Perioperative Pain Management for Mastectomy in Dogs: A Narrative Review

Area of Science:

• Veterinary Medicine
• Oncology
• Pain Management

Background:

• Mammary tumors are the most common neoplasia in adult female dogs.
• Mastectomy surgery in dogs often results in moderate to severe pain.
• Effective perioperative pain management is critical for canine welfare.

Purpose of the Study:

• To review analgesic techniques for perioperative pain in dogs undergoing mastectomy.
• To evaluate the efficacy of various analgesic protocols.
• To identify optimal strategies for pain control in canine mastectomy.

Main Methods:

• Literature search conducted from January 2001 to January 2025 on dog mastectomy analgesia.
• Review of studies on pre-emptive analgesia, opioid-sparing techniques, and local anesthetic methods.
• Analysis of multimodal analgesic protocols including NSAIDs, gabapentin, tramadol, methadone, ketamine, lidocaine, and regional blocks.

Main Results:

• Pre-emptive meloxicam reduces postoperative cardiovascular changes without impacting renal function.
• Combinations of meloxicam/gabapentin or robenacoxib decrease the need for rescue opioids.
• Methadone offers superior pain control, especially when administered preoperatively or intraoperatively.
• Local infiltration, tumescent anesthesia, epidural, paravertebral, and TAP blocks are effective.
• Transdermal patches and electroacupuncture provide prolonged analgesia and reduce rescue analgesic requirements.

Conclusions:

• Multimodal analgesic protocols are essential for effective pain management in canine mastectomy.
• Optimizing perioperative pain control minimizes the requirement for rescue opioids.
• A combination of systemic and regional techniques offers the best pain relief for dogs undergoing mastectomy.