Pain management in veterinary rehabilitation

Pain management in veterinary rehabilitation

Debunking animal pain myths, exploring the benefits of multimodal therapy
Jun 01, 2010

Home care: Make sure your pain-management protocols take into account the fact that animals can experience postoperative pain days or possibly weeks after a procedure — even those rehabilitating from elective surgeries. (PHOTO: SARAH M. GOLONKA/GETTY IMAGES)
The veterinary profession is slowly coming to the realization that treating pain is a fundamental part of practicing good medicine. Research and clinical experience have debunked outdated assumptions about the biology of animal pain, and the number of treatment options and their efficacy continues to increase. There is growing concern in our society for the ethical and compassionate care of animals, and pet owners are routinely seeking out practices that provide comprehensive and humane care.

Adding pain management to a practice is not difficult or time-consuming, and profit margins on drugs and services can be significant. Indeed, pain management provides one of those rare convergences of benefits for the patient, satisfaction for the client and economic health for the practice.

Busting the myths about animals and pain

For a long time, misunderstandings about the way animals experience pain devalued the concept of pain management in the veterinary community.

Myth 1: Animals do not feel pain like people do. In fact, the basic anatomy, physiology and biochemistry of pain are remarkably similar in animals and people.

Myth 2: Pain benefits an animal by limiting its activity. Pain may actually make it more difficult to control an animal's activity because unmanaged pain can trigger a stress response, including increased arousal and other changes detrimental to healing.

Myth 3: Elective surgical procedures do not require "take-home medication." Acute pain is most intense during the first 24 to 72 hours after surgery, but pain often persists for days or even weeks after the patient returns home. Postoperative pain is not determined by whether the surgical procedure is elective or not.

Myth 4: Animals tolerate pain better than people do. Human and animal pain thresholds are about the same. Animals, however, will instinctually hide the signs of pain so potential predators do not see them as easy prey. This behavior is true even in pets.

Myth 5: Pain relief "masks" physiologic signs of patient decline. In cases in which pain management is effective, patients are less likely to experience detrimental tachycardia, hypotension and other stress-induced abnormalities. Blood pressure, heart rate and partial pressure of carbon dioxide and oxygen will all still change and can be monitored for evidence of patient decline.

Myth 6: Analgesics are toxic and can cause adverse events. When used appropriately, many analgesics are considered safe and effective for pain management. As is the case with any medication, it is the responsibility of the veterinarian to weigh the risks and benefits and make the appropriate recommendation for each patient.

Myth 7: Pet owners won't pay for pain control. The reality is that the vast majority of pet owners see their animals as members of the family. They are sensitive to their pets' comfort and well-being and are likely to pay for what they perceive as compassionate care.