• DVM360_Conference_Charlotte,NC_banner
  • ACVCACVC
  • DVM 360
  • Fetch DVM 360Fetch DVM 360
DVM 360
dvm360 | Veterinary News, Veterinarian Insights, Medicine, Pet Care
dvm360 | Veterinary News, Veterinarian Insights, Medicine, Pet Care
By Role
AssociatesOwnersPractice ManagerStudentsTechnicians
Subscriptions
dvm360 Newsletterdvm360 Magazine
News
All News
Association
Breaking News
Conference Coverage
Education
Equine
FDA
Law & Ethics
Market Trends
Medical
Politics
Products
Recalls
Regulatory
Digital Media
dvm360 LIVE!™
Expert Interviews
The Vet Blast Podcast
Medical World News
Pet Connections
The Dilemma Live
Vet Perspectives™
Weekly Newscast
dvm360 Insights™
Publications
All Publications
dvm360
Firstline
Supplements
Top Recommended Veterinary Products
Vetted
Clinical
All Clinical
Anesthesia
Animal Welfare
Behavior
Cardiology
CBD in Pets
Dentistry
Dermatology
Diabetes
Emergency & Critical Care
Endocrinology
Equine Medicine
Exotic Animal Medicine
Feline Medicine
Gastroenterology
Imaging
Infectious Diseases
Integrative Medicine
Nutrition
Oncology
Ophthalmology
Orthopedics
Pain Management
Parasitology
Pharmacy
Surgery
Toxicology
Urology & Nephrology
Virtual Care
Business
All Business
Business & Personal Finance
Hospital Design
Personnel Management
Practice Finances
Practice Operations
Wellbeing & Lifestyle
Continuing Education
Conferences
Conference Listing
Conference Proceedings
Resources
CBD in Pets
CE Requirements by State
Contests
Veterinary Heroes
Partners
Spotlight Series
Team Meeting in a Box
Toolkit
Top Recommended Veterinary Products
Vet to Vet
  • Contact Us
  • Fetch DVM360 Conference
  • Terms and Conditions
  • Privacy
  • Do Not Sell My Information
  • About Us

© 2023 MJH Life Sciences and dvm360 | Veterinary News, Veterinarian Insights, Medicine, Pet Care. All rights reserved.

Advertisement
By Role
  • Associates
  • Owners
  • Practice Manager
  • Students
  • Technicians
Subscriptions
  • dvm360 Newsletter
  • dvm360 Magazine
  • Contact Us
  • Fetch DVM360 Conference
  • Terms and Conditions
  • Privacy
  • Do Not Sell My Information
  • About Us
  • MJHLS Brand Logo

© 2023 MJH Life Sciences™ and dvm360 | Veterinary News, Veterinarian Insights, Medicine, Pet Care. All rights reserved.

Recognizing and managing pain in small mammals (Proceedings)

August 1, 2010
Teresa Bradley Bays, DVM

Physiologic "stress" response to pain.

Physiologic "Stress" Response to Pain

      - Vasoconstriction

      -Increased Heart Rate and Stroke Volume

      -Decreased GI & Urinary Tone

      -Physiologic "Stress" Response to Pain:

      -Endocrine Responses

      -Nociceptive Stimulation of Brain

      - Enhance Reflex Sympathetic Responses

      -Immune Suppression

      -Impaired Wound Healing

      -Decreased Food & Water Intake

      -Secondary Medical Problems

      -Gastric ulcers GI Stasis

      -Shock

      -Death

• Higher rate of anesthetic death in exotics?

• Higher rate of death postoperatively?

How is this related to inadequate use of pre, intra & postoperative analgesics in prey species????? Stress???

Behaviors Associated with Pain in Small Mammals

      -Predators such as ferrets are more likely to show overt signs of pain

      -Prey species such as rabbits and guinea pigs are less likely to show overt signs of pain

      -Half-closed/dull/unfocused eyes

      -Aggressive when normally docile

      -Pressing abdomen on the floor

      -Immobility/Lethargy/Isolation

      -Fewer, smaller or no fecal pellets

      -Vocalization (squeal may be fear in rabbits)

      -Increased frequency and depth of respirations or rapid shallow breathing

      -Polyuria/Polydipsia (especially w/GI pain)

      -Teeth grinding (bruxism)                                          Lameness/Ataxia

      -Reluctance to curl when sleeping (ferrets)                 Anorexia

      -Stretching w/back arched                                        Hunched posture

      -Tucked appearance                                               Chewing at affected site

      -Strained facial expression w/bulging eyes                Piloerection

      -Head extended and elevated                                   Stiff movements

Advertisement

      -Stinting on palpation                                               Self-mutilation

      -Porphyrin secretion (stress)                                      Squinting (especially ferrets)

Painful Disease Processes

Pain Management Considerations

      - Pre-emptive analgesia

      -Neuropathic Pain

      -Inflammatory Pain

      -Decreases dose of maintenance anesthetic

      -Care with injectable anesthetics

      -Individualize treatment and provide Multimodal Pain Therapy

      -Numerous pain pathways

      -Synergistic effect

      -Analgesics often used at lower doses

      -Anxiety lowers the pain threshold

      -The effects of illness, restraint and environmental changes w/hospitalization increase the level of stress experienced.

      -Never discount the owners concern - familiarity w/daily behavior is important in assessing pain.

