Anesthesia; Pain Management
6th Annual Gulf-Atlantic Veterinary Conference
To treat pain, we must first recognize it and quantify it in some way so we can assess the efficacy of our interventions. Pain is a complex multidimensional experience with both sensory (type, location and intensity) and emotional (how it makes the patient feel) components. In cats, physiologic variables (e.g. heart rate, respiratory rate and blood pressure) are not, on their own, good indicators of pain because these are also altered by other factors, including fear and stress. It is now accepted that quantitative measurement of behaviour is the most reliable method for assessing pain in animals. Knowledge of the normal behaviour for the individual being evaluated is important and deviations from normal behaviour suggest pain, anxiety, fear or some combination of these. Normal behaviours should be maintained post-operatively if a cat is comfortable. The occurrence of new behaviours – such as a previously friendly cat becoming aggressive, or a playful and friendly cat becoming reclusive – should raise our suspicion that pain may not have been adequately addressed. There are now validated tools for assessing acute pain in cats, including the Glasgow Composite Measure Pain Scale and the UNESP-Botucatu Multidimensional Composite Pain Scale. These tools assess specific domains including vocalization, posture, attention to the wound, facial expressions, and response to palpation of the wound and interaction with the observer. In addition, the observer decides as to the cat’s overall mental status; for example, is it happy and content, anxious, fearful or dull? Intervention levels for treatment are also suggested. These tools can be easily integrated into veterinary clinics and will improve pain management for cats.