4 keys to communicate clearly about pain in pets
Andrew Claude, DVM, DACVAA
Dr. Claude is an assistant professor in the Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University.
You are your veterinary patient's advocate. Use these principles to prevent discomfort and suffering.
(Getty Images)The key to owner communication is to discuss pain management in veterinary patients using clear, understandable, scientific and ethical explanations. Here are four ways to do so:
1. NEVER allow clients the choice of whether or not pain management should be used in their pets. This practice is wrong on several levels. First, clients do not possess the understanding of how pain is caused and how to manage it in their pets. You, the veterinarian, does. Why then should the client be forced to make that decision? The Veterinary Oath obligates us as veterinarians to relieve the pain and suffering of our animal patients, so it goes against our oath to allow clients to make that decision.
In addition, it's immoral and, in my opinion, malpractice to withhold pain control in an animal because a client refuses it. The physiology of pain in animals is very similar to humans. In human medicine, proper analgesic administration and pain mitigation modalities are never a question. In veterinary medicine, we tend to hold onto old, antiquated concepts that allow us to justify substandard pain control.
Finally, including pain management as a part of the entire procedure is more professional and allows you the opportunity to communicate clearly with the client about how pain will be controlled. The focus of the discussion should not be on the necessity of pain management in animals but instead on its benefits (and side effects) for the client's pet.
2. Present a brief tutorial of the physiology of pain in dogs or cats and how it is similar to that in people.
3. Relate a personal surgical or other experience the client has had to the procedure that will be performed on the pet. This puts pain control at a personal level. For example, “Mrs. Jones, have you ever had surgery before, or an invasive dental procedure? The surgery we are going to perform on Fluffy is going to produce similar pain and discomfort for her as it did for you. Because we understand pain in dogs and cats, we are going to employ current methods of analgesia to help you take care of Fluffy's postoperative recovery at home in addition to managing her pain here.”
4. Apply the principles of preventive pain control:
- Preemptive: Preanesthetic medication, locoregionals
- Intraoperative: Additional pain medication, constant-rate infusions, locoregionals
- Postoperative: Immediately after surgery, apply patient welfare principles and administer postoperative medication. Short term at home, describe to clients the expected levels of discomfort, pharmaceutical choices, patient welfare and comfort at home. Long term at home, recommend modalities such as physical therapy and low level laser therapy.