In the last 10 years, the veterinary profession has undergone what can only be described as a sea change in perspectives about animal pain and pain control. A 1993 evaluation of a veterinary teaching hospital surgical caseload revealed only 40% of patients that had undergone highly invasive, painful procedures (including orthopedic repair, thoracotomy, and intervertebral disc decompression) received any sort of pain control, and then only based on clinical signs.
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.
What is a neonate or pediatric patient? Neonate patients are between 0 to 6 weeks of life and a pediatric patient is between 6 to 16 weeks of life.
Arterial hypotension is a common anesthetic complication. Perfusion of vital organs depends largely on arterial blood pressure. Mean arterial blood pressure (MAP) below 60 mmHg and systolic blood pressures below 80 mmHg can result in reduced perfusion of the vital organs. Oxygen debt can ensue in morbidity and mortality.
Whenever confronted with a painful animal, one should consider employing a considerable effort to control the pain as best as possible and as early as possible. This is true for both acute and chronic cases of pain.
Non-steroidal anti-inflammatories, or NSAIDs, are unique drugs that provide analgesia by decreasing peripheral inflammatory enzyme conversion and reducing central pain perception.
Maintenance of anesthesia using an inhalant agent has been associated with cardiopulmonary depression. Some small animal patients are more sensitive to the cardiopulmonary depressant effect of inhalant agents.
Most recent estimates suggest there are over 80 million cats in the United States. Many of these cats will undergo a procedure expected to result in pain, underscoring the need for sound pain assessment tools.
What is a geriatric patient? Geriatric patients are pets that have attained 75% of that species or breeds expected life span. Therefore, a 6 year old Yorkshire terrier would not be considered geriatric, but a 6 year old Irish wolfhound would fall under this definition.
The framework of effective pain management systems rests solidly on the foundation of recognition/assessment, pre-emption, and using multiple modalities. Multiple modalities allow for intervention at several different places of the nociceptive pathway, increasing effectiveness and minimizing the need for high or protracted doses of any one particular drug.
There are many physiologic variables that can be monitored in anesthetized small animal patients. The major goal of monitoring an anesthetized patient is to ensure adequate oxygen delivery to the tissue. Appropriate oxygen delivery to the tissue needs the proper functioning of the cardiovascular and respiratory systems.
Probably the most common condition associated with osteoarthritis, post-surgery and musculoskeletal abnormalities. Yet, it is rarely taught in veterinary university settings, few practitioners even know of its existence, all despite the fact that muscles compromise half of an animal's body weight.
The practice of veterinary anesthesia has been impacted by the short supply of propofol and discontinued production of thiopental. Thiopental is officially in the "Discontinued Drug" list of the FDA. The company that used to make thiopental decided to stop production because of its stand against the use of this drug for lethal injections.
To safely anesthetize small animal patients with preexisting cardiac condition, it is important that specific hemodynamic goals are set for the particular heart condition. It is easy to state that for patients with cardiac problem, "heart-friendly" drugs need to be used.
You can never become good at pain management without understanding basic pain pathways. You will have trouble understanding pain pathways without understanding the terminology used to describe them.
Our selection of analgesic options for the feline is influenced by the species' characteristic physiology and individual variation. The increasing popularity of the cat fuels exploration of this complex animal's unique attributes.
The risk of anesthesia is higher in emergency cases compared with elective cases. Most of these patients are compromised and this increases the danger of anesthesia, especially in cases when there is no time to optimize the condition of the patient before anesthesia.
Exotic small mammals (formally known as pocket pets) are challenging creatures to work with. When working with dogs and cats, it is usually easy to place an intravenous catheter, intubate, provide fluid therapy, hook up an ECG, place a blood pressure cuff, and keep track of the core body temperature.
Medical Acupuncture and Chinese Acupuncture
Local anesthetics were once a mainstay of pain management in veterinary medicine, and may now be one of the most under-utilized modalities. Administered locally or regionally, they are the only modality that renders complete anesthesia to a site, i.e. no transmission of nociceptive impulses as long as the drug exerts its effect.
Rigid endoscopy can be performed in many reptiles by passing the endoscope through the oral cavity and into the stomach. Endoscopy is primarily used to obtain gastric biopsies or to retrieve foreign bodies from the stomach.
In this photo gallery, Dr. Dani McVety of Lutz, Fla. guides a client through the emotional process of euthanasia.
You can reduce your patients' potential for problems by staying clear of these common pitfalls.
