Carolyn McKune, DVM, DACVA
In the veterinary profession, ?-2 adrenergic receptor agonists (?-2 agonists) are either loved or feared; this is often determined by a veterinarian's familiarity with the drug. There is no doubt that ?-2 agonists have complex effects, but understanding ?-2 agonists increase options for analgesic use, as well as sedation.
Currently, the only analgesics available to veterinarians that prevent pain transmission are local anesthetics, which facilitate a variety of veterinary procedures.
Even in the modern day, opioids remain the cornerstone of analgesia. Aesop's fables gave rise to the saying that "Familiarity breeds contempt"; these drugs are often underappreciated because of their long history as analgesics. Opioids may not be "novel" but they are critical to pain relief and a strategy that our patients benefit from.
Veterinary pharmacology is increasing in complexity with advances in analgesia. A veterinarian's knowledge of drug interactions is critical to prevention of a potentially harmful event. Drug interactions are considered undesired increases OR decreases in drugs co-administered.
Pain transmission is complex and pain itself is difficult to manage in some cases. While a standardized approach to pain management forms a cornerstone from which to work, there are a variety of analgesic options available with which to provide multimodal analgesia; many veterinarians already have some of these modalities on hand.
Before improving quality of life for patients, a veterinarian must first understand the cause of a decrease in quality of life. Pain is universally accepted as decreasing quality of life but is fairly ambiguously defined; according the International Association for the Study of Pain (IASP), pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.