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Flashcards in Pain Asessment and Treatment Deck (40):
1

What are some painful dog behaviors?

Lamenss, "praying position", head tilt, guarding, behavior change

2

What is the praying position indicative of in dogs?

Abdominal pain

3

What are some painful cat behaviors?

Hiding, decreased appetite, decreased grooming, excessive grooming of effected area, reluctance to use box, squinting eyes, lowered ears, aggression, crouching

4

What are some painful horse behaviors?

Lameness, standing at back of stall, decreased socializing, decreased appetite, low ears, angled eye, staring, dilated nostrils, tension of face, colic

5

What are some painful ruminant behaviors?

Buxism, hypersalivation, abnormal expression, decreased appetite/rumination, decreased milk production, isolation, vocalization, grunting

6

What are some biological markers for pain?

Cortisol, glucose, catecholamines, endorphins, enkephalins, lactic acid, FFAs

7

What are some signs of pain in an anesthetized animal?

Movement, trembling, increased HR/RR/BP

8

T/F: Peripheral and central sensitization are prevented by general anesthesia.

False, they are not prevented

9

Is pain scoring subjective or objective?

Subjective- physiologic markers are inadequate and individual variation is high

10

What are the pain scales used in small animal vet med?

Simple descriptive
Visual analog scale
Glasgow composite pan scale
Colorado state pain scales

11

What is the simple descriptive pain scale?

Uses simple descriptors to classify pain (mild, moderate severe etc)

Very subjective

12

What is the visual analog scale?

Commonly used in researched

Subjective sliding scale from no pain to sever pain- not graduated

13

What is the glasgow composite pain scale used for?

Assessing post-op pain in dogs based on behavioral changes

14

What are the max scores in the glasgow scale if the patient is abulatory vs non-ambulatory?

Ambulatory- 24
Non-Ambulatory- 20

15

When are analgesics recommended in the glasgow scale?

6/24 or 5/20

16

What are the three criteria used in the colorado state pain scale?

1. Physiological and behavioral
2. Response to palpation
3. Body tension

17

Should an animal be evaluated while sleeping?

No

18

What do the scores range from in the colorado state pain scale?

0-4

Reassessment of analgesic plan anywhere from score of 2-4

19

Is the colorado state pain scale appropriate for both dogs and cats?

Yes

20

Are there different scales for equine abdominal and orthropedic pain?

Yes

21

What is the equine abdominal pain scale based on?

Behaviors and palpation

22

What is the equine orthopedic scale based on?

- Physiologic characteristics
- Response to treatment
- Behavior

23

What is the treatment plan for painful animals?

1. Analgesic drugs
2. Bedding
3. Bandaging/stabilization
4. Cooling
5. Acupuncture/laser

24

What is the advantage of pre-emptive analgesic strategies?

- Allows lower doses of systemic anesthetics and analgesics during procedures
- Prevention of central sensitization

25

What is multimodal analgesia and what is the advantage?

- Usage of multiple analgesics with different MOAs synergistically
- Lowers dosing of each individual drug to minimize side effects

26

What are the common analgesics used in vet med?

Local anesthetics
NSAIDs
Opioids
NMDA antagonists
Alpha-2 agonists

27

What part of the pain pathway to local anesthetics work on?

Transduction or transmission depending on route of administration

Transduction= topicals
Transmission= epidurals or IVRA

28

What is a disadvantage of using LAs as analgesics?

Short acting

29

What part of the pain pathway do opioids work on?

Transduction, modulation, or perception depending on type

30

What is a disadvantage to opioid use in animals?

Limited oral options (take home tricky)

31

What is the only oral opioid in vet med?

Tramadol

32

T/F: Bioavaliability is limited in oral dosing of tramadol in animals.

True- Use highest safe dose and do not use alone

33

What patients are NSAIDs contraindicated in?

GI, renal or liver patients

34

How do NMDA antagonists effect the pain pathway?

Block NMDA receptors so that glutamate cannot bind and facilitate transmission of pain (Modulation); also decreases central sensitization

35

What are the two common NMDA antagonists used in vet med?

Ketamine and amantadine

36

Which of the NMDA antagonists is used in conjunction with NSAIDs for chronic pain?

Amnantidine- oral administration

Typically used for OA or cancer patients

37

Alpha-2 agonists provide the most potent analgesia in which species?

Horses

38

Can alpha-2 agonists be used in equine epidurals?

Yes, commonly used

39

What is gabapentin typically used for?

Analgesic adjunct in neuropathic and chronic pain (modulation)

40

Do we know gabapentins MOA?

Not really