Non-steroidal anti-inflammatory drugs are toxic in dogs and cats' False. As most pain is associated with inflammation NSAIDs are the mainstay of analgesia for both acute and chronic pain in dogs and cats, and are widely and safely used in many animals around the world. The analgesic benefits far outweigh the potential risks. However, it is essential that the individual patient is screened for potential risk factors prior to administration and monitored during treatment. Many of the NSAIDs licensed for use in humans have a narrow safety margin in animals and should be used with caution. Where approved drugs are available, they should be used preferentially. 'If I alleviate pain, the animal will move and disrupt its suture line/fracture repair' False. The use of pain to control movement following surgery is unethical. Where activity needs to be controlled, other means should be adopted (e.g. cage confinement, controlled leash walking). Controlled walking exercise is essential for postoperative orthopaedic E24
The Glasgow Composite Measure Pain Scale (CMPS) for dogs suffering acute pain, developed using psychometric methodology, measures pain to a level of precision suitable for clinical trials. However, for routine clinical use, where the emphasis is on speed, ease of use, and guidance for analgesia provision, a short form (CMPS-SF) was developed. The CMPS-SF comprises six behavioural categories with associated descriptive expressions (items): vocalisation (4), attention to wound (5), mobility (5), response to touch (6), demeanour (5) and posture/activity (5). Items are placed in increasing order of pain intensity and numbered accordingly. The observer chooses that item within each category which best describes the dog's behaviour and ranked scores are summed; the maximum pain score is 24, or 20 if mobility is impossible to assess. Veterinary surgeons in Glasgow, University College Dublin and North Carolina Veterinary Schools completed the CMPS-SF for 122 dogs undergoing post-operative care and thereafter were asked “Do you think this animal requires analgesia? Yes/No”. The population difference in median pain score, for dogs considered to require analgesia (seven) compared with those that did not (three), was highly statistically significant (P < 0.001). Consideration of a clinical decision-point for analgesia gave an intervention level of 6/24, and 5/20 when section B (mobility assessment) could not be carried out. Difficulties in recognising pain contribute to the sub-optimal use of analgesics in veterinary practice. The CMPS-SF provides a practical means of assessing acute post-operative pain and provides guidance with regard to analgesic requirement, so improving pain management and welfare. The CMPS-SF can be downloaded from the Glasgow Pain and Welfare website at http://www.gla.ac.uk/vet/painandwelfare.
1. The excretion of electrolytes was studied in six obese subjects before, during and after a 7 day fast.2. Despite a constant sodium intake throughout the study, there was a marked but transient increase in sodium excretion during the fast, and a sharp reduction in sodium excretion on resuming the carbohydrate diet.3. Fasting was associated with an increase in the excretion not only of sodium but also of potassium, magnesium, calcium, ammonium, titratable acid, chloride, phosphate, sulphate and organic acids. Refeeding was associated with a prompt reduction in the excretion of all ions other than chloride.4. The patterns of electrolyte excretion indicated that a major factor responsible for the increased excretion of sodium on fasting and for the retention of sodium on refeeding was a failure of ammonium excretion to keep pace with the changing output of organic acid.
SURGICAL treatment of neoplastic disease is playing an ever-increasing role in the veterinarian's approach to cancer therapy. In order to carry out successful oncological surgery, surgeons require more than a comprehensive knowledge of anatomy, physiology, and resection and reconstruction techniques for the specific area or organ involved. A thorough understanding of general tumour biology, the specific characteristics of the neoplasm involved, the stage of the disease and thus the prognosis, and the adjunctive therapies that may be appropriate, is also essential in each case.
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