Page 32 - BSAVA Guide to Pain Management in Small Animal Practice

4 | Chronic and osteoarthritic pain

VetBooks.ir Pain assessment tool Validation and examples of Comments
use
Helsinki Chronic Pain (Hielm-Björkman et al., 2009) • Owner questionnaire
Index (HCPI) • 11 questions
• Questions cover mood and mobility. Dogs
experiencing ongoing painful conditions are
di erentiated from dogs without pain when they score
greater than 12 on the HCPI
American College of (Brown, 2013) • Owner questionnaire
Veterinary Surgeons • 16 questions using a 5-point Likert scale
Canine Orthopaedic • Relating to four domains; sti ness, function, gait, and
Index quality of life
Client Speci c A patient speci c tool for all • Objective tool designed between owner and
Outcome Measures species; templates are veterinary surgeon for each dog to assess measures
(CSOM) available (Lascelles et al., to which the client can relate
2008)
Quality of Life (Reid et al., 2013) • Web-based owner questionnaire
Assessment (HRQL) • 46 questions
Vetmetrica • he outcome generates a oL pro le
Quality of Life (Yazbek and Fantoni, 2005) • Owner questionnaire
Assessment (Yazbek) • 12 questions
• QoL tool to assess pain secondary to cancer
End of trial (Hielm-Björkman et al., 2007) • Can be used to assess satisfaction with trial or
questionnaires guessing what group the animal was in
Visual analogue scale (Hielm-Björkman et al., 2011) • Useful low cost, basic observational tool
(VAS) • Some limitations for inexperienced owners
Numeric rating scale (Wiseman-Orr et al., 2006) • Useful low cost, basic observational tool
(NRS) • VAS more sensitive than NRS
Simple descriptive (Hielm-Björkman et al., 2003) • Simple tool
scale • 3–5 answers ranked on a severity scale
(continued) Pain assessment tools for maladaptive pain in dogs. QoL = quality of life.

Cats for addressing the pain. igure 4. details the
PATs that can be used for cats.
The assessment of chronic pain in cats is
particularly di cult; the signs of pain are subtle Physical examination
and can be di cult to describe. In addition,
owners are typically less likely to seek veteri- The environment for the examination is very
nary advice in these cases, and it is likely that important; a table with a comfortable soft,
the options for treatment are considered very non-slip surface, away from other animals and
limited. A paucity of validated quality of life with no places to escape (for cats) should be
questionnaires or chronic OA questionnaires, used, with an awareness that the examination/
and limited data about complementary consultation can take considerable time to
treatments and disease-modifying agents or perform thoroughly.
dietary supplements, which is often at best Gently examine the animal with minimal
anecdotal, further hamper this, in contrast to the restraint; this may require a stepwise approach,
dog. Notwithstanding these challenges, the pausing regularly to allow the animal to move
feline patient should not be deprived of options around and explore before resuming

27

Ch04 Pain Management.indd 27 20/12/2018 10:10