The core perioperative multimodal analgesic protocol for dogs combines an opioid, a nonsteroidal anti-inflammatory drug (NSAID), and a local anesthetic, with adjuncts added based on procedure type and patient comorbidities. This combination targets different points in the nociceptive pathway, allowing lower doses of each agent and reducing adverse effects. Veterinary Clin…+1

Pre-emptive administration — giving analgesics before the surgical insult — is a foundational principle. Analgesic therapies should be initiated prior to surgery or as early as possible, as this approach has demonstrated benefit in dogs. Analgesia should be continuous and overlapping, extending into the early at-home period, and matched in intensity to the degree of surgical trauma. AAHA Clinical G…

Opioids are the first-line perioperative analgesic for moderate-to-severe pain. Methadone provides superior pain control compared to tramadol, particularly when administered preoperatively or intraoperatively. Animals Oral tramadol has not been shown to be effective postoperatively in dogs, and injectable tramadol shows mixed efficacy for surgical pain in dogs. AAHA Clinical G…

NSAIDs are a core component of the multimodal plan. Pre-emptive meloxicam reduces postoperative cardiovascular changes without affecting renal function in dogs undergoing mastectomy. When meloxicam is combined with gabapentin, the need for rescue opioid analgesia is reduced, with robenacoxib producing similar results. Animals Tramadol's analgesic effect appears enhanced when combined with meloxicam or dipyrone compared to tramadol alone. Animals

Local anesthetics are the third pillar. Lidocaine provides blockade for 1 to 2 hours, while bupivacaine and ropivacaine typically last 4 to 6 hours. Journal of the… Local infiltration with lidocaine or bupivacaine provides effective wound-site pain control. Animals Ropivacaine carries less risk of cardiac and systemic toxicity than bupivacaine, which is relevant when larger volumes are used. BMC Veterinary… Intraperitoneal ropivacaine at 3 mg/kg has been used in canine ovariohysterectomy as part of a multimodal protocol. Journal of Vete…

Intraoperative adjuncts — ketamine, lidocaine, and maropitant in combination — enhance intraoperative pain management. Fentanyl, alone or combined with lidocaine and ketamine, is effective for intraoperative pain control. Animals Maropitant provides established antiemetic benefit and some visceral analgesia, though the analgesic evidence is limited. AAHA Clinical G…

Gabapentin is not recommended for acute perioperative pain in dogs — it has not been shown to be effective for acute pain in this species despite widespread use. AAHA Clinical G…

Locoregional techniques should be incorporated whenever feasible, particularly in patients with comorbidities where systemic opioids or anti-inflammatory drugs carry higher risk. Patients receiving multimodal perioperative analgesia that includes a locoregional block are less likely to require rescue analgesia postoperatively. Journal of the… The caudal thoracic paravertebral block has demonstrated effectiveness in reducing perioperative rescue analgesia requirements in abdominal procedures and provided analgesia for up to 8 hours post-extubation in one canine case. Veterinary Anae…

Intraperitoneal magnesium sulfate at 20 mg/kg reduces intraoperative opioid requirements but increases the incidence of hypotension (systolic arterial pressure below 90 mmHg) and provides minimal postoperative analgesic benefit; it is not recommended as a routine adjunct. Journal of Vete…

Pain should be assessed preoperatively and at regular postoperative intervals using a validated tool, with owner follow-up at least daily for the first few days after discharge. AAHA Clinical G…

Would you like specific dosing protocols for locoregional blocks — such as the paravertebral or incisional infiltration techniques — for common canine procedures?