In this episode of The Vet Dental Show, Dr. Brett Beckman, a board-certified veterinary dentist, shares valuable insights into pain management, anesthesia protocols, and best practices in veterinary dentistry. The episode discusses the cautious use of lidocaine in cats, the role of bupivacaine for effective local blocks, and the potential applications of Renia for managing chronic pain in refractory stomatitis cases. Packed with actionable advice, this episode is a must-listen for veterinarians and technicians looking to elevate patient care in their practice.

Podcast Details

Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM

Key Highlights Topic 1: Lidocaine Use in Cats

• Question: Should lidocaine be used with caution in cats?

• Answer: Yes, lidocaine can potentially cause seizures in cats, especially when used as a continuous rate infusion (CRI).

• Recommendation: Replace lidocaine with bupivacaine for local nerve blocks to ensure longer-lasting analgesia (6-10 hours). Use lidocaine sparingly and with proper discretion.

Topic 2: Lidocaine for Intubation

• Discussion:

• Historically, lidocaine was applied to the larynx for intubation in cats.

• Dr. Beckman and his team now prefer using a blunt cannula for safer intubation without the risks associated with lidocaine.

Topic 3: Pain Management for Chronic Cases

• Case Example: Use of Renia (NK1 antagonist) in refractory stomatitis

• Mechanism: Blocks Substance P at the postsynaptic membrane to prevent ascending pain signals.

• Clinical Context: Effective for managing chronic pain when combined with ketamine (NMDA receptor antagonist).

• Outcome: While Dr. Beckman's team hasn't used it extensively, anecdotal feedback from the veterinary community is positive.

Topic 4: Local Blocks with Bupivacaine

• Best Practice: Use 0.5% bupivacaine for local nerve blocks in cats and small animals.

• Dosage: 0.2 mL per foramen ensures safety and efficacy.

• Rationale: Provides prolonged analgesia compared to lidocaine, minimizing the risk of complications.

Actionable Takeaways

1. Transition to bupivacaine for local nerve blocks to enhance patient comfort and safety.

2. Consider using Renia for managing chronic pain in severe stomatitis cases.

3. Adopt safer intubation techniques, such as using blunt cannulas, to mitigate risks in feline patients.

4. Leverage evidence-based pain management protocols to improve patient outcomes.

Sponsor Mention: This episode is brought to you by the Veterinary Dental Practitioners Program. Learn more and request an invitation at ivdi.org/inv.

Closing Note: "I hope you enjoyed this episode filled with actionable items to elevate your dentistry practice. Implement these tips today and see the long-term benefits for your patients and practice!"

If you're ready to take your dentistry skills to the next level, visit ivdi.org/inv to join the Veterinary Dental Practitioners Program!