Page 31 - BSAVA Guide to Pain Management in Small Animal Practice
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BSAVA Guide to Pain Management in Small Animal Practice



        VetBooks.ir  noxious inhibitory control   NIC , which   currently published work investigating the
           increases the activity in descending alpha
                                                  presence of   rPs in animals with respect to
                                                  validated pain scoring or objective measures
           adrenergic and      neurones, resulting in
           decreased dorsal horn activity in response to   of locomotor function; however, it is likely that,
           noxious stimuli applied to distant sites. In a   as in humans, they do represent further
           number of chronic pain conditions, including   sources of pain beyond the joint and the
            A, decreased e cacy of  NIC has been   nervous system.
           reported, which has then normalized following
           successful joint replacement (Kosek and
            rdeberg,      .                       Assessment of chronic

           Glial cell activation                  pain
           Non-neuronal peripheral and centrally located
           immune cells have been implicated in the    he assessment of chronic pain in dogs is reliant
           maintenance of neuropathic pain through their   upon subjective and objective measures
           release of cytokines, histamine and serotonin   reported by the owner.  hese will likely include
             oalem and  racey,    6 . Experimental   changes in daily activities, behaviours and
           inhibition of glial cells reduced the   pos sibly lameness. Owners may observe
           development of hyperalgesia associated with   changes such as aggression, withdrawal or
           myositis in rats (Chacur et al.,    9 .  mood changes and, in some cases, signs such as
                                                  inappropriate elimination or lack of grooming. It
                                                  may not be obvious on initial presentation that
            yofascial trigger points    rPs , de ned as  a   some of these signs are related to pain.
           hyperirritable spot in skeletal muscle that is   A comprehensive and methodical history-
           associated with a hypersensitive palpable   taking and clinical examination are of the
           nodule in a taut band’ (Dommerholt et al.,   utmost importance.
              6  may contribute to the overall pain    here are a small number of pain
           experience of patients with musculoskeletal   assessment tools  PA s    igure 4.1  that can
           disease. In humans, such points exhibit   be used to help the owner and vet describe
           characteristic ultrasonographic,       the maladaptive pain that the dog is
           electromyographic, biochemical and clinical   experiencing and these can also help in
           features (Dommerholt et al.,    6; Shah et al.,   monitoring the response to treatment. Pain
              8; Sikdar et al.,    9 .  he presence of   assessment tools should ideally be able to
           active   rPs correlates with a higher intensity   cover the various domains of chronic pain, and
           of ongoing pain in women with OA of the knee   include changes in movement, posture, and the
           (Alburquerque-García et al.,   1  .  here is no   emotional aspects.



            Pain assessment tool  Validation and examples of   Comments
                            use
            Liverpool         alton et al.,        •  Owner questionnaire
            Osteoarthritis in Dogs              •  23 questions using a 5-point Likert scale
             uestionnaire  L A                  •  Questions cover lifestyle and mobility
            Canine Brief Pain   (Brown et al.,        •  Owner questionnaire
            Inventory  CBPI                     •      uestions on an    point        numerical scale
                                                •  Questions cover pain severity and pain interference
                  Pain assessment tools for maladaptive pain in dogs.  oL    uality of life.  continues

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