Chronic maladaptive pain in cats: A review of current and future drug treatment options

•Maladaptive pain can involve actual damage to neural tissue and/or changes in nociceptive processing.•Techniques like activity data, owner questionnaires, QST, and NWR may help in identifying maladaptive pain in the cat.•Options for long-term pain control in the cat are lacking, with no drugs approved in North America, and one worldwide.•While some data is available for potential therapies, most is limited to normal cats with poor measurements of efficacy.•It is hoped that future research will yield a better understanding of maladaptive pain the cat and potential treatments. Despite our increasing understanding of the pathophysiology underlying chronic or maladaptive pain, there is a significant gap in our ability to diagnose and treat the condition in domestic cats. Newer techniques being used to identify abnormalities in pain processing in the cat include validated owner questionnaires, measurement of movement and activity, and measurement of sensory thresholds and somatomotor responses. While some data are available evaluating possible therapeutics for the treatment of chronic pain in the cat, most data are limited to normal cats. This review details our current understanding of chronic or maladaptive pain, techniques for the detection and measurement of the condition and the associated central nervous changes, as well as an overview of the data evaluating potential therapeutics in cats.