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Purpose and Brief Explanation of Study:
Neuropathic pain is a complex, chronic pain state that can develop secondary to osteoarthritis in people, leading to significant loss of function with substantial healthcare costs. Spontaneous torn knee ligament (Cranial cruciate ligament rupture-CCL) is the most common cause of pelvic limb lameness in the dog, and causes secondary osteoarthritis in the stifle.
It is commonly corrected with tibial plateau leveling osteotomy (TPLO) surgery. Neuroanalgesic procedures including epidurals and direct nerve blocks are common prior to surgical correction of cruciate disease.This investigation will evaluate the efficacy of three common neuroanalgesic procedures on short term perioperative pain management and evaluate chronic sensory threshold as a measure of neuropathic pain in the dog.
If dogs are shown to have chronic neuropathic pain with osteoarthritis, spontaneous CCL rupture in the dog may serve as a naturally occurring animal model for studying neuropathic pain in both dogs and humans.
Which patients are eligible to participate in this study?
Healthy dogs with a lameness due to torn knee ligament (cranial cruciate rupture) undergoing TPLO surgery as recommended by a board certified surgeon with no other orthopedic or neurologic disease.
What does enrolling my dog in this clinical trial involve?
Your pet will be evaluated by a surgeon and deemed an appropriate candidate for a TPLO. Once enrolled, gait analysis will be obtained by having your pet walk over a pressure mat prior to and after surgery. Additionally, von Frey anesthesiometry data will be collected using an electronic system placed on the top of the paw before and after surgery. Your pet will receive one of three pain management protocols (epidural, nerve block, intravenous pain medications), which are all currently standard of care and all used routinely for dogs undergoing TPLO. Pain scores will be evaluated while in hospital. When your pet returns for 2 week suture removal, and recheck with radiographs 8 weeks after surgery, the walkway test and von Frey assessment will be repeated as part of their recheck examination.
Your dog will participate in the trial for 8 weeks. This includes the first 24 hours after surgery, while your pet would normally be in hospital for a TPLO, the second is at their routine 2 week recheck for suture removal, and a final visit is the recheck examination at 8 weeks post-operatively.
Clients participating in this study will be given approximately $200 of services. This includes the cost of the 8 week recheck examination fee and the standard recheck radiographs.