Topical Ozone Therapy in the Treatment of Pharmacodermia in a Dog (Canis lupus familiaris)

Background: Pharmacodermia is a drug reaction that manifests itself on the skin and mucous membranes. The main drugs that cause pharmacodermia are β-lactam antibiotics. It has a rare occurrence in dogs and may present different clinical signs. Ozone therapy is used to treat various conditions, such as infections and inflammatory diseases. This therapy acts through oxidative stress generating a positive inflammatory response to the body and stimulating the formation of granulation tissue and angiogenesis. Since pharmacodermia is rare in dogs and reports of ozonized sunflower oil and ozone for treat pharmacodermia is are rare in the literature, this paper aimed to report the use of ozonized sunflower oil in the treatment of pharmacodermia in a young female Rottweiler dog assisted and treated at a private veterinary clinic in Garanhuns, Pernambuco, Brazil. Case: A 2-year-old Rottweiler female, weighting 53.3 kg was attended at a private veterinary clinic in Garanhuns (Pernambuco - PE) with a history of dystocia. The dog was submitted to ovary-hysterectomy under general anesthesia. After anesthesia recovery was prescribed omeprazol (1 mg/kg, orally (P.O) SID for 10 days), cephalexin (20 mg/kg,  P.O. BID for 10 days), tramadol hydrochloride (4 mg/kg, P.O. BID for seven days), carprofen (4.4 mg/kg, P.O. SID for three days), and the use of Elizabethan collar. Furthermore, for topical treatment was described chlorhexidine digluconate (0.2%) and ointment of allantoin and zinc oxide, SID, for 10 days. Seven days after the surgical procedure, the owner's dog reported by a telephone call the appearance of wounds in the dorsal region of the dog. Ten days after surgery, the dog returned to the veterinary clinic for stitches removal and wounds evaluation. During the physical examination, observed the presence of two cutaneous wounds, one located in the cervicothoracic region and the other wound was identified in the thoracic region and presence of pain during palpation. The wounds presented purulent secretion, pink coloration, and presence of necrosis. No changes were observed in the physiological parameters during the physical examination. The owner reported normophagia, ingestion of water, normal defecation and urine. The wound region was clipped, and prescribed topical chlorhexidine digluconate (2%), allantoin with zinc oxide ointment every 8 hours, amoxicillin and clavulanate potassium (20 mg/kg, P.O. BID for 10 days), and dipyrone (20 mg/kg P.O. BID for five days). Five days after the beginning of the second treatment the owner reported no improvement and the increased of the lesion, although the dog presented normophagia, ingestion of water, normal defecation, and urine. Thus, according to a therapeutic history of the use of cephalexin and amoxicillin with clavulanate potassium, both belongings to the β-lactamic antibiotic, the clinical diagnosis of pharmacodermia was determined. Wound cleaning and debridement were performed It has been recommended to suspend the previous treatment, and prescribed the use of ozonized sunflower oil (4 drops in each wound, BID) until the complete healing, associated to cleaning with ozonized (47 μg/mL) saline solution (0.9%). The sunflower oil contained linoleic acid (48-74%) and oleic acid (14-39%), and it was purchased directly from the supplier. Discussion: Thirty days after the treatment with ozonized sunflower oil, there was complete remission of the wounds Five months after the treatment the dog returned to clinical examination. No remnants of the wounds were observed and there were no changes in the physiological parameters or in the laboratory exams. According to the present report case, the use of ozone therapy using the ozonized sunflower oil and saline solution (0.9%) is effective to treat wounds related to pharmacodermia

Measurement properties of pain scoring instruments in farm animals: A systematic review protocol using the COSMIN checklist.

Society has been increasingly concerned about the impact of pain on farm animal welfare. This systematic review aims to provide evidence relating to the measurement properties (i.e. reliability, validity, and sensitivity) of pain scoring instruments used for pain assessment in farm animals. A literature search will be performed using five databases (MEDLINE, EMBASE, Web of Science, CAB abstracts and Biological Abstracts) and search terms related to pain, pain scales and different species of farm animals. Eligibility criteria will include full-text studies on the development and/or validation of acute and chronic pain scoring instruments for farm animals including bovine (beef and dairy), ovine, caprine, camel, swine and poultry. Exclusion criteria will include studies that report the use of pain scales for the validation of another instrument, or those reporting ethograms/list of behaviors potentially indicating pain without a scoring system. Study titles and their abstracts will be screened for eligibility by one investigator. Full-text articles will be independently reviewed for eligibility and evaluated by two investigators. Relevant information will be recorded and evaluated systematically according to the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist using an adapted data collection sheet. The following measurement properties and characteristics of the instruments will be assessed: content validity (internal consistency, structural and cross-cultural validity), reliability, measurement error, criterion and construct validity, responsiveness, interpretability and feasibility. Following the assessment of methodological quality and quality of the findings, evidence for each measurement property will be summarized into high, moderate, low or very low. This systematic review will provide further insights into the evidence-based measurement properties of pain scoring instruments in farm animals. It may identify possible gaps of knowledge with these tools as a potential target for future studies in farm animals with a positive impact on animal welfare

Measurement properties of pain scoring instruments in farm animals: A systematic review using the COSMIN checklist.

