Chiavaccini Ludovica, Santoro Domenico, Dwyer Colleen E, Vettorato Enzo, Nelson Tyler S, Khanna Rajesh
Department of Comparative, Diagnostic and Population Medicine, University of Florida, College of Veterinary Medicine, Gainesville, FL, USA.
Department of Small Animal Clinical Sciences, University of Florida, College of Veterinary Medicine, Gainesville, FL, USA.
Vet Anaesth Analg. 2025 Mar-Apr;52(2):257-261. doi: 10.1016/j.vaa.2025.01.004. Epub 2025 Jan 10.
Burn-related neuropathic pain (BRNP) can arise following burn-induced nerve damage, affects approximately 6% of burned human patients and can result in chronic pain. Although widely studied in humans, data on BRNP or its treatment in animals is lacking. A 4-year-old domestic shorthair cat was presented with an infected, non-healing wound suspected to be a caustic burn. Initial treatments included surgical debridement, antimicrobials, and corticosteroids, but the cat developed persistent pruritus leading to self-inflicted trauma. Despite various interventions, including prednisone, chloramphenicol and cyclosporine, clinical signs persisted, leading to a referral for suspected BRNP. Additional support for neuropathic pain was provided through thermal sensitivity testing and applying a modified Neuropathic Pain Symptoms Inventory. Treatment with gabapentin, amantadine, and acupuncture yielded little improvement, prompting an increasing escalation in gabapentin dosage. The cat was then treated with gabapentin compounded with compound 194, a small molecule that is a potent and selective inhibitor of voltage-gated sodium channel 1.7 (Na1.7). The cat exhibited significant pain relief and improvements in overall condition. After gabapentin was tapered, compound 194 effectively maintained pain control. The cat's clinical condition stabilized with no adverse effects. Hematology and serum biochemistry results remained within reference intervals throughout the treatment period. This case highlights the potential of Na1.7 inhibitors in multimodal management of neuropathic pain in animals.
烧伤相关性神经病理性疼痛（BRNP）可在烧伤导致神经损伤后出现，约6%的烧伤患者会受到影响，并可能导致慢性疼痛。尽管在人类中对此进行了广泛研究，但关于动物BRNP或其治疗的数据却很缺乏。一只4岁的家养短毛猫因感染且不愈合的伤口就诊，怀疑是苛性烧伤。初始治疗包括手术清创、使用抗菌药物和皮质类固醇，但这只猫出现了持续性瘙痒，导致自我造成创伤。尽管采取了各种干预措施，包括使用泼尼松、氯霉素和环孢素，临床症状仍持续存在，因此转诊以怀疑患有BRNP。通过热敏感性测试和应用改良的神经病理性疼痛症状量表，为神经病理性疼痛提供了额外支持。使用加巴喷丁、金刚烷胺和针灸治疗效果甚微，促使加巴喷丁剂量不断增加。然后，这只猫接受了与化合物194混合的加巴喷丁治疗，化合物194是一种小分子，是电压门控钠通道1.7（Na1.7）的强效选择性抑制剂。这只猫表现出明显的疼痛缓解和整体状况改善。在逐渐减少加巴喷丁用量后，化合物194有效地维持了疼痛控制。这只猫的临床状况稳定，没有不良反应。在整个治疗期间，血液学和血清生化结果均保持在参考区间内。该病例突出了Na1.7抑制剂在动物神经病理性疼痛多模式管理中的潜力。
