Demystifying feline pain management - DVM
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Demystifying feline pain management
Keen observation will provide clues to diagnose pain in cats.


What about chronic pain?

While most cats will likely be exposed to an acutely painful procedure, such as surgery, at some point in their lives, it's not an everyday occurrence. But for some cats, chronic pain can be. From degenerative joint disease to cancer, certain conditions can negatively affect a cat's behavior and activity level and, as such, managing chronic pain has become a much greater concern for today's pet owners and veterinarians.

Degenerative joint disease is one of the most common sources of chronic pain in cats but it can also be one of the more difficult conditions to accurately assess. Although pet owners may notice subtle signs of their cat's discomfort at home, such as reluctance to jump or a slower, stiffer gait, it can be tricky for veterinarians to make a clinical assessment based on examination alone. "Cats are smaller and have a natural agility," Robertson says. "It can be difficult to elicit pain in cats or even perform a physical exam at all. They often don't give as much information as dogs."

Cats don’t have to suffer. A stimulus-rich environment that includes playing and petting can prove to be a powerful distraction to chronic pain.
Because of this, it's critical to enlist the help of the pet owner to get a true sense of the cat's level of pain and discomfort. Robertson recommends developing an owner questionnaire to evaluate the cat's normal behaviors—such as walking, playing and jumping—at home. Find out if the cat is developing coping strategies to deal with pain, such as jumping first onto a chair or table, rather than jumping directly onto a countertop or taking stairs one at a time.

Changes in the cat's elimination habits should also be part of the discussion. Many cats who experience chronic pain will avoid covering their urine or feces with litter, or may refuse to climb into a litter box altogether. What some pet owners may confuse as inappropriate urination may actually be a sign that the cat is experiencing pain due to degenerative joint disease or another chronic condition.

Assessing quality of life

Robertson points out that in humans, pain is self-reporting—we state how we feel. But in animals, pain is what the pet owner or veterinarian says it is. The same is true for quality of life. Quality of life in pets is relative and often measured by the amount of pain we believe the animal is in. But pain isn't the only factor to be considered.

In a study conducted by B. Duncan X. Lascelles, BSc, BVSc, PhD, DECVS, DACVS, professor of small animal surgery at North Carolina State University, it was hypothesized that quality of life in cats was predominantly linked to mobility. However, 60 percent of pet owners in the study reported that habits such as engaging in play or being receptive to petting were of far greater importance in assessing their pet's quality of life than mobility alone.

Based on the results of studies such as this, Robertson emphasizes the importance of managing chronic pain through environmental enrichment as well as traditional medical intervention in order to improve a cat's quality of life. A stimulus-rich environment that includes playing and petting can prove to be a powerful distraction to chronic pain, Robertson states. And that can make a huge difference.

"Cats sitting in a barren environment will focus on the pain," she says. "But in a highly enriched environment, they will focus on things other than the pain."


Source: DVM360 MAGAZINE,
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