      -Train your staff to recognize pain in exotics

      -Assign staff member to monitor patient throughout their hospitalization

NSAID's

      -Don't use with renal and hepatic impairment, bleeding disorders, enteritis, gastritis, gastric ulcers hypotension or hypovolemia

      -Don't combine with corticosteroids

      -Use lower doses with ferrets

      -Use with caution for prolonged use in herbivores, use gastric protectants

      -Hypotension is often seen as an anesthetic complication in small mammals – use pre-op NSAIDS w/caution

Opioids

      -Avoid use in hypotensive patients

      -Short duration of action

      -Decrease need for isoflurane

      -Administer during lighter plane when also using injectable anesthesia

      -Butorphanol – least potent and shortest duration

      -Buprenorphine – intermediate strength and longest duration (6-8 hrs.)

      -Morphine – most potent and intermediate duration

      -Oral buprenorphine (transmucosal) has been found pharmacologically effective in cats and more recently dogs (abstract from ACVA mtg). Clinically effective in rabbits and ferrets.

      -Pica has been noted in rats on buprenorphine

      -Ferrets can be prone to side effects including hypotension, sedation and respiratory depression

      -Guinea pigs, rabbits, chinchillas can be prone to side effects associated with the GI tract.

Analgesics for Small Mammals

NSAIDS

      -Acetylsalicylic Acid - 50 to 100 mg/kg q 8 - 24 h PO

      -Carprofen - 1 to 4 mg/kg q 12 to 24 h PO, SQ, IM

      -Flunixin meglamine - 0.1 to 2 mg/kg q 12 -24 h SQ, IV, IM (herbivores)

      -Piroxicam – 0.2 mg/kg PO q 8 h

      -Ibuprofen - 2 to 7.5 mg/kg q 4 to 24 h IM, PO

      -Ketoprofen - 1 to 3 mg/kg IM, SQ, PO q 24 h

      -Meloxicam - 0.1 to 0.2 mg/kg q 24 hr SQ, PO

      -Meloxicam (Metacam)

      -6 to 8 hrs to reach blood levels so use well before procedure for post-op pain

      -Possibly d/t rapid metabolism higher doses may be needed in rabbits/rodents

      0.3 mg/kg/day PO in rabbits (Turner, et al)

      1-2 mg/kg pre-op in rats (to achieve post-op pain) (Roughan and Flecknell)

      -Ferrets can be more sensitive to NSAID side effects so be more cautious w/dose (similar to cats)

      -Do not use in ferrets if ulcers are suspected or if vomiting/diarrhea or melena are present

      -Bloodwork to R/O liver/kidney disease

Opioids

      -Butorphanol - 0.1 to 0.5 mg/kg q 4-6 h SQ, IV, IM

      -Buprenorphine - 0.01 to 0.1 mg/kg q 6 to 12 h SQ, IM, IV

      -Tramadol (syn. Analogue of codeine) – less side effects than opiods.

      -Pharmacological studies indicated 10 mg/kg safe in rabbits (TBB uses 3 mg/kg)

      -Can decrease blood glucose levels

      -Morphine - 1.25 to 5 mg/kg q 2-4 h SQ, IM

      -Oxymorphone 0.05 to 0.2 mg/kg q 4-12 h SQ, IM

           Combining NSAIDS and Opiods provides multimodal analgesia (usually at lower dosages) with less side effects.

Local Analgesia

      -Lidocaine 2% - 1 mg/kg (can be used in combo with bupivicaine for longer analgesia)

      -Bupivicaine 0.5% - 1 mg/kg (can be used in combo with lidocaine for longer analgesia)

      -Cetacaine on wounds from maggots and on incisions if chewing postoperatively

Nerve Blocks

Epidural Analgesia

Lidocaine 1.5% 0.4 ml/kg

Fentanyl

     • 0.0074 mg/kg IV

     • 0.15 to 0.44 ml/kg IM (can cause muscle necrosis)

Fentanyl Patches

     • Rabbits: 1/3 to 1/2 patch per 3 kg rabbit X 3 days

Alternative Approaches to Pain Management

      -Acupuncture

      -Massage Therapy

      -Chiropractic

      -Physiotherapy

      -Cranioelectrical Stimulation (CES)

      -Alpha Stim TM

      -Uses a biphasic square electrical wave

      -Rx for pain, anxiety, depression and insomnia

      -Current studies in amputees & breast cancer patients

      -Pain, Wound Healing, Anxiety in animals

      -Alternative Approaches to Pain Management

      -Produces the alpha state within the body's electrical activity pattern

      -Calmness, mental focus, pain control

      -Disregulation of firing patterns in the brain responsible for behavioral anomalies:

      -depression, anxiety, insomnia. addictions, OCD, etc.

Microcurrent Electrical Therapy (MET)

      -Electrical current stimulates healing and growth and regeneration

      -Initiates and sustains chemical & electrical relations in the healing process

      -Bacteria do not like the microcurrent

      Injury causes a change in polarity that is reestabished with MET

Assessment of Response to Analgesics

      Return to Normal Behavior:

          • Eating

          • Sleeping

          • Stretching

          • Grooming

Always sedate or preferably anesthetize small mammals before euthanasia

Related Content:

Exotic Animal Medicine
From the lens of a veterinarian: Voyaging to Camp Leakey in a klotok
From the lens of a veterinarian: Voyaging to Camp Leakey in a klotok
Oakland Zoo mourns the death of an African Elephant
Oakland Zoo mourns the death of an African Elephant
Unusual parasite strain kills 4 California sea otters
Unusual parasite strain kills 4 California sea otters

Advertisement

Latest News

3 Must-sees from the Fetch Charlotte conference

Morris Animal Foundation appoints new chief program officer

CDC issues warning over cat-transmitted sporotrichosis

An AI solution is speeding up insurance claims processing

View More Latest News
Advertisement