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Chapter 10 Management of Hospitalized and Boarding Pets 183

Learning Exercise

Bent coat hanger Describe the different techniques to catch a
voluntary urine sample from a dog and a cat. Do
you know of other methods? Share those as well.

Pain Evaluation
and Monitoring
Petri dish
FIGURE 10.17 Urine collection tool. Pain may or may not be a vital sign depending on the
authority cited. Regardless, alleviating pain and suffering
is an important and essential job within the veterinary
If a voluntary urine sample is required, a clean water profession. Uncontrolled pain can cause tachycardia,
dipper works well to collect the sample without disturb- tachypnea, and hypertension which in turn slows healing.
ing the patient. A voluntary sample is collected after the Various pain scales have been deployed to standardize
first bit of urine is voided. Slip the cup under the stream pain evaluation; however, no gold standard has come
without bumping the patient. For tiny dogs, you may forth. None are perfect for these reasons:
need to use a modified coat hanger with a Petri dish to 1. Pain can be chronic or acute. The longer the pain
catch the sample (Figure 10.17). lasts the more difficult it is to assess.
After you have collected the urine sample, transfer it
to a clean, dry container with a lid. Mark the patient’s 2. How pain is exhibited is influenced by the environ-
ment. Prey animals mask pain as a survival
name, date, and time of collection on the container, mechanism.
treatment board, and patient’s record. Put the samples 3. How pain is demonstrated varies by species, breed,
in the lab or refrigerator if the technician cannot get to sex, age, and the presence of fear.
it right away. Alerting the technician that there are sam- 4. Pain causes behavioral changes and can increase
ples available will always be appreciated. heart rate, respiratory rate, arterial blood pressure,
Cat samples are easier to gather because of their use
of a litter pan. A fecal sample can be sifted from the litter and cause pupil dilation.
using the litter scoop or using a gloved hand to gather a If your workplace uses a specific pain assessment evalua-
piece and place it into a bag. Tie the opening shut with tion, then memorize it and apply it to all patients.
an overhand knot and label it with name, date, and time. Usually, veterinarians and technicians are responsible
Put the sample in the lab or the lab refrigerator and for scoring a patient’s pain level, but assistants are vital in
mark the treatment board and record. If a urine sample recognizing symptoms of pain because of their continued
is required, a little more preparation is involved. Clean, interactions within the wards.
tiny beads are used to replace the litter in a clean litter Pain evaluation is a very subjective observation and
pan. This is usually left in the kennel only as long as it prone to error. Lack of change in a patient’s behavior
takes to catch a sample. Once the cat has urinated a does not mean pain is absent. A key thought to keep in
strainer is placed over a clean, dry container and the mind is if what is being done or was done would hurt you
litter box is tilted over the strainer to catch the beads and it hurts the animal. If you see what you think is an animal
allow the urine to run into the container. If the strainer in pain consult with the veterinarian or technician. It is
is large you may dump all the beads into it; however, you always best to error on the side of caution than to let an
may lose some of the sample as well, so go slow enough animal suffer.
to allow the urine to flow into the container. Once you In order to alleviate pain, we must first recognize it by
have the sample, tighten a lid on top of the container, monitoring patient’s behavior during treatments and
label it appropriately, take it to the lab or lab refriger- while at rest. Changes in behavior can be subtle, so care-
ator, and mark the treatment board and record. The ful observation without letting the patient know you are
beads and strainer can be washed with a dish detergent, watching is often recommended. Some signs of pain
rinsed thoroughly, and allowed to dry before storing include diminished eating, drinking, and self‐grooming,
them in a container for use with another patient. Put a restlessness, reluctance to move or having difficulty
regular litter box into the kennel. If the cat defecated moving, recoiling from touch, shivering, vocalizing,
and urinated in the beads check with the veterinarian or mental depression, constant licking on an area, aggres-
technician to see if the urine sample is acceptable. sion, panting, and elevated vital signs. Facial expressions