Pain Management in Veterinary Practice

Pain Management in Veterinary Care

• Understanding Animal Pain

  • Animals express pain through behavior and actions, not words.

  • Veterinary Assistants must recognize behavioral signs of pain to alert veterinarians for treatment.

• Regular Pain Assessment

  • Pain should be assessed at every visit using a pain scale.

  • The SOAP method records patient's pain levels to facilitate treatment decisions.

  • The Glasgow Pain Scale is frequently utilized for assessments, providing a numerical value to describe the pain level.

• Glasgow Pain Scale Overview

  • Fill out during patient examination to quantify pain in various assessment categories.

  • Total scores indicate if intervention is necessary.

• Colorado State's Adaptation

  • Simple pain charts adapted from the Glasgow Pain Scale are used in practices to easily interpret pain levels for interventions.

• Canine Acute Pain Scale

  • Pain is evaluated on a scale considering psychological responses, behavior during palpation, and body tension.

  • Each score reflects the level of comfort and response to stimuli, ranging from comfortable (0) to potentially unresponsive (4).

• Pain Recognition Standards

  • Recommended by AAHA and AAFP, available guidelines assist in pain recognition and management practices.

  • URL: AAHA/AAFP Pain Guidelines

• Steps for Evaluating Pain

  1. Recognize: Identify behaviors indicating pain.

  2. Assess: Determine pain severity using pain scales.

  3. Prevent: Implement measures to prevent pain.

  4. Treat: Decide on medication or therapy needed.

• Pain Definition

  • Defined by the International Association for the Study of Pain as an unpleasant sensory and emotional experience with actual or potential tissue damage.

• Types of Pain

  • Acute Pain: Normal response to tissue damage, often short-term (e.g., post-surgical).

  • Chronic Pain: Results from unmanaged acute pain leading to changes in the nervous system, requiring ongoing management.

• Causes of Pain

  • Various origins including cardiac, cancer, dermal, dental, gastrointestinal, musculoskeletal, ocular, urogenital, neurologic, and surgical.

• Recognizing Signs of Pain

  • Changes in behavior, lethargy, running away, altered posture, and physical signs like body tension and increased heart rate.

• Assessing Pain

  • Evaluate expressions of pain among different animal species; repeat assessment often, especially for surgical or chronic pains.

  • Utilize pain scales to ensure consistent assessments.

• Preventing and Treating Pain

  • Immediate pain management strategies after procedures or injuries.

  • Routine lifestyle management, including dental care, annual check-ups, and tailored therapies.

• Common Pain Medications

  • Alpha-2 Agonists: For short procedures (e.g., Dexdomitor).

  • Local Anesthetics: For localized pain control (e.g., Lidocaine).

  • Corticosteroids/NSAIDs: Manage chronic pain (e.g., Carprofen, Meloxicam).

  • Opioids: Strong pain relief (e.g., Morphine, Buprenorphine).

  • Nutraceuticals/CBD: Used as supplements for pain management.

• Case Studies

  • Monty: Experience with chronic pain resulting from FLUTD and ultimately euthanized due to progressed disease despite treatment.

  • KC (Beepers): Pain identification post-surgery led to effective treatment strategies and recovery, illustrating the importance of post-op pain management.

• References for Further Reading

  • Epstein, Rodan et al. (2015). AAHA/AAFP Pain Management Guidelines for Dogs and Cats.

  • Merck Veterinary Manual, FDA Animal Drugs.

Conclusion

Veterinary assistants play a crucial role in recognizing, assessing, preventing, and treating pain in animals. Continuous education on pain management practices, and adherence to guidelines will enhance the quality of care provided to animal patients.