Impact of emotional heath in naturally occurring animal models of neuropathic pain

Abstract

• Pain extends beyond being a mere unpleasant sensory and emotional experience; it prompts a
behavioural response to protect body tissue from danger.
• Pain-related behavioural change can result from protective emotional bias in animals, while chronic
physiological stress can exacerbate these manifestations.
• Pets can suffer from neuropathic pain disorders and, due to this and the influence of genetic and
environmental factors, can be predisposed to poor emotional health.
• Pets serve as valuable One Health models, shedding light on various disease aspects due to their
parallel experiences with human health challenges.

Full text

Impact of emotional heath in naturally occurring animal models of neuropathic pain
Clare Rusbridge1 Sarah Heath 2
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1. School of Veterinary Medicine, Faculty of Health & Medical Sciences, Daphne Jackson Road, Guildford, Surrey, UK.
2. Behavioural Referrals Veterinary Practice, 10 Rushton Drive, Upton, Chester, UK
Background & Aims
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Canine Chiari malformation and syringomyelia
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References:
1. Rutherford L, Wessmann A, Rusbridge C, McGonnell IM, Abeyesinghe S, Burn C, et al. Questionnaire-based behaviour analysis of Cavalier King
Charles spaniels with neuropathic pain due to Chiari-like malformation and syringomyelia. Vet J. 2012;194(3):294-8.
2. Rusbridge, C, McFadyen, AK, Knower, SP. Behavioral and clinical signs of Chiari-like malformation-associated pain and syringomyelia in Cavalier
King Charles spaniels. J Vet Intern Med. 2019; 33: 2138–2150. https://doi.org/10.1111/jvim.15552
3. Amengual Batle P, Rusbridge C, Nuttall T, Heath S, Marioni-Henry K. Feline hyperaesthesia syndrome with self-trauma to the tail: retrospective
study of seven cases and proposal for an integrated multidisciplinary diagnostic approach. Journal of feline medicine and surgery. 2019;21(2):178-85.
4. Ellis SLH, Rodan I, Carney HC, Heath S, Rochlitz I, Shearburn LD, et al. AAFP and ISFM Feline Environmental Needs Guidelines. Journal of feline
medicine and surgery. 2013;15(3):219-30.
A. B.
Feline Orofacial pain syndrome (FOPS)
Rusbridge © 2022
•Canine patients with CMSM show signs of emotional arousal.
•Social contexts like encounters with strangers or walks
reduce their available emotional capacity.
•Reduced emotional capacity hinders coping with
neuropathic pain.
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Methods
• Reduced emotional capacity hinders the individual’s ability to cope with neuropathic pain.
•Assessment of emotional health should be an integral part of the diagnostic work up of a patient with
neuropathic pain.
•Enhanced emotional capacity can mitigate the clinical impact of neuropathic pain.
•Consider emotional bias and arousal state of patients during assessment.
•Address social and environmental factors impacting emotional well-being.
•Focus on addressing emotional compromise to increase emotional capacity.
Methods
, in additional to rippling skin the tail is making fllainingly moenebt
•Pain extends beyond being a mere unpleasant sensory and emotional experience; it prompts a
behavioural response to protect body tissue from danger.
•Pain-related behavioural change can result from protective emotional bias in animals, while chronic
physiological stress can exacerbate these manifestations.
•Pets can suffer from neuropathic pain disorders and, due to this and the influence of genetic and
environmental factors, can be predisposed to poor emotional health.
•Pets serve as valuable One Health models, shedding light on various disease aspects due to their
parallel experiences with human health challenges.
:
•This poster highlights three instances of maladaptive pain syndromes in pet animals.
•Emphasis is placed on the crucial role of emotional health assessment in achieving comprehensive
management strategies.
•Management focuses on addressing emotional compromise and increasing available emotional capacity to
mitigate clinical impact of neuropathic pain.
•We cannot appreciably change overall emotional capacity, but we can alter available capacity or functional
capacity.
•The authors have no conflicts of interest related to this poster
Feline Hyperaesthesia Syndrome (FHS)
Cats in multi-cat households may face
prolonged protective emotional bias.
Physiological stress in such
situations affects pain perception.
Conclusions
Scan the QR code to see a dog with CMSM presented for “aggression” ;
which actually was a protective response due to undiagnosed pain.
Contact and social media
C.rusbridge@surrey.ac.uk, heath@brvp.co.uk @neurovet_clare, @BRVP_UK neurovetclare, behaviouralreferrals
•Canine patients with Chiari malformation/syringomyelia (CMSM) are
more likely than normal dogs to show stranger-directed fear, non-
social fear, separation-related behaviour, attachment behaviour,
anxiety, poor ability to settle and reluctance to exercise.1
•1 in 3 dogs with CMSM show behaviour change of increased
“aggression” or signs of anxiety.2
•For 1 in 3 Cavalier King Charles spaniels surrendered into rescue
“aggression” is cited as the reason - 95% of these are subsequently
diagnosed with CMSM.
Pain face before and after
medication. The dog on the
left shows a grimacing and
anxious expression. On the
right is the same dog after
pain relief medication.
Scan the QR code to see case (above) presented with feline
hyperaesthesia triggered by anxiety (especially to cats) and the wind.
Scan the QR code to see a Singapura cat (above) presented with FOPS (like
trigeminal neuralgia) triggered after eating, grooming and sometimes yawning
•FOPS is a spontaneous model of trigeminal neuralgia.
•Characterised by recurrent episodic oral / tongue discomfort.
•Eating, drinking, grooming, or any activity that involves mouth
movement can trigger pain.
•Dental disease can exacerbate FOPS.
•1 in 5 patients have painful episodes that can be directly linked to
anxiety due to psychosocial stress or other environmental situations
•A multidisciplinary approach is required – veterinary specialists in
neurology, pain management, dentistry and behavioural medicine. .
Above – a 13-year-old Singapura cat with
FOPS displaying characteristic mouth and
tongue movements suggesting discomfort
with attempts to paw at the tongue. The
caregiver is restraining to prevent tongue
injury as in the image to the left.
•FHS is a poorly understood maladaptive pain condition.
•Classic signs are lumbar hyperesthesia, rippling skin,
vocalization, and episodes of attacking or over-grooming the tail
causing soft tissue damage or mutilation. 3
•A diagnosis of exclusion requiring a systematic approach to rule
out dermatological disease and other causes of spinal or tail pain.
•Treatment with neuropharmacological agents is indicated only
after addressing environmental needs according to the five
‘pillars’ framework. 4
Left – video
stills (below)
from a cat with
FHS. Body
posture and ear
position
suggest
protective
emotional state
Right Cat with FHS. In additional
to rippling skin (see video) the tail
makes flailing movements.