In the first cancer pain webinar from Dr Louise Clark she examined the epidemiology and mechanisms of cancer pain. With a focus on pain types, nociception and sensitisation, that webinar set the scene for this webinar which provides us with a rational approach to treating the pain. In this session Louise draws upon that knowledge and helps us create an analgesic treatment plan. Learning outcomes Recognise pain contributors in cancer pain patients Develop rational analgesic plans for clinical oncology Effectively assess pain and critically appraise the clinical approach in light of response to the plan

In various countries around the world, access to opioids is limited. This is the main driver in opioid-free anaesthesia in the veterinary world. There are patients where opioids may be contra-indicated such as dogs with the MDR-1 genetic abnormality. In this webinar RCVS & EBVS specialist Dr Tristan Merlin examines the topic of opioid-free anaesthesia with a review of the literature on the topic, highlight the problem in human medicine and explains what we need to know for our patients. Learning outcomes Understand why opioid free anaesthesia may need to be considered Describe how to plan an anesthetic without opioids Explain the veterinary studies that have examined this topic

Magnesium is an NMDA antagonist and therefore is of interest as an adjunct analgesic. In this webinar, Carl explores the literature relating to magnesium for analgesia and discusses potential for use in our acute pain cases. Learning outcomes Understand if there is the role of magnesium as an adjunct analgesic Describe how the analgesic benefit is thought to occur Explain the veterinary studies that have examined this topic

With validated pain scales for dogs and cats, we consider how these can be used in dental cases. As well as acute pain we take a look at the options available to us for chronic pain given how common this is in dental patients. Learning outcomes Understand which pain scales can be used for dental patients Appreciate the pitfalls of pain scoring and how to adapt our approach Describe the use of pain scales in clinical research

Neuropathic pain is pain that originates from a lesion or dysfunction of the somatosensory system. In this webinar we review pathophysiology, consider the literature regarding treatment options and consider case studies which document the use of these treatment options. Learning outcomes Define what neuropathic pain is Describe underlying mechanisms Explain treatment options Also recommended - listen to our podcast 'Shoe size and the wrong shaped brain' with Prof Clare Rusbridge

Description: The NMDA receptor is a key focus for the pathophysiology of chronic pain, in particular central sensitisation. In this webinar you will discover how the receptor functions and what the impact of that is on our chronic pain patients. Learning outcomes: 1. Explain where NMDA antagonists work 2. Detail which NMDA antagonists are available 3. Describe the consequences of central sensitisation

Myofascial trigger points are a sneaky cause of pain! You may even not be aware of how much they are contributing to the pain picture. This is one of my favourite topics, because the understanding is easy and the treatment is so satisfying! Learning outcomes Define what myofascial trigger points are Discuss causes of mTrPs Explain how to find mTrPs Understand treatment options

What is the rationale for adding an adjunct analgesic to a local anaesthetic? This webinar explores the reasons for adding to a local anaesthetic, the current evidence supporting their use and the potential patient benefits and adverse effects. Learning outcomes Describe the rationale and benefits for adding an adjunct analgesic agent to a local anaesthetic Detail which adjunct agents have been investigated for clinical use Describe how adjuncts may be incorporated into a multimodal analgesia plan

What does the literature say about nutraceuticals? How do you navigate the information out there on adjuncts to pain management and what should you offer your clients? In our latest webinar Matt presents the latest literature to help you define your approach to these options.

Kirby's rule of 20 is an essential guide to the daily assessment of our critical patients. In this webinar Matt reviews key components of the rule of 20 and outlines the important considerations for analgesic provision in our critical cats and dogs. Learning outcomes Explain which analgesics are suitable for certain critical patients Understand how we identify these cases and make decisions in the context of their co-morbidities List the adverse effects associated with commonly used analgesics

There is always more than meets the eye in a chronic pain consultation. In this webinar Matt covers his approach to the first consultation, covering the questions we need to ask to enable us to understand the concerns of the caregiver and make an assessment of the pain experienced by the pet. Your learning outcomes for this are: Plan the structure of your consultation Understand the outline of a treatment plan for chronic pain Add your own elements!

This webinar will examine feline pain, how you can assess and be able to recognise pain in feline surgical patients. We will go through some pain principles and considerations in cats and we will discuss the options available in the market to provide analgesia in cats undergoing abdominal surgery. Learning outcomes Recognise acute pain in cats Understand species differences when treating acute pain Learn different pharmacologic and non-pharmacologic options available to treat pain in abdominal surgery in cats Useful references Steagall P, Robertson S et al. 2022 ISFM Consensus Guidelines on the Management of Acute Pain in Cats. Taylor S, Gruen M et al. 2024 ISFM and AAFP consensus guidelines on the long-term use of NSAIDs in cats.

