Evaluation of the analgesic (pain relieving) effects of liposomal bupivacaine (Nocita®) in client-owned dogs following enucleation

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Study Purpose

This study aims to assess the pain-relieving properties of a long-acting local anesthetic, liposomal bupivacaine (Nocita®), in dogs following enucleation (surgical removal of the eye). Oral pain medications are commonly used after surgery, but can have side effects involving the gastrointestinal tract, kidneys, and liver. Local anesthetics, used to block pain sensation to nerves that go to the surgery site, have a much lower rate of systemic side effects. Local anesthetics are highly effective in preventing pain, but most only last a few hours after administration. Nocita® is a newly developed, long acting local anesthetic that has been shown to provide up to 72 hours of pain relief in dogs undergoing knee surgery. We will evaluate the effectiveness of this medication in dogs undergoing enucleation.

Explanation

Routine enucleation will be performed in all dogs in the study. This is a randomized, blinded study, meaning that your dog will be randomly assigned (like flipping a coin) to receive either Nocita® or sterile saline, and neither you nor your doctor(s) will know which your dog received. All dogs will be closely monitored. Your dog will receive a dose of injectable opioid prior to surgery, and will start on a nonsteroidal anti-inflammatory drug (NSAID pain medication) the evening after surgery. Your dog will be monitored in the hospital for 72 hours after surgery and pain scoring will be performed routinely during that time. If pain scoring indicates that pain is not adequately controlled on NSAIDs, additional pain medication (“rescue opioid analgesia”) will be administered. If rescue analgesia is needed, your dog will be removed from further participation in the study and sent home with additional pain medications.

Investigators

Megan Cullen, DVM
Amy Rankin, DVM, MS, DACVO
Jessica Meekins, DVM, MS, DACVO
Rose McMurphy, DVM, DACVAA, DACVECC

Eligibility

  • This study is for dogs with ocular disease where enucleation has been recommended to control pain and/or to help diagnose the underlying condition. Dogs with diseases of the orbit or trauma to the head or face are not candidates for this study.

  • Your dog must be at least 6 months of age and 3.4 kg (7.5 lb) or greater in weight. Any breed or sex of dog may participate.

     

  • Your dog must not have any systemic disease that contraindicates the use of oral nonsteroidal anti-inflammatory medications (NSAIDs) following surgery, such as kidney disease. Additionally, your pet cannot have recently received oral or long-acting injectable steroids.

     

  • Your dog must not have any behavioral condition that would prevent the accurate assessment of pain scoring post-operatively, such as extreme anxiousness.

Risks

  • The medications that will be given (NSAIDs, opioids) are considered standard-of-care, and we will discuss risks associated with these medications with you.

  • The most common complication seen with enucleation is bruising and swelling of the incision site.

  • Nocita® injection is associated with a mildly increased, short-term risk of swelling and discharge from the incision site. Uncommonly, gastrointestinal side effects (inappetence, vomiting, and diarrhea) have been reported in dogs that receive Nocita®.

Fees For Services

Study funds will cover the cost of Nocita® and three nights of hospitalization in the Veterinary Health Center following surgery. There will be no extra charge for examination of your pet or pain scoring following surgery and by participating in the trial, additional discounts toward the surgical procedure (up to approximately $200) will apply. Study funds do not cover the initial examination fee, pre-operative blood work, enucleation surgery, Elizabethan collar (“cone”), oral medications to go home, or submission of the eye to a pathologist (histopathology). These are considered standard-of-care and would be performed regardless of study participation.

Owner Responsibilities

You are asked to keep your pet in the hospital for up to 72 hours post-operatively to allow for pain scoring at all predetermined time points. Additionally, a short questionnaire will be sent to you to gauge your opinion of your dog’s comfort once home.

Contact Information

Please contact Kris Richardson, Clinical Trials Coordinator at the Veterinary Health Center, for more information about this study.

Phone: (785)-532-3046, email: ClinicalTrials@vet.k-state.edu