Neuropathic pain in dogs and cats: if only they could tell us if they hurt.

Neuropathic pain is difficult to diagnose in veterinary patients because they are unable to verbalize their pain. By assuming that neuropathic pain may exist based on the history of events that each patient has experienced, a focused client history and neurologic examination may identify a lesion resulting in persistent or spontaneous pain. Once neuropathic pain is diagnosed, a trial analgesic or acupuncture session(s) should be prescribed with instructions for owners to observe behavior. Dosing of the analgesic can be titrated to the patient's needs while avoiding adverse effects. When a particular analgesic may be ineffectual, an alternate class should be tried. As research into the neurobiologic mechanisms of neuropathic pain continues, specific therapies for its management should eventually appear in the human clinical setting and subsequently be investigated for veterinary clinical use.