ALIAMIDES WITHIN MULTIMODAL MANAGEMENT OF DENTAL PAIN IN CATS: STUDY PROTOCOL AND PRELIMINARY DATA FROM A DOUBLE-BLIND, RANDOMIZED, PLACEBO-CONTROLLED TRIAL

D. Gamba¹, F. Colonna¹, K. Weizman¹, C. Schievano², G. Vidili³, G. Della Rocca⁴ | ¹Veterinary Clinic Gran Sasso, Milano; ²Innovative Statistical Research Srl, Padova; ³Information and Documentation Center (CeDIS), Innovet Italia, Saccolongo, Padova; ⁴Department of Veterinary Medicine, Centro di Ricerca sul Dolore Animale (CeRiDA), University of Perugia

INTRODUCTION
Oral pain in cats may be caused by several disorders, like periodontal disease and feline odontoclastic resorptive lesions (FORL), which are usually managed through proper dental extraction(s). Although time-limited, pain from tooth extraction can further decrease the quality of life (QoL). Nonetheless, feline dental pain is still poorly studied¹. ALIAmides are a family of safe pro-homeostatic compounds endowed with pain-relieving functions².
METHODS
This study is investigating whether ALIAmides, as administered topically (Adelmidrol) and orally (palmitoylethanolamide co-micronised with quercetin, PEA-q), enhance the analgesic effect of a 7-day Meloxicam treatment (0.1 mg/kg on the surgery day and then 0.05 mg/kg/day), in cats subjected to tooth extraction for retained roots (RR), stage 3-4 periodontitis (P) or FORL (any type/stage). The study is double-blind, randomized and placebo-controlled. Thirty to 50 client-owned otherwise healthy cats that meet specific enrollment criteria are included (T0) and assigned to the ALIAmide or placebo group, based on a stratified randomization considering pain severity at the owner-administered Composite Oral and Maxillofacial Pain Scale-Canine/Feline (COPS-C/F)³. Cats receive PEA-q (20 mg/kg bid) or placebo for 1 pre- and 3 post-extraction weeks and are daily treated with an oral gel containing 2% Adelmidrol or placebo for 10 post-surgery days. Tooth extraction is performed according to good surgical practice, using the most appropriate technique for each case. Pain is reassessed just before extraction (T1) and 2 weeks later (T2), both by the owner (COPS-C/F) and the veterinary pain specialist (short form of the Unesp-Botucatu Feline Pain Scale, UFEPS-SF)⁴, with the latter being also applied post-extraction. To assess the cat’s QoL, the Karnofsky scale (KS) is used at T0 and T2. One- and 2-month follow-ups after surgery are also planned, with owners being telephonically administered COPS-C/F and KS at both timepoints. The detailed study timeline is summarized in Figure 1.
RESULTS
Ten out of 17 cats included since January 2025 completed the first three visits, being randomised to group A (n=6) or B (n=4). Allocation codes were not opened to maintain blindness to treatment. Males and females were equally represented. All were FIV and FeLV negative. The mean body weight was 4.8kg (range 3.4-6.8kg) and mean age 7.35y (range 3-11y). Eight cats presented FORL, either as the only diagnosis (n=2) or associated with RR (n=3) and/or P (n=3), while in 2 cats only P was diagnosed. Extracted teeth ranged from 1 to 25. At generalized linear mixed model analysis, pain significantly decreased over time in terms of COPS-C/F (p=0.014) and UFEPS-SF (p=0.031), with no differences being detected between groups. Notably, a significant within group decrease of pain at COPS-C/F was observed at T-test in group A (p=0.025), but not B (p=0.778) during the T0-T1 period. At study entry, QoL at KS was surprisingly rated as good in both groups and did not change between nor within groups.
CONCLUSIONS
This still ongoing study may expand our understanding of feline dental pain and gain new insights in the possible advantage of combining ALIAmides with NSAIDs for dental pain relief in the feline species.