WSAVA review revisits NMDA antagonists for pain in dogs
Bottom line
A new mini review from the World Small Animal Veterinary Association’s Pain Committee is bringing N-methyl-D-aspartate, or NMDA, receptor antagonists back into focus for canine pain management. Published online September 21, 2026, in the Journal of Small Animal Practice, the review assesses the evidence for this drug class in dogs, especially for chronic pain and central sensitization, and highlights where data are still thin. The authors examine clinical use of agents including amantadine and ketamine, and frame them as adjuncts within multimodal analgesia rather than stand-alone solutions. (pubmed.ncbi.nlm.nih.gov)
Why it matters: For veterinary professionals, the review offers a practical reset on where NMDA antagonists may fit when routine analgesic approaches aren’t enough, particularly in dogs with maladaptive or chronic pain states. Existing guidance from AAHA/AAFP and the Merck Veterinary Manual already places amantadine and ketamine in the conversation for reducing “wind-up” and supporting multimodal pain plans, but the WSAVA review underscores that evidence remains uneven and that knowledge gaps persist around indications, protocols, and outcomes in everyday practice. That’s especially relevant as pet parents continue to look for pain relief options, including over-the-counter products that can be unsafe in dogs unless specifically directed by a veterinarian. (pmc.ncbi.nlm.nih.gov)
What to watch: Watch for whether this review shapes future pain-management updates, continuing education, and more targeted studies on which canine patients benefit most from amantadine- or ketamine-based adjunctive protocols. (pubmed.ncbi.nlm.nih.gov)
Key facts
- Organization
- World Small Animal Veterinary Association Pain Committee
- Article type
- Mini review
- Topic
- N-methyl-D-aspartate, or NMDA, receptor antagonists for canine pain management
- Species
- Dogs
- Focus areas
- Chronic pain and central sensitization
- Key agents discussed
- Amantadine and ketamine
- Publication date
- September 21, 2026
- Journal
- Journal of Small Animal Practice
- Clinical role
- Adjuncts within multimodal analgesia, not stand-alone solutions
A new WSAVA Pain Committee mini review is putting NMDA receptor antagonists back on the radar for canine pain control. Published online September 21, 2026, in the Journal of Small Animal Practice, the paper reviews the scientific evidence for using this drug class in dogs, with an emphasis on chronic pain, central sensitization, and practical clinical application. It also identifies substantial knowledge gaps, signaling that interest in these drugs is ahead of the evidence base in some areas. (pubmed.ncbi.nlm.nih.gov)
That timing matters because canine pain management has been moving steadily toward multimodal, mechanism-based care. The 2022 WSAVA pain guidelines and the updated AAHA/AAFP guidance both emphasize recognizing maladaptive pain and using therapies that target central sensitization when appropriate. In that framework, NMDA antagonists have remained clinically relevant, not because they replace NSAIDs or opioids, but because they may help in patients whose pain is being amplified by “wind-up” and altered central processing. (pmc.ncbi.nlm.nih.gov)
The new review appears to focus on the best-known veterinary examples in this class: amantadine and ketamine. PubMed’s summary says the authors assess the pathophysiology of chronic pain related to the NMDA receptor, review clinical applications of drugs in the class, and include suggested dosage regimens. Secondary references tied to the paper point back to a familiar evidence base, including studies on perioperative ketamine, a case report on amantadine for chronic neuropathic pain, and prior WSAVA guidance. (pubmed.ncbi.nlm.nih.gov)
That aligns with existing reference sources. The Merck Veterinary Manual describes ketamine as an NMDA receptor antagonist used as a perioperative analgesic adjunct, including CRI protocols, and notes that amantadine has been used in multimodal regimens for refractory osteoarthritis pain in dogs. The AAHA/AAFP guidelines similarly describe amantadine as useful for chronic pain management in dogs and ketamine as a tool to reduce “wind-up,” while also making clear that these agents are typically adjunctive rather than first-line monotherapies. (merckvetmanual.com)
Expert commentary outside the new paper reinforces the same message: these drugs are most relevant when clinicians are trying to address pain mechanisms that standard protocols may not fully control. A review on neuropathic pain in dogs notes that amantadine is commonly suggested in veterinary literature, but also points out how limited the direct canine evidence remains, especially for neuropathic pain specifically. In other words, enthusiasm for NMDA antagonists in practice has outpaced the depth of condition-specific trial data. (pmc.ncbi.nlm.nih.gov)
Why it matters: For veterinarians, this review is less about a brand-new therapeutic option than about sharpening clinical judgment around an existing one. It may help teams better define when to consider NMDA antagonists, how to explain their role to pet parents, and where expectations should stay cautious. That’s particularly important in a broader pain-management environment where pet parents may ask about over-the-counter pain relief after hours or between visits. FDA and consumer-facing veterinary sources continue to warn that common human pain relievers, including ibuprofen, naproxen, and acetaminophen, can be dangerous in dogs unless specifically prescribed or directed by a veterinarian. That makes clinician-guided multimodal plans even more important. (fda.gov)
The bigger takeaway is that the WSAVA review may help normalize more mechanism-based conversations about canine pain, while also exposing where research still needs to catch up. If the field wants broader, more confident use of NMDA antagonists, it will likely need stronger comparative studies, clearer patient-selection criteria, and better data on long-term outcomes, adverse effects, and real-world protocols across different pain states. That’s an inference based on the review’s stated goal of identifying knowledge gaps and on the limits described in current guidelines and reviews. (pubmed.ncbi.nlm.nih.gov)
What to watch: The next signal will be whether this mini review feeds into future guideline revisions, CE programming, or new clinical research on chronic pain, neuropathic pain, osteoarthritis, and perioperative analgesia in dogs. (pubmed.ncbi.nlm.nih.gov)