauga, ON, Canada 8. American Veterinary Dental College. Nomenclature. https://www.avdc.org/Nomenclature/Nomen-
Intro.html. Cited 2 September 2018.