This systematic review aimed to investigate the measurement properties of pain scoring instruments in farm animals. According to the PRISMA guidelines, a registered report protocol was previously published in this journal. Studies reporting the development and validation of acute and chronic pain scoring instruments based on behavioral and/or facial expressions of farm animals were searched. Data extraction and assessment were performed individually by two investigators using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. Nine categories were assessed: two for scale development (general design requirements and development, and content validity and comprehensibility) and seven for measurement properties (internal consistency, reliability, measurement error, criterion and construct validity, responsiveness and cross-cultural validity). The overall strength of evidence (high, moderate, low, or very low) of each instrument was scored based on methodological quality, number of studies and studies' findings. Twenty instruments for three species (bovine, ovine and swine) were included. There was considerable variability concerning their development and measurement properties. Three behavior-based instruments scored high for strength of evidence: UCAPS (Unesp-Botucatu Unidimensional Composite Pain Scale for assessing postoperative pain in cattle), USAPS (Unesp-Botucatu Sheep Acute Composite Pain Scale) and UPAPS (Unesp-Botucatu Pig Composite Acute Pain Scale). Four instruments scored moderate for strength of evidence: MPSS (Multidimensional Pain Scoring System for bovine), SPFES (Sheep Pain Facial Expression Scale), LGS (Lamb Grimace Scale) and PGS-B (Piglet Grimace Scale-B). Most instruments (n = 13) scored low or very low for final overall evidence. Construct validity was the most reported measurement property followed by criterion validity and reliability. Instruments with reported validation are urgently required for pain assessment of buffalos, goats, camelids and avian species

Effects of assessment method (real-time versus video-recorded) on a validated pain-altered behavior scale used in castrated piglets

Abstract We aimed to compare two assessment methodologies (real-time vs. video-recorded) using the Unesp-Botucatu Pig Composite Acute Pain Scale (UPAPS) in piglets before and after castration. Twenty-nine male piglets were castrated. Four observers scored the UPAPS over three perioperative timepoints of castration following two assessment methodologies. In real-time assessments, the observers were in-person observing the piglets in front of the pen. After two weeks, the observers did video-recorded assessments randomizing piglets and timepoints. Modeling was conducted to compare the UPAPS and each pain-altered behavior between methodologies. Intraclass correlation coefficient (ICC), Bland–Altman, and Lin’s concordance correlation coefficient (CCC) were conducted to investigate agreement between methodologies. UPAPS was statistically equivalent between methodologies (P = 0.4371). The ICC for each method was very good (0.85 to 0.91). The agreement of the UPAPS assessed between methodologies had minimal bias (− 0.04), no proportion bias, and 53% of the assessments presented a perfect agreement. However, CCC of the UPAPS was moderate (0.65), and only one pain-altered behavior (“presents difficulty in overcoming obstacles or other animals”) occurred more in real-time assessments (P = 0.0444). In conclusion, piglet pain assessment by UPAPS can be conducted in real-time based on a suitable agreement between the real-time and video-recorded assessment methods

Real-time and video-recorded pain assessment in beef cattle: clinical application and reliability in young, adult bulls undergoing surgical castration

Abstract Bovine pain assessment relies on validated behavioral scales related to normal and pain-related behaviors. This study investigated the reliability and applicability of real-time and video-recorded pain assessment, and their agreement, in young, adult bulls undergoing surgical castration. Ten Nelore and nine Angus bulls underwent general anesthesia and surgical castration. Three-minute real-time observations and simultaneous videos were recorded at − 48 h (M0), before sedation, under fasting (M1), after surgery, 3 h after sternal recumbency (M2), after rescue analgesia (M3) and at 24 h (M4). Animals received morphine (after M2), dipyrone (after M3), and flunixin meglumine after surgical castration (M4). Two trained evaluators assessed real-time (n = 95) and video-recorded time-points (n = 95) using the Unesp-Botucatu Cattle Pain Scale (UCAPS). Both assessment methods inferred ‘very good’ reliability (≥ 0.81) with minimal bias, however, video-recorded assessment (4.33 ± 2.84) demonstrated slightly higher scores compared to real-time (3.08 ± 2.84). The results from this study suggest that UCAPS can be used in real-time or video-recorded to assess pain and guide analgesic therapy in cattle