RCVS Accreditation

Pain is Unacceptable 

PAIN IS UNACCEPTABLE

There is no reason for a pet animal to be in pain especially as animals cannot rationalise and accept suffering. We spend a lot of time and effort identifying painful animals and trying to make our patients as comfortable as possible.

The official definition of pain by the International Association for the Study of Pain (IASP) is: “an unpleasant sensory and emotional experience, associated with actual or potential tissue damage, or described in terms of such damage”. Pain is a uniquely individual experience in humans and animals, which makes it hard to appreciate how individuals feel. 

Animals feel pain as much as people do but are very good at hiding it. In the wild this would stop predators targeting them and other animals trying to overtake them in the pack dominance structure. This makes early identification and treatment of pain very important but challenging.

Cats and dogs in pain will show changes in their behaviour. As you may have experienced with pain, the sore area and the area around it may become more sensitive to touch and animals can show guarding or aggressive behaviours around the area. Animals will often change their body position to reduce pressure on the sore areas; this includes hunching their back, sitting in a “praying” stance and being restless. Of course, if a pet has a sore part its function will become altered and abnormal, for example, a sore limb joint or muscle results in lameness, or non-weight-bearing.

Animals may vocalise if they are in pain – yelping, growling, barking or (with cats) hissing. They can also show pain through their facial expressions; painful animals often have their ears back and, particularly with cats, have wide pupils. Cats will also squint their eyes and attempt to hide in corners and may stop grooming themselves. All animals, particularly cats and rabbits, may go off their food when they are in pain. Other signs include shivering and panting or even open mouth breathing. There are international scales for grading animal pain since it cannot be accurately measured.

If you spot any combination of these signs in your pet it is important to get a vet’s opinion and investigating things further. Even before the condition is diagnosed pain relief is administered commensurate with the perceived level of pain. The pain killers or analgesics continue until the primary cause of the pain is diagnosed and resolved.

CLASSIFICATION OF PAIN

At its simplest, pain is classified as either ACUTE or CHRONIC. The distinction between acute and chronic pain is not clear, although traditionally an arbitrary interval of time from onset of pain has been used – _e.g. pain of more than 3 months’ _duration can be considered to be chronic. 

ACUTE pain is generally associated with tissue damage or the threat of this and serves the vital purpose of rapidly altering the animal’s behaviour in order to avoid or minimize damage, and to optimize the conditions in which healing can take place, stopping when healing is complete. Acute pain varies in its severity from mild-to-moderate to severe-to-excruciating. It is evoked by a specific disease or injury; it serves a biological purpose during healing and it is self-limiting. Examples of acute pain include that associated with a cut/wound, elective surgical procedures, or acute onset disease e.g. acute pancreatitis. 

In contrast, CHRONIC pain persists beyond the expected course of an acute disease process, has no biological purpose and no clear end-point and in people, as well as having an effect on physical wellbeing, it can have a significant impact upon the psychology of the sufferer. 
Chronic pain is generally described as pain that persists beyond the normal time of healing, or as persistent pain caused by conditions where healing has not occurred or which remit and then recur. Osteoarthritis (OA) is one of the most important and recognised source of pain.
Thus acute and chronic pain are different clinical entities, and chronic pain may be considered as a disease state that requires specific treatment.

THERAPEUTIC OPTIONS FOR PAIN

The therapeutic approaches to pain management should reflect these different profiles. The therapy of acute pain is aimed at treating the underlying cause and interrupting the nociceptive signals at a range of levels throughout the nervous system, while treatment approaches to chronic pain must rely on a multidisciplinary approach and holistic management of the patient’s quality of life. 

There is a wide variety of analgesics. They range from anaesthetics which stops the feeling pain altogether via opioids which include the morphine family, non-steroidal anti-inflammatory drugs (NSAIDs) like Rimadyl®, Metacam® and Meloxidil® or Previcox®.

During surgery or in animals with severe injuries we use combinations of opioids and NSAIDS like Methadone, Carprophen as well as general or local anaesthetics. Some drugs can be given at home but unfortunately some these pain killers are ‘Controlled Drugs’ or injectables which are not easy to give at home. However some version of opiods like Tramadol and certain slow-release patches, may be dispensed for your pet to go home with.

Most commonly we prescribe NSAIDs pain killers including Metacam® and Meloxidil® or Previcox®. These medications can be given by injection or by mouth as a syrup or a tablet, depending on the product, and are very effective at taking away painful inflammation and reducing fevers. Such products are designed to be given at home so are an ideal way to manage pain in the long term, although they do have some side effects to watch out for which your vet will advise you on.

Some chronic painful conditions as Osteoarthritis may need treatment with different kind of medications other than opioids and NSAIDs. 

CartrophenVet® is a semisynthetic polysulphated polysaccharide which possesses anti-inflammatory and anti-arthritic chondroprotective properties. It is a recent and revolutionary advance in the treatment for arthritis in dogs. It is given by injection in a similar way to a vaccine with with four weekly doses and it is a convenient way to ensure that your pet receives the appropriate dosage without daily regimen.

A variety of supplements may as well help in the management of osteoarthritis. Glucosamine sulfate and chondroitin sulfate are components of normal cartilage and if given as nutritional supplements (Cosequin®, CANINE JOINT AID HA®), they may be able to stimulate the production of new cartilage components and help the body to repair cartilage damaged by osteoarthritis .These supplements are well-tolerated and safe.

Finally, it is important to remember that paracetamol, ibuprofen and other human pain killers can be very poisonous to cats and dogs so you should never give human medications to your pet unless your vet advises you to. For any questions why not email or phone us.

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