When we asked our Facebook fans “which of the following is the main obstacle to treating chronic feline pain — owner compliance or recognition?” a whopping 71% of the 258 poll participants said “recognition.”
Today’s Veterinary Nurse Spring 2018 issue published Me-oww! Managing Chronic Feline Pain, by Alison Gottlieb. “The veterinary paradigm has shifted from questioning whether animals feel pain to recognizing and treating their pain,” Gottlieb wrote. But she also acknowledged that “recognizing chronic pain in cats is challenging.”
Among the reasons for this, Gottlieb cites:
• A lack of prompts/triggers
• Lack of data connecting different maladies with pain levels
• The obscure nature of clinical signs associated with neuropathic pain
• Cats often try to hide pain, especially in the presence of humans and other animals
How Can You Help Assess Pain in a Cat?
Use the Feline Acute Pain Scale from Colorado State University to help determine how much pain your patient is in.
There is also the Pain Management Guidelines for Dogs and Cats published by the American Animal Hospital Association (AAHA). In its introduction the AAHA states: “Alleviating pain is not only a professional obligation (recall the veterinarians pledge to ‘the relief of animal pain and suffering’) but also a key contributor to successful case outcomes and enhancement of the veterinarian-client-patient relationship. A commitment to pain management identifies a practice as one that is committed to compassionate care; optimum recovery from illness, injury, or surgery; and enhanced quality of life.”
Make sure the whole veterinary team is equipped to assess and treat pain. Does your veterinary team:
• Assess pain in every patient regardless of appointment type (e.g., wellness, sick, follow-up)?
• Have standard operating procedures to prevent pain, including weight management, prevention of dental disease, and handling techniques to prevent fear and pain?
• Educate staff on recognizing, assessing and preventing pain strategies?
• Educate staff about drug interactions and adverse effects?
• Routinely ask about the patient’s medication history?
• Understand painful procedures?
• Assess postoperative patients and record pain score?
• Assess chronic-pain patients and record pain score?
• Note any patient behavioral changes?
• Maintain effective client communication and education?
If not, the AAHA Pain Management Guidelines for Dogs and Cats are a great place to help your practice develop a pain management plan where each and every team member has a role to play.
As the AAHA notes in its guidelines: “Pain management in clinical practice is a team effort, with the pet owner functioning as an integral part of the team. All healthcare team members should have a defined role in the practice’s approach to providing compassionate care to its patients. That enables the practice to speak with one voice and in a consistent manner in the implementation of pain management protocols. Client education is a key component that enables the pet owner to manage pain in the home setting. Direct involvement of the client in pain management efforts is consistent with the continuum of care concept and a demonstration of the practice’s commitment to the pet’s QOL. A fully integrated approach to pain management, involving recognition and systematic assessment, pharmacologic and nonpharmacologic methods, and one that includes both healthcare team members and the pet owner, ensures that everything possible has been done to relieve a patient’s pain once it enters the practice’s care.”