AAHA releases new pain-management guidelines

DENVER, COLO. — Changing viewpoints on addressing companion-animal pain and the benefits of doing so are highlighted in newly created pain-management guidelines — the product of a partnership task force between the American Animal Hospital Association (AAHA) and the American Association of Feline Practitioners (AAFP).

The AAHA/AAFP Pain Management Guidelines for Dogs and Cats are meant to serve as a blueprint for veterinarians.

"Addressing contemporary approaches to manage pain gives us the ability to fulfill our veterinary duty to alleviate suffering of animals. These guidelines will give veterinarians and pet owners a common compass to diagnose and manage pain that affects cats and dogs," says Thomas Carpenter, DVM and AAHA president.

"The guidelines are written in a way that provides a lot of information, and a foundation for providing pain management within our standards. It is a really good road map."

Prevention of maladaptive pain, identification of overlooked causes of pain and use of multimodal pain therapy are among the most important segments of the guidelines, says task-force member Ilona Rodan, DVM, Dipl. ABVP and AAFP member.

"Since pain management applies so well to both dogs and cats, it made perfect sense for us to work together on it," says Jane Brunt, DVM, AAHA member and immediate past president of AAFP, of the AAHA-AAFP partnership task force. "I hope practitioners will take the time to read them, think about them and see how they can integrate pain management into their practice if they are not already doing so.

"Guidelines can help educate veterinarians about the latest information, and help them educate clients. It's good medicine and it's good for the practice. It shows clients we care about their pets to the end," Rodan adds.

A recent article by Bernard Rollin, animal ethicist and Colorado State University Distinguished Professor of Philosophy, helped initiate the task force, says Bill Folger, DVM and chair of the AAFP feline-welfare committee.

A major role of the veterinarian is to treat and control animal pain and distress, but historically this role has been neglected in both human and veterinary medicine for ideological reasons, Rollin's article contends. Ethically, it is vital for society to move past this ideology to ensure proper medicine and ethical treatment for companion animals.

"I would love for veterinary medicine to move way ahead of human medicine in this regard," Folger says.

Changing standards

The guidelines create an outline for meeting standards of care that are evolving rapidly, says Rodan. Three reasons are driving the shift in expectations:

• Medical advances provide more analgesics with fewer side effects.

• Clients view their pets as family members and demand better care, including the prevention and treatment of pain.

• Pets live longer, so DVMs need to ensure older animals are not living in pain.

"Pain management has not been implemented as it should for a number of reasons. In the past, it was thought that pain prevented the animal from being too active and further injuring itself. We now know that pain management is important to help with healing, quicker recovery and quality of life for our patients," Rodan says.

The guidelines magnify the importance of pain management and how thoughts on its administration have changed, says Folger.

"A decade ago, no one used pain management. I started making pain management non-elective on a variety of procedures in 1998. A whole lot of my colleagues would say that was unnecessary. Now we have a whole body of evidence to show it reduces the healing time and reduces complications," he says.

"Preoperative pain management is imperative. I can tell you the people on the animal-welfare committees, all of us, recognize our profession is moving in that direction and there are many barriers that need to come down."