Page 159 - BSAVA Guide to Pain Management in Small Animal Practice

BSAVA Guide to Pain Management in Small Animal Practice

VetBooks.ir care professional who are termed proxy invasiveness within sites including body
cavities, soft tissues, bone and nervous tissues
informants a back and antoni, .
may re uire both physical examination and
Cancer associated pain may also be complex in
nature and may be persistent or intermittent. advanced imaging studies igure 7.19 .
ue to such challenges, it can be assumed that
cancer associated pain is potentially under
diagnosed and therefore under treated
a back and antoni, .
A number of factors can be assessed to
help to predict the occurrence of pain in
veterinary patients a ected by cancer

■ umour type and location
■ Presence of co morbidities
■ ccurrence of paraneoplastic e ects
■ herapies and associated side e ects
■ Inference from human reporting.
Patient history and physical
examination (a)
he owner interacts with their pet every day and
can describe changes in behaviour or personality
that may indicate the presence of pain. It is
important to recogni e that the species, age,
breed and personality of the individual animal
may in uence the expression of these
behaviours. urthermore, some behaviours may
occur spontaneously and others may be evoked
by physical examination; and some may occur
fre uently and others rarely ansen, . See
Chapter and Appendix 1 for information on pain
assessment tools.
anagement of the veterinary cancer
patient typically involves repeat visits and
re examinations. his positions the clinician
ideally for two way communication with the
owner and for fre uent pain reassessment. his
highlights the value of one single clinician or a
clinician and veterinary nurse within the practice
being assigned to the management of an
individual cancer patient throughout its care, if
possible.

Tumour type and location (b)
umours that exhibit invasive or destructive umours associated with ulceration,
growth, or are associated with necrosis igure necrosis or in ammation are likely to
7.18a , ulceration igure 7.18b or in ammation be painful. (a) issue necrosis secondary to dermal
lymphatic invasion of an in ammatory mammary
are likely to be associated with signi cant pain. carcinoma in a ungarian Visla. (b) An ulcerated oral
Assessment of the degree of tumour tumour in a crossbreed dog.
154

Ch7H Pain Management.indd 154 19/12/2018 10:45