Acupuncture is a valuable addition to our analgesic options for chronic pain cases. In this webinar Isi guides the learner through how acupuncture works. Isi makes reference to a number of studies which illustrate those various benefits. Learning outcomes: Detail the different mechanisms of action of acupuncture State the challenges associated with acupuncture research Recognise which cases would benefit from acupuncture in your practice

Description: What next? You have a plan A for analgesia. And the pet responds, but over time the pain progresses, and we need plan B. In this webinar, Matt looks at the options we have and guides you through the choices you have to make in chronic pain cases. Learning outcomes: Describe how to recognise progression of pain Understand the mechanisms involved in chronic pain Plan a second and third line analgesic to manage chronic pain

Nociplastic pain in a third pain descriptor introduced by the International Association of the Study of Pain. Nociplastic pain is described as ‘Pain that arises from altered nociception despite no clear evidence of actual or threatened tissue damage that causes peripheral nociceptor activation or evidence of disease or lesion of the somatosensory system causing the pain’. At the present time there is a need for further understanding of this pain type and in our webinar Matt reviews the literature and starts us thinking about possible veterinary examples. Learning outcomes •Explain how nociplastic pain differs from other pain types •Define nociceptive, neuropathic & nociplastic pain

Some of our most common questions are centred on the use of NSAIDs in cats. In this webinar, Matt reviews the licence indications for the NSAIDs available to us, and answers these common questions. By watching this webinar you will gain a full understanding of the use of NSAIDs in cats. Learning outcomes Detail specific recommendations for individual NSAIDs in cats Outline how to use pain scoring to judge the effect of NSAIDs Analyse feline analgesic studies to judge reported benefits

The advances in pain assessment tools in cats now enable us to evaluate pain closely in this species. Despite a number of tools available, not all are validated. We discuss this and review the three current validated tools with reference to case examples where you are encouraged to make your own assessment. Prior to starting this webinar we recommend you access the Shortform of the Glasgow Pain Scale, the Botucatu Pain Scale and the Feline Grimace Scale app. 1. Explain which pain scales are validated for acute pain in cats 2. Establish a process for pain scoring cats 3. Describe behaviours indicative of pain in cats

When you recognise pain in a cat you need to reach for first line analgesics. Our common first lines are opioids and NSAIDs and in this webinar we cover our suggested approach for escalation beyond these analgesics when pain is still present. The analgesics we review for acute pain management are ketamine, the alpha-2-agonists, gabapentin and illustrate the use of local anaesthesia with some case studies. Learning outcomes: Design a pain plan for acute pain in cats Describe where analgesics for acute pain target the pain pathway Explain how to escalate a pain protocol beyond opioids & NSAIDs

The evidence gathering for this webinar looks at two areas – the data provided in the summary of product characteristics of our licensed options, plus published literature on the use of NSAIDs in chronic kidney disease. Learning outcomes 1. Recognise the impact of NSAIDs on renal function 2. Assess if NSAIDs are suitable for cats with renal disease 3. Describe how to monitor for efficacy and adverse effects

Chronic pain is under recognised in cats. In this webinar Matt brings us an understanding of chronic pain by explaining the concept of pain drivers. We review the evidence behind the analgesics for the management of chronic pain that we have available. The alternative title to this session in our cat course, is ‘analgesia beyond NSAIDs’. With chronic pain, there is a limit to what NSAIDs can be expected to do. We will start with an understanding of the pathophysiology and explain why NSAIDs may hit their limit. Then what are our options? And how do we know our next line is effective? After this session you will approach chronic pain in cats with greater confidence. Learning outcomes 1. Illustrate a first line approach to chronic pain management in cats 2. Detail how to assess the efficacy of a chronic pain management plan 3. Explain some of the pain drivers in chronic pain

Starting out with CRIs? Which one should you choose? Or which combination? In this masterclass Matt will guide you through the options for your patients. Your learning objectives for this masterclass are; Describe common agents used for infusions Explain how infusions fit within multimodal protocols Understand concept of drugs choices

Opioids are part of our essential analgesics which bring pain relief to our patients. In this webinar Carl review the 'other' effects of opioids and looks beyond analgesia. We should always consider all the effects the drugs we choose have on our patients and this session will bring you up to speed with this need to know information. The learning objectives that you will achieve with this webinar are: Explain various effects of opioids, beyond analgesia Describe the mechanism of action of opioids Plan for adverse effects and respond appropriately to such events

This webinar will cover the mechanism of action of alpha 2 agonists including an in-depth look at how they provide analgesia. It will discuss the pros and cons of using alpha 2 agonists for analgesia and how they fit in to a multi-modal analgesia regime. It will also highlight the studies that have been conducted about alpha 2 agonist analgesia in cats and dogs and how these are applicable to clinical practice. It will discuss the contra-indications to alpha 2 agonist use for analgesia. Learning objectives Describe the mechanism of action of alpha 2 agonists Explain when it is appropriate to use alpha 2 agonists for analgesia in cats & dogs Detail when alpha 2 agonists are contraindicated in cats & dogs Further reading Medetomidine and dexmedetomidine: a review of cardiovascular effects and antinociceptive properties in the dog. Murrell JC, Hellebrekers LJ. Vet Anaesth Analg. 2005 May;32(3):117-27. Clinical evaluation of the efficacy and safety of a constant rate infusion of dexmedetomidine for postoperative pain management in dogs. Valtolina C, Robben JH, Uilenreef J, Murrell JC, Aspegrén J, McKusick BC, Hellebrekers LJ. Vet Anaesth Analg. 2009 Jul;36(4):369-83.

