Table 2.
Pharmacological and nonpharmacological therapies for the treatment of different clinical signs in pets with cancer.
| Clinical sign | Pharmacological treatment | Nonpharmacological treatment |
|---|---|---|
| Pain | (i) Nonsteroidal and steroidal anti-inflammatory drugs: as indicated, choose the one for which the patient has greater tolerability (ii) Opioids: morphine, methadone, buprenorphine, tramadol, and fentanyl (iii) Anticonvulsants: gabapentin and Pregabalin (iv) Local anesthetics: bupivacaine, ropivacaine, and lidocaine (v) Paracetamol: exclusive use for dogs, should not be administered to cats (vi) N-methyl-D-aspartate (NMDA) receptor antagonists: amantadine (vii) Alpha 2 adrenergic receptor agonists (viii) Ketamine (ix) Cannabinoid: CBD (x) Antinerve growth factor monoclonal antibody (xi) Bisphosphonates |
(i) Cold therapy (ii) Environmental modifications and assistance with ambulation (iii) Palliative radiation (iv) Omega 3 (v) Acupuncture (vi) Rehabilitation therapy (vii) Laser therapy (viii) Pulsed electromagnetic field therapy (ix) Stem cells (x) Such as platelet-rich plasma |
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| Emesis | (i) Antiemetics: metoclopramide, ondansetron, maropitant, mirtazapine, and dolasetron (ii) Prokinetics: metoclopramide and cisapride Adjuvant therapies: (i) H2 receptor antagonists: famotidine and cimetidine (ii) Proton pump inhibitor: omeprazole |
(i) Acupuncture |
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| Seizures | (i) Anticonvulsants: potassium bromide, phenobarbital, gabapentin, felbamate, levetiracetam (ii) Intranasal diazepam for seizure control |
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| Mobility reduction | (i) Rehabilitation therapy (ii) Periodic change of position every 2 to 4 hours (iii) Use of padded surfaces, soft cushions, eggshell mattresses, waterbeds, with washable covers (iv) Preventive care of pressure ulcer formation (v) Pay attention to the animal's social welfare aspects (vi) Changes in the arrangement of food and water bowls, and litter boxes or toilet mats |
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| Pressure ulcers | (i) Frequent cleaning of wounds and use of ointments and topical antibiotics (ii) Use of repellents (iii) Preventive skin care: use of hypoallergenic moisturizing creams based on urea or lactic acid |
(i) Periodic change of position every 2 to 4 hours (ii) Use of padded surfaces, soft pillows, eggshell mattresses, and waterbeds, with washable covers (iii) Ozone therapy (iv) Laser therapy |
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| Anorexia and cachexia syndrome | (i) Hormone: nandrolone decanoate (ii) Appetite stimulants: magestrol acetate, cyproheptadine, corticosteroids, metoclopramide, mirtazapine, and capromorelin (iii) Nutritional supplements: valine, leucine, and isoleucine; glutamine |
(i) Offering highly palatable foods (ii) Omega 3 (iii) Offer of heated food (iv) Encouragement of moderate physical exercise (v) Rehabilitation therapy (vi) Feeding using probes force-feeding by placing food in a pet's mouth should not be recommended! |
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| Cough | (i) Antitussive agents such as opioids: butorphanol and hydrocodone (ii) Steroids: fluticasone (iii) Mucolytic agents (iv) Bronchodilators: albuterol (v) Antibiotics if necessary for suspected infection |
(i) Nebulization (ii) Rehabilitation therapy |
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| Cold | (i) Use of laxatives: psyllium 2%, mineral oil, petrolatum, sodium dioctyl sulfosuccinate, magnesium salts, lactulone, and bisacodyl (ii) Glycerin suppository |
(i) Wet feed supply (ii) Replacement of dehydration with subcutaneous fluids (iii) Encouragement of light physical exercise (iv) Pelvic massage (v) Enema |
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| Dyspnea | (i) Opioids: morphine and codeine (ii) Benzodiazepines: midazolam (iii) Bronchodilators (iv) Nebulization with magnesium sulfate (v) Blood transfusion (vi) Palliative sedation |
(i) Respiratory physiotherapy (ii) Oxygen (iii) Fans (iv) Thoracentesis for drainage of effusions |
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| Sleep disorders | (i) Hormone: melatonin (ii) Antidepressants: amitriptyline and trazodone (iii) Benzodiazepines: clonazepam, diazepam, lorazepam, and oxazepam (iv) Antihistamine: diphenhydramine (v) Phenothiazines: chlorpromazine, and acepromazine (vi) Anticonvulsant: gabapentin and phenobarbital |
(i) Encourage sleep hygiene habits: turn off the lights, keep the animal in a quiet environment, and find the place where the animal is used to sleeping (ii) Acupuncture (iii) Rehabilitation therapy |
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| Ulcerated nodules | (i) Surgical removal (ii) Anesthetic block (iii) Antihemorrhagics: tranexamic acid (iv) Topical odor reduction treatment with activated charcoal, metronidazole, or aluminum hydroxide |
(i) Daily dressing (ii) Cold saline solution and petrolatum compresses for bleeding wounds |