Metacam: Pain Management in Cats - Dr Rowena Watson (Boehringer-Ingelheim)

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1. Which ONE of the following statements are correct regarding acute pain?

1 point

a. Acute pain is adaptive or physiological

b. Acute pain is maladaptive or pathological

c. It does not serve a purpose

d. It persists from incurable conditions

e. It is driven by sources other than the original lesion

Clear selection

2. Which ONE of the following is NOT a sign of acute pain in cats?

1 point

a. Cats that are hunched up/crouched

b. Cats lying in an unnatural position e.g. lateral recumbency with extended pelvic limbs

c. A cat is disinterested in the owner or environment

d. A cat that is reluctant to move

e. A cat that is playful and relaxed

3. At what score of the Feline Grimace Scale is analgesia recommended?

1 point

a. 0

b. 1

c. 2

d. 3

e. ≥4

4. At what time point after a procedure should pain assessment start? *

1 point

a. Immediately

b. 5 – 10 minutes

c. 15 - 20 minutes

d. 30 - 45 minutes

e. 1 hour

5. Excluding cats that have received rescue medication, how often should a cat’s pain be reassessed after the initial post procedure assessment? *

1 point

a. Every 15 minutes

b. Every 30 minutes

c. Hourly

d. Every 2 hours

e. Every 3 hours

6. The acronym TELLS is a tool to guide decision making when pharmacotherapy is required. Which ONE of the below is NOT correct as part of the TELLS acronym?

1 point

a. Testing blood and urine for abnormalities

b. Expected duration

c. Location of the noxious stimuli

d. Location of the patient

e. Severity of the noxious stimuli

7. Which ONE of the following statements are correct about the components of a
pain management plan?

1 point

a. The home environment does not play a role in recovery

b. Non-pharmacological therapy does not play a role in the pain management plan

c. Grooming and patient positioning by nurses are unnecessary in the pain management plan

d. Pharmacological therapy with analgesics, antiemetics and anxiolytics are components of the pain management plan

e. The clinic environment is not important at all

8. Which ONE of the below analgesic agents is associated with dysphoria in cats?

1 point

a. Locoregionall anaesthesia

b. Opioids

c. NSAIDs

d. Gabapentin

e. Alpha-2 agonists

9. Which ONE of the below is NOT a CHRONIC pain condition in cats?

1 point

a. Cancer

b. Diabetic neuropathy

c. Postoperative dental pain

d. Degenerative joint diseases

e. Hyperaesthesia syndrome

10. Complete the sentence with regard to the assessment of chronic pain in cats.
Client reported outcome measures are:

1 point

a. based on telephonic interviews

b. based on WhatsApp feedback

c. based on pain specific questionnaires

d. based on Google polls

e. based on diary entries

11. What does the “A” in the PLATTER approach to chronic pain acronym refer to?

1 point

a. Analgesia should be reserved for special cases

b. Assess movement and function

c. Anticipate pain management needs

d. Avoid unnecessary consultations

e. Award improvement in function

12. Which ONE of the following are environmental factors that should be taken into
consideration when managing chronic pain in cats?

1 point

a. Presence of a fence around the property

b. Access to food and water

c. Open windows in the house

d. Hard and structured supportive bedding

e. Presence of other cats in the neighbourhood

13. Which ONE of the below statements is INCORRECT about biologics? *

1 point

a. Monoclonal antibodies are biologics

b. They are associated with high efficacy

c. They are considered first line for chronic arthritis

d. They are not registered for pain conditions other than chronic arthritis

e. They have potent anti-inflammatory properties

14. Complete the sentence. NSAIDs in the treatment of chronic pain is usually given
every:

1 point

a. 2 hours

b. 6 hours

c. 12 hours

d. 18 hours

e. 24 hours

15. Which ONE of the below statements are CORRECT about NSAID treatment of
chronic pain in cats?

1 point

a. It is unnecessary to assess blood pressure before giving an NSAIDs to a cat

b. No monitoring of pain is necessary if the dosing interval is increased to 2 or 3 days

c. Use the highest effective dose

d. Take the cat’s circadian rhythm and activity into account when deciding upon morning or evening dosing

e. Dose is based on the shoulder height of the cat

16. What was the duration of studies done with Onsior in cats with CKD?

1 point

a. 2 – 3 weeks

b. 4 – 12 weeks

c. 8 – 20 weeks

d. 24 weeks

e. 56 weeks

17. What is the ISFM recommended initial dose for meloxicam for cats with chronic
pain and CKD?

1 point

a. 2 mg/kg once a day

b. 0,2 mg/kg once a day

c. 0,02 mg/kg once a day

d. 0,2 mg/kg twice/day

e. 0,1 mg/kg twice a day

18. What added benefit does gabapentin have?

1 point

a. It is an antidepressant

b. It is an anxiolytic

c. It lowers blood pressure

d. It boosts immunity

e. It builds cartilage

19. Which ONE of the following is recommended as FIRST TIER treatment by the American Association of Feline Practitioners for BOTH ACUTE AND CHRONIC
pain?

1 point

a. Opioids

b. NSAIDs

c. Ketamine

d. Gabapentin

e. Steroids

20. Which ONE of the following non-pharmacological treatment options is recommended as FIRST TIER treatment by the American Association of Feline Practitioners for acute pain of known initial cause?

1 point

a. Anti-inflammatory diets

b. Weight optimisation

c. Cold therapy/nursing care

d. Surgery

e. Therapeutic exercise

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