Prescription of perioperative analgesics by UK small animal veterinary surgeons in 2013

Abstract

Data from a survey conducted in 1996-1997 suggested a low level of perioperative analgesic administration to cats and dogs in the UK. In order to evaluate current practice and attitudes with regards to perioperative analgesic prescription, a cross-sectional survey of UK practising small animal veterinary surgeons was undertaken in spring 2013. Four thousand one hundred paper questionnaires were distributed and the survey was made available online. Seven hundred and twenty valid responses were received and analysed. All respondents had access to at least one non-steroidal anti-inflammatory drug (NSAID) and one opioid within their practice. Respondents considered analgesic efficacy, and degree of intraoperative pain, the most important factors governing their selection of NSAID and opioid analgesics. Perioperative NSAIDs were administered by approximately 98 per cent of respondents to dogs and cats undergoing neutering. Multimodal (opioid+NSAID) analgesia was prescribed by the majority of respondents. Neutering was considered more painful in dogs than in cats, and lower rates of opioid and postdischarge NSAID prescription were reported for cats. Orthopaedic, abdominal and dental surgeries were considered equally painful in dogs and cats. Local analgesic techniques were not commonly used. Analgesic prescription has increased since previous surveys, which should translate to improved animal welfare.

The lack of analgesic use (oligoanalgesia) in small animal practice

“…However, cats [5/5 (100%)] were more effectively managed for pain when compared with dogs (25/57 [44%]), although these low numbers preclude drawing precise conclusions (Muir et al ). Perioperatively, cats routinely received fewer analgesics for most surgical procedures, especially opioids, when compared with dogs (Hansen & Hardie , Capner et al , Lascelles et al , Raekallio et al , Hugonnard et al , Williams et al , Hewson et al ,, Lorena et al , Perret‐Gentil et al , Hunt et al ). In contrast, a survey study performed in Brazil indicated no differences in the percentage of dogs and cats being treated with analgesics for surgical procedures (Lorena et al ), 50% of these Brazilian respondents had participated in a continuing education, master's, PhD or residency programme, which may have biased the results.…”

“…In contrast, a survey study performed in Brazil indicated no differences in the percentage of dogs and cats being treated with analgesics for surgical procedures (Lorena et al ), 50% of these Brazilian respondents had participated in a continuing education, master's, PhD or residency programme, which may have biased the results. In Canada and the UK, cats were less likely to receive perioperative analgesia for orthopaedic, abdominal and castration surgeries when compared with dogs (Hewson et al , Hunt et al ). These disparities in the prevalence of analgesic administration may be due to the differences in the perception of pain for specific procedures between species, challenges in pain assessment including failure of recognition, level of education and fear of adverse effects produced by analgesics in general (Muir et al , Lorena et al ).…”

Pilot evaluation of a novel unilateral onychectomy model and efficacy of an extended release buprenorphine product

“…Additionally, the incidence of undesirable side effects, such as vomiting, nausea, respiratory depression and dysphoria, is reportedly lower compared to other opioids [2]. Due to these characteristics, it has become one of the most popular opioid analgesics for use in cats in many countries [9, 10]. A recent clinical study, however, did illustrate that cats undergoing ovariohysterectomy may require a second dose of buprenorphine 4 h after surgery [11].…”

Best opioid choice for canine ovariohysterectomy still uncertain

“…Current practice for most elective surgery, including canine OH, is to give a non‐steroidal anti‐inflammatory drug (NSAID), such as meloxicam, perioperatively (Hunt et al . ). Ideally, it should be given preoperatively for the bitch to benefit from “pre‐emptive analgesia” (Lascelles et al .…”