Page 102 - BSAVA Guide to Pain Management in Small Animal Practice

6 | Physical methods used to alleviate pain: nursing considerations

VetBooks.ir guide treatment and recommendations for discussed during the consultation. Salivating, lip
Nausea and side e ects should be
geriatric or chronically painful patients; see also
licking, eating more grass, yawning, stretching,
Chapters 4 and 7g.
pica, and coprophagia may all be signs of
■ A analgesia. nausea. Cats experiencing nausea tend to
■ B bodyweight and body score. become anorexic whereas dogs often keep
■ C comfort, compliance, common sense, eating. Owners must also look out for side
complications, core territory. e ects of analgesic therapies. Combinations of
■ disease modi cations. drugs may be prescribed and the
■ E exercise, environment enrichment. pharmacokinetics/pharmacodynamics may be
unknown. Some drugs are psychoactive so will
Each of these categories are outlined in in uence behaviour, anxiety and disinhibition.
more detail below. While veterinary surgeons are responsible
for prescribing drugs, veterinary nurses can
Analgesia explain the reason for prescription and correct
Analgesia tends to form the cornerstone of use of the drugs, side e ects, licensing and
treatment in chronic pain cases. Educating further information where human drugs are
owners about all the options available, and used and repurposed.
informing them that it may take some time to
nd the right balance for their pet, is important. Analgesia checklist

■ Pharmaceutical therapies see Chapter . ■ Start simple but prepare the owner for
■ Physical therapies, for example acupuncture the possibility of multiple interventions.
igure 6.11; see also Chapter 6b , ■ Listen to owner concerns about
transcutaneous electrical nerve stimulation medication types (they may have
(TENS), physiotherapy, hydrotherapy and personal experience or friend/family
laser therapy. who experienced negative e ects .
■ Interventions, such as platelet rich plasma ■ Listen for signs of misunderstanding
injections and stem cell therapy. ‘aren’t we just masking the pain?’
■ er physical interventions with positive
associations gentle touch, gentle
massage at hand , gentle stretching.
■ Establish clear targets of treatment.

PRACTICAL TIP
Pain is a stressor and causes all the same
physiological changes as chronic stress.
This is important to communicate to owners
as most will understand the detrimental
effects of stress
Bodyweight and body score
When deciding if a patient is under- or
Author performing acupuncture in an overweight it is important to also consider fat
elderly Greyhound. A thick mattress is used and muscle distribution. Adipose tissue is well
for comfort. The patient is calm, unrestrained and does established as an endocrine gland that
not need sedation. Veterinary nurses can perform
acupuncture under the direction of a trained veterinary produces adipokines. Adipokines possess pro-
surgeon. and anti in ammatory properties that play a

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