Guidelines for recognition, assessment and treatment of pain

Abstract

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

Tongue lacerations in a geriatric dog after bilateral inferior alveolar nerve blocks with bupivacaine

“…Bupivacaine is a long-acting local anaesthetic with a duration of effect lasting 3–10 hours 1. It is useful in procedures lasting more than an hour, as it can provide long-lasting locoregional anaesthesia perioperatively.…”

“…However, in the context of inadvertent blocking of the lingual nerve, this can result in reduced tongue sensation of a prolonged duration and potentially increase the risk of tongue laceration. Lidocaine is an alternative, with a duration of action between 90 and 200 minutes 1. However, in short procedures, the risk of tongue laceration persists as the effects of lidocaine can extend into the recovery period.…”

Monitoring small animal patients in the intensive care unit

“…To try to do this, pain should ideally be measured effectively and accurately, but this is difficult to do. The World Small Animal Veterinary Association states that pain assessment should be part of every patient assessment, but recognises that it is a uniquely individual experience (Mathews and others 2014). Elevated heart rate, respiratory rate and blood pressure can all be associated with pain but many other factors can also cause these changes, particularly in patients in the ICU with serious underlying disease processes.…”

“…Response to appropriate analgesic treatment is the gold standard for assessing the presence and degree of pain an animal is experiencing (Mathews and others 2014). Therefore, if there is doubt either as to whether the ICU patient is in pain and requires analgesia, or whether sufficient analgesia is being provided, additional analgesia (via either increased doses or administration of a different or additional drug) can be provided and the patient reassessed.…”

Using acute pain scales for cats

“…The inevitable outcome of this faulty assumption is administration of analgesia regardless of individual needs, resulting in inadequate analgesia in a proportion of cases, adequate analgesia in others, and unnecessary side effects of analgesic drugs in some animals that do not require them. The fact that an analgesic, or combination of them, has been administered to an animal does not guarantee the desired analgesic effect; similarly, we must accept that after certain procedures some animals may have minimal analgesic requirements (Mathews and others 2014). …”