Zero Pain Philosophy – Details, episodes & analysis

Spoiler alert - you need to listen to this podcast to understand if there is a place for subcutaneous methadone in veterinary clinical practice!

In this edition, Matt reviews the first paper that investigated pharmacokinetics of subcutaneous methadone and first raised the question of using this route in dogs. Matt then chats to anaesthesia specialist Aoife Ryan about a study they performed together to attempt to enhance our understanding around this topic. With Carl, we then chat through a recent publication examining this route of administration in dogs.

For more on methadone, please see our pain update 'Methadone, the most versatile opioid' here

https://www.zeropainphilosophy.com/post/methadone-the-most-versatile-opioid

Need more detail? You can watch this webinar on methadone

https://www.zeropainphilosophy.com/members-webinars

References discussed in this podcast

Bini G, Vettorato E, De Gennaro C, Corletto F. A retrospective comparison of two analgesic strategies after uncomplicated tibial plateau levelling osteotomy in dogs. Vet Anaesth Analg. 2018 Jul;45(4):557-565. doi: 10.1016/j.vaa.2017.11.005.

Ingvast-Larsson C, Holgersson A, Bondesson U, Lagerstedt AS, Olsson K. Clinical pharmacology of methadone in dogs. Vet Anaesth Analg. 2010 Jan;37(1):48-56. doi: 10.1111/j.1467-2995.2009.00476.x.

Ryan AC, Murrell JC, Gurney MA. Post-operative nausea and vomiting (PONV) observed in a clinical study designed to assess the analgesic effects of intravenous and subcutaneous methadone in dogs. Vet J. 2022 Sep;287:105876. doi: 10.1016/j.tvjl.2022.105876.

Upchurch D, Lin KTT, KuKanich B. Two doses of subcutaneous methadone for postoperative analgesia in dogs undergoing tibial plateau levelling osteotomies. J Small Anim Pract. 2024 Jun;65(6):368-375. doi: 10.1111/jsap.13728.

Professor Clare Rusbridge is a global thought leader in the management of syringomyelia, Chiari malformation and phantom scratching. To assist vets in treatment of these conditions, Clare has recently updated and released her 2024 treatment algorithms. In this episode, Matt discusses the new algorithms with Clare, as well as ensuring we have our diagnosis correct and also looking to the future with these diseases.

You can read the treatment algorithms here:

https://veterinary-neurologist.co.uk/cmsm-new-treatment-algorithm-2024/

This is the link to the symptom checker:

https://veterinary-neurologist.co.uk/chiari-checker/

Find Clare's YouTube channel here:

https://www.youtube.com/@clare-neurovet

Link to Head Space project:

https://www.surrey.ac.uk/research-projects/head-space-project-canine-chiari-group

If you are thinking about intra-articular therapies, where do you start? In this episode Matt chats to the Vet Vault team about where he sees IA therapies fit with Oa management

Continuing our OA series, the Zero Pain & Vet Vault teams chat about the role of NSAIDs and grapiprant in management of your OA cases. 

Matt joins Hugh and Gerardo from Vet Vault to discuss bedinvetmab, in one of three podcasts on OA management. 

Earlier this year Matt joined the guys from The Vet Vault to chat all things chronic pain management. In this episode we chat about the use of ketamine subcutaneously for chronic pain. 

Always a popular topic, we decided to go back to the literature to guide your use of tramadol for post operative pain control. 

In this Vet Vault chat, Matt talks to Hubert and Gerardo about our second line options in OA. We cover amantadine and discuss is there room for tramadol? 

NMDA antagonists are excellent additions to chronic pain management. Why would you choose either? How do they work and what evidence do we have? In this edition of our member podcast, Matt reviews the use of these drugs and how they can help your patients. 

Recently Matt joined the team at Vet Vault to discuss analgesic management of Caesarean sections - amongst other things! You'll enjoy this lively discussion!