Canis ISSN: 2398-2942
Contributor(s): Prof Stephen Greene, B D X Lascelles, Jo Murrell, Sheilah Robertson
Why control pain?
- It causes suffering. The primary duty of veterinary surgeons is to relieve suffering of animals in their care.
- It causes anorexia, catabolism and a stress response. These all result in delayed wound healing.
- It results in prolonged recoveries, longer recumbencies and a greater risk of post-operative complications.
- It can cause ineffective ventilation leading to hypoxia or acidosis.
- It may lead to self-mutilation and interference with wounds.
- It may result in chronic pain.
Considerations of providing analgesia
- The following signs may indicate the dog is in pain Pain: assessment :
- Dullness and depression.
- Whining or howling.
- Restlessness, being unable to settle, or sitting in unnatural positions.
- Self-mutilation or chewing at wounded area.
- Tachypnea, tachycardia, hypertension.
- Aggression or unresponsiveness.
- Resentment of gentle palpation of wound.
- An injury or surgical procedure that would be painful in a human can be assumed to be painful in a dog. If in doubt, administer a moderate dose of analgesic and assess response.
- Pain is much more difficult to control once it is established due to a combination of peripheral and central hypersensitivity ('wind-up'). Therefore post-surgical pain can be minimized by preventing the nociceptive input from entering the spinal cord that facilitates this wind-up mechanism. This can be achieved by the use of pre-emptive analgesia Pain: management.
- The use of balanced analgesia, ie combining more than one class of analgesic agent, eg opioid + NSAID reduces the total amount of any one analgesic required and thus reduces the risk of unwanted side effects.
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- Recent references from PubMed and VetMedResource.
- Hansen B (2008) Analgesia for the critically ill dog or cat: an update. Vet Clin North Am Small Anim Pract 38 (6), 1353-1363 PubMed.
- Mathews K A (2008) Pain management for the pregnant, lactating, and neonatal to pediatric cat and dog. Vet Clin North Am Small Anim Pract 38 (6), 1291-1308 PubMed.
- Woodward T M (2008) Pain management and regional anesthesia for the dental patient. Top Companion Anim Med 23 (2), 106-114 PubMed.
- Capner C A, Lascelles B D, Waterman-Pearson A E (1999) Current British veterinary attitudes to perioperative analgesia for dogs. Vet Rec 145 (4), 95-99 PubMed.
- Carroll G L (1999) Analgesics and pain. Vet Clin North Am Small Anim Pract 29 (3), 701-717 PubMed.
- Johnson C (1999) Chemical restraint in the dog and cat. In Practice 21 (3), 111-118 VetMedResource.
- Taylor P M (1999) Newer analgesics. Nonsteroid antiinflammatory drugs, opioids, and combinations. Vet Clin North Am Small Anim Pract 29 (3), 719-735 PubMed.
- Torske K E, Dyson D H, Pettifer G (1998) End-tidal halothane concentration and post operative analgesia requirements in dogs - a comparison between intravenous oxymorphone and epidural bupivicaine alone and in combination with oxymorphone. Can Vet J 39 (6), 361-369 PubMed.
Other sources of information
- American College of Veterinary Anesthesiologists' (1998) Position paper on: The treatment of pain in animals. JAVMA 213 (5), 628-630.