Page 101 - BSAVA Guide to Pain Management in Small Animal Practice

BSAVA Guide to Pain Management in Small Animal Practice

VetBooks.ir Outpatient focus with disorders such as anxiety and depression.
This aspect is not well researched in veterinary
Veterinary nursing clinics have become more
common in many hospitals throughout Britain. patients. However, understanding of pain
pathology and processing in mammalian
Veterinary nurses have long been the species supports the presence of emotional
intermediary between clients and veterinary states in some veterinary patients that are
surgeons. Their roles in education, provision of unaddressed. Assessment and examination of
care and utilization of a myriad of clinical skills chronic pain cases are discussed in Chapter 4.
makes veterinary nurses key team members, For chronic pain patients, the support
especially when considering painful patients. provided by a nurse clinic can be instrumental in
Most nurses are already familiar with successful management. Any chronic condition
postoperative check-ups and addressing involves a period of both client education and
commonly related concerns such as: adjustment. Clients may not understand the
condition, how it a ects their animal, how it
■ Is the patient eating regularly? a ects themselves, and the continuing
■ Are any side e ects to the medications management required. Nurses can competently
dispensed apparent? advise clients on topics such as diet,
■ Has the patient been interfering with the nutraceuticals, exercise, modi cations around
wound? the home, medication dosing and side e ects,
■ Can the wound be palpated without and pain recognition and assessment. Of
adverse reaction? importance are both owner awareness of the
■ Has the wound healed as expected? support network available to them and provision
■ Can the patient go outside exercise o of an interdisciplinary, holistic approach to
leash? chronic pain management. Owners need to
Geriatric and arthritis nursing understand that most chronic conditions are
incurable and that a long-term commitment to
clinics management is required. The aim of long-term
The nurse consultation involves assessing the management of arthritic cases is to slow down
patient’s comfort level and how well both the progression of this degenerative disease.
patient and client are coping at home. Geriatric Good management of an arthritic patient will
and arthritis clinics have a commonality in that both reduce patient su ering and produce
during this stage in a patient’s life cycle the top improvements in mobility. In the geriatric patient
priority is to minimi e su ering. Patient su ering with cognitive dysfunction, it can be challenging
may arise in response to an illness or disease. to distinguish pain from other signs of cognitive
Su ering can encompass many contributing decline. Maintaining organ function when
states such as pain, anxiety, stress and concurrent disease is present may in uence
starvation. Some of these states arise from a drug choices. Owners may need advice and
dysfunctional care delivery system or may vary reassurance that they will recognize the correct
based on di erences in how clinics provide time for euthanasia of their pet. Quality of life
care. Ultimately, these states are avoidable. (QoL) assessments are critical in assessing both
Some animals su er more by imposed lifestyle geriatric and arthritic patients. A validated
restrictions than by the su ering caused by the measure of health-related QoL and pain in
pain induced by regular lifestyle activities; for animals is available through NewMetrica and
example, a patient may mentally su er more by the University of lasgow see Appendix 1 .
not playing with the ball or going out for walks hese oL assessments support veterinary sta
than they would su er physically if they and owners by providing a meaningful shift in
performed the activities. veterinary care and animal welfare.
Pain has a strong emotional component. A very simple mnemonic, ABC E courtesy
Chronic pain in humans is frequently associated of Professor Stuart Carmichael), can be used to

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