Mark Papich, DVM, MS, Diplomate ACVCP & Lisa Posner, DVM, Diplomate ACVA
Tuesday, January 20 • 1:45-2:35, Gaylord
Pain control is humane, ethical, and contributes to decreased morbidity, decreased mortality, and earlier return to function. Acute pain is associated with tissue repair and readily responds to most medications. Chronic pain lasts longer than 3 to 6 months and is associated with a highly attenuated neuroendocrine response; as a result, it is not as readily responsive to medications. Neuropathic pain is associated with nerve damage and altered neurologic sensory processing. Referred pain is complex and is usually related to visceral pain. Pain results in physiologic stress responses with generalized increases in sympathetic tone. Animals in pain have greater morbidity and mortality rates. Therefore, it is medically beneficial to