Implementing Pain Scoring in Cats

Because cats cannot verbally communicate their pain, assessing pain in cats falls to human caregivers. To do that accurately, validated pain scoring systems should be used; however, these systems can be cumbersome and hard to implement.

In this study, data were distilled from 2 validated feline pain scoring systems (ie, UNESP-Botucatu Multidimensional Composite Pain Scale, Glasgow Feline Composite Measure Pain Scale) and applied to a process that can be easily implemented and sustained in practice. Considering normal cat behavior when assessing cats after painful insults (eg, surgery, trauma) is key; clinicians should compare preinsult behavior with postinsult behavior. Abnormalities in posture, attention to the wound or incision, facial expressions, response to petting, and response to gentle palpation of the wound or incision should also be considered.

With pain scoring systems, analgesic protocols should not be assumed to be adequate; the assessment of the individual cat should determine adequacy of pain management. Pain perception also differs among individual patients; thus, even with adequate analgesic protocols, pain relief may not be achieved in all patients and additional analgesic management may be necessary.

Key pearls to put into practice:

Veterinary nurses should be encouraged to assign pain scores to every cat and discuss the scores with the clinician. Changes in behavior following a painful insult (eg, surgery, trauma) are the main indications that a cat may be painful; veterinary nurses generally tend to spend the most time with patients and thus may be best at assessing behavior changes.

Not all changes in behavior or other scored components (eg, body posture) are indicative of pain. To eliminate or decrease confounders, palpation should be gently performed around the painful site and the patient observed for a behavioral reaction.

The techniques described in this paper should be used to assess pain, but staff should also use their intuition with individual patients and administer analgesic drugs if needed, even if the pain score is in range. These scoring systems are guidelines; the final decision on whether to treat should be based on the veterinary team’s understanding of the patient.