Recognition of Pain in Animals

Question 1

what is the purpose of pain?

Answer 1

protective mechanism to prevent the body from damage. stops the animal from doing their NORMAL behavior (ie stops jumping on couch, etc)

Question 2

T/F: congenital analgesia (people who cannot feel pain) is usually not compatible with life

Answer 2

true

Question 3

what part of the veterinary pledge says we must improve pain management?

Answer 3

“the relief of animal pain and suffering”

Question 4

what are negative aspects from acute pain?

Answer 4

• predisposes to chronic pain and maladaptive pain
• predisposes to cardiac dysrhythmias (autonomic response)
• prevents from sleeping
• prevents normal fx of affected area and compensatory areas
• may push the body into a catabolic state (fight and flight)
• the emotional component may lead to depression, aggression, etc

these are all reasons why pain is considered the 4th vital sign after heart rate, resp rate, and body temp

Question 5

T/F: pain is considered the 4th vital sign

Answer 5

true: after HR, RR, and body temp

Question 6

why is pain recognition in vet med difficult?

Answer 6

1. difficult to recognize (subjective assessment)
2. difficult to communicate
3. species, breed and individual variations
4. vet patients often do not complain (ethical?)

Question 7

T/F: pain assessment in animals is completely subjective

Answer 7

true

Question 8

when assessing pain in animals, you want to make it as ______ as possible. how do you do this

Answer 8

objective as possible. use a pain score!

Question 9

why should you avoid anthropomorphism when assessing pain?

Answer 9

this is giving human feelings to animals. assuming a dog with a stick thru its eye is super painful is not always true, the Labrador might go run and chase after a ball if you throw it even with a stick in the eye!

Question 10

pain is an _____ response

Answer 10

emotional response. need to consider behavior

Question 11

when a patient is in acute pain, what do you aim for?

Answer 11

analgesia

Question 12

when a patient is in chronic pain, what do you aim for?

Answer 12

quality of life and client-pet interaction. you cannot eliminate the pain in these cases, and often treatments will have worse side effects than is worth the compromise in QOL

Question 13

what are the steps for pain assessment and recognition?

Answer 13

1. observe patient without any interaction (facial expressions, posture, behavior, vocals)
2. observe patient while interacting with patient
3. observe patient while moving freely (if possible. ex collie after sx stepping up into cage)
4. observe response to palpation (don’t do first or animal will not approach you anymore)
5. score patient using a score system

Question 14

pain scales are ______ specific

Answer 14

species specific. cannot use dog pain scale on cat, dog on horse, etc

Question 15

Glasgow composite measure pain scale is for what species?

Answer 15

dogs

Question 16

Glasgow composite measure pain scale

Answer 16

• partially validated in vetmed
• used in dogs
• limited to specific characteristics within the scale
• does not account for sedation
• does not give final overall score

Question 17

what are limitations of the Glasgow composite measure pain scale?

Answer 17

• limited to specific characteristics within the scale
• does not account for sedation
• does not give final overall score

Question 18

visual analogue pain scale (all animals)

Answer 18

• all animals
• 100% subjective so same person should make all evaluations
• validated in human and vetmed
• absence of guidelines - not commonly used in vetmed
• simple and easy, gold standard in human med
  not used anymore because is extremely subjective. someone else can come and assess but give a completely different number

Question 19

T/F: the visual analogue pain scale is not commonly used in vetmed

Answer 19

true. not used anymore because is extremely subjective. someone else can come and assess but give a completely different number

Question 20

Melbourne pain scale

Answer 20

• dogs
• validated in vetmed
• more difficult to use
• adds physiologic parameters, but caution bc those could be changing for different reasons (ie an exercising dog has high HR)
• doesn’t account for sedation, or behavior
• limited to specific characteristics within the scale

Question 21

what pain scale is used at CSU?

Answer 21

CSU pain scale in dogs and cats
- partially validated in vetmed
- easy to use w color and pictures
- no physiologic parameters, does not account for sedation
- not limited to specific characteristics within the scale
-

Question 22

what is commonly used to assess pain in cats?

Answer 22

grimace pain scale: position of ears, orbit, muscle tension and relaxation, whiskers, and head position in cat

Question 23

what is a disadvantage of the grimace scale in lab animals?

Answer 23

• cannot be present in room because that changes the animal behavior
• have to video it

Question 24

how can you assess pain/nociception in anesthetized animals?

Answer 24

• patient movement
• increased RR, HR, BP
• signs of light plane of anesthesia
• knowledge of surgical procedure

Question 25

patient movement during anesthesia is what kind of reflex?

Answer 25

spinal cord reflex rather than emotional- but it can be conscious depending on anesthesia plane - conscious response how anesthesia MAC is determined!!

Question 26

________ response is how anesthesia MAC is determined

Answer 26

conscious

Question 27

increased respiratory rate with patients under anesthesia should not be confused with

Answer 27

- hypoxemia - hypoventilation/hypercapniea both can cause increased respiratory rate: if you administer more anesthesia because you think pt is in pain, pt gets deeper anesthesia and does worse if in these conditions

Question 28

what is one of the best indicators of horse anesthesia?

Answer 28

increased BP from fight or flight response- autonomic NS response fight or flight increases blood flow and DO2 to organs and muscles - tends to be an early response to nociception

Question 29

in large animals especially in horses, you will see a change in _____ as one of the first indicators of pain

Answer 29

increased blood pressure, early response to nociception. increased ANS increases BF and DO2 to organs and muscles

Question 30

in small animals under anesthesia, you will see change in BP but why is it different than horses

Answer 30

- usually using doppler or oscillometric so only measuring it every 3 minutes so don't always know what goes on every time

Question 31

increased heart rate in an anesthetized patient shouldn't be confused by

Answer 31

hypovolemia or hypotension, pt could be bleeding!

Question 32

what are signs of light plane of anesthesia in horses that is different than most other horses? what type of anesthesia is this in?

Answer 32

palpebral reflex and nystagmus - telling you horse is feelin git this is seen in GAS anesthesia, not under injectables!!

Question 33

what is a sign of a light plane of anesthesia in small animals?

Answer 33

jaw and muscle tone: opening jaw and feeling if jaw tone present or not. also depends on surgical stimulation = it is not even throughout the surgery

Question 34

what is the definition of chronic pain?

Answer 34

pain that extends beyond the expected period of healing

Question 35

what is the definition of pain?

Answer 35

unpleasant sensory and emotional experience associated with actual or potential tissue damage

Question 36

T/F: there are chronic pain scores available

Answer 36

true, but not many. ex are cancer pain score for dogs and cats and osteoarthritis pain assessment as well as activity score for cats

Question 37

what chronic pain scores are available for horses?

Answer 37

there are none- no scoring system available for chronic pain. sometimes just adjust the acute pain scales available, sometimes adjust the assessment to the individual needs