Page 16 - BSAVA Guide to Pain Management in Small Animal Practice

2 | Physiology of pain

VetBooks.ir Authors’ perspective continued

. The scales include observation of patients from a distance so that behaviour can be
assessed in the absence of a human. This allows the patient to act ‘normally’ without feeling
the need to hide pain. Watch the patient care fully for:
• Abnormal body posture (e.g. hunched back, tucked abdomen)
• Grimaced facial expressions (e.g. position of ears, ‘openness’ of eyes)
• Location in the cage (e.g. at cage door or hiding or facing the back of the cage)
• Mobility (e.g. ‘frozen’ stillness, excessive movement like pacing or circling)
• Interest in surroundings (are they watching activity or just ‘staring’?)
• Abnormal behaviours (e.g. excessive grooming or licking)
• Vocalization (e.g. howling, growling, purring)
• Abnormal physiological parameters that can be assessed without interaction (e.g.
respiratory rate, pupil size).
. The scales include interaction with the patient so open the cage door and touch the patient.
Get the patient out of the cage (if appropriate). Measure heart rate and other physiological
parameters at this step. ay close attention to response to
• Approach of the observer (e.g. wanting to be petted versus withdrawing or attacking)
• Normal handling, such as petting
• Gentle palpation around the painful area
• Ability to/interest in ambulating, if appropriate (get the animal out of the cage)
• ood, if appropriate offer appetizing food .
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• If unsure, always ‘ask’ the patient, pharmacologically, if it is in pain. Administer a dose of
analgesic drugs
• pioids and alpha- agonists are commonly used for this uery. They are rapidly acting
and their effects are reversi le if the patient is not in pain and adverse effects from the
drugs occur. This is actually unlikely: if you think the patient is in pain, it likely is.
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• If the patient is comfortable, resume the normal schedule for assessment
• If the patient is not comfortable, add another analgesic drug to the protocol or increase
the dose of the previously administered drug and reassess in minutes.

behaviour in the dog and the cat. he
composite C PS for dogs has a long form
Glasgow Composite Pain and short form. he long form is more robust in
Scoring Scale its guidance for the evaluator with de nitions of
f the composite multidimensional scales terms used to describe the speci c pain
developed, the lasgow Composite Pain related behaviours. he scale does take some
Scoring Scale CPSS; see Appendix 1 or time to complete and does not have a numeric
lasgow Composite easure Pain Scale scoring system.
C PS is the original scale designed using he C PS S for short form is a
psychometric principles that are well condensation of the most important composite
established in human medicine to measure information in a clinically useful form i.e. simple
complex variables. he components of the and uick to apply with a numeric scoring
scales are based on speci c behaviours that system. Included in the C PS S is the
have been identi ed to indicate pain and patient s overall behaviour, including behaviour
weighted as to their importance in pain in the cage, on a leash and during palpation

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