This webinar provides an overview of the advantages of doing nerve blocks to provide analgesia for the hind limb with emphasis on ultrasound guided techniques. Learning objectives Explain the advantages of using nerve blocks Describe the neuroanatomy of the hind limb and technical aspects of nerve blocks Decide which specific nerve blocks are suitable for different surgeries (e.g. saphenous and sciatic nerve block for stifle surgery) Further reading Regional anesthetic techniques for the pelvic limb and abdominal wall in small animals: A review of the literature and technique description. Portela DA1, Verdier N2, Otero PE2. Vet J. 2018 Aug;238:27-40. Manual of Small Animal Regional Anaesthesia, Otero P & Portela D, 2017, Intermedica.

We welcome Ian Self back to present this webinar looking at the premedication process and how it contributes to pain-free anaesthesia. As well as examining the basic theories, it will take real life case examples and put them in context of veterinary practice. At the end of this session, delegates should be able to; 1. List appropriate analgesic agents when used as part of a premed prior to surgery . 2. Recognise adverse side effects of commonly used analgesic agents 3. Apply the knowledge of differing analgesic agents to real-life cases encountered in practice.

Which ocular surgeries are you performing in practice? This webinar covers local anaesthetic techniques required for basic ocular surgery to techniques used for more advanced surgery. A common procedure in practice that can benefit from a local anaesthetic block is an enucleation. We demonstrate the retrobulbar and peribulbar technique in this webinar – a block that from experience we know makes a huge difference to your patient both during and after surgery. For ear surgery we demonstrate current approaches to the nerves that innervate the ear canal. Learning outcomes: Describe which nerve blocks can be used to provide anaesthesia for ocular & aural surgery Detail which other analgesic options are useful in such cases

The WSAVA Global Pain Council have published recommendations regarding local anaesthesia which can be incorporated into neutering techniques. In this webinar we review the options available and provide easy solutions to increase the use of local anaesthesia in these procedures. Learning outcomes: List the local anaesthetic techniques used for neutering surgeries in male and female dogs and cats Describe how to perform these techniques Detail the recommendations made by the Global Pain Council

Our expert series webinars bring in specialist colleagues to discuss new topics. This webinar completes our collection of webinars to date on epidurals. This collections starts with our masterclass by Matt, continues with Fernando Martinez Taboada questioning some of our long held beliefs on epidurals, and finishes with Chris Miller talking about where we can go further with our epidural analgesia. Epidural catheters can provide targeted, repeatable and titratable analgesia in the perioperative period. This webinar will discuss when to place them, how to place them and what medications to administer when using epidural catheters in dogs and cats. Key considerations that will be discussed include how to confirm appropriate placement of the catheter and potential complications associated with their use. Learning outcomes Gain insight about which cases may benefit from epidural catheter placement Understand the principles behind the technique and how to confirm placement of the catheter Be aware of potential complications and how to minimize them Gain an understanding of drug choices, doses and methods of administration Further reading Epidural and Spinal Anesthesia, Manuel Martin-Flores, DVM, Vet Clin Small Anim 49 (2019) 1095–1108, https://doi.org/10.1016/j.cvsm.2019.07.007 Chapter 14 Epidural and Spinal Anaesthesia, Small Animal Regional Anesthesia and Analgesia, Luis Campoy LV CertVA, DipECVAA, MRCVS,, Matt R. Read DVM, MVSc, DACVA, Copyright © 2013 by John Wiley & Sons, Inc. Credits Video and some images have been kindly shared for use by Hulda Hardardottir

Epidural anaesthesia is one of the oldest and most performed locoregional anaesthetic techniques nowadays. In this webinar, we will discuss the pros and cons of its use, we discuss some dogmas about the technique that have no scientific support and we will make some suggestions to make your epidural blocks reliable and safe. Learning outcomes: Anatomical revision and limitations of the technique based on the anatomy. Identification of the epidural space. Differences between epidural and spinal anaesthesia. References: Romano M, Portela DA, Breghi G, Otero PE. Stress-related biomarkers in dogs administered regional anaesthesia or fentanyl for analgesia during stifle surgery. Vet Anaesth Analg. 2016 Jan;43(1):44-54. doi: 10.1111/vaa.12275. Epub 2015 May 20. PMID: 25996102. Martinez-Taboada F, Sun TC, Redondo JI. Onset of Action of Bupivacaine Administered via Dural Puncture Epidural versus Spinal, Lumbosacral, and Sacrococcygeal Epidural Injections in Dogs: Randomised Clinical Trial. Animals (Basel). 2021 Oct 19;11(10):2996. doi: 10.3390/ani11102996. PMID: 34680015; PMCID: PMC8532631.

Our paracetamol webinar was one of the first we produced back in 2020, so it's time to an update. During this webinar we cover the reported mechanisms of action of paracetamol, we delve into the pharmacokinetics in dogs and we look at the evidence we have for clinical practice. There is plenty to reflect on with this webinar and this will equip you to have practice discussions on using paracetamol, and the dose you should use. As always, we uncover what we don't know about the analgesics in our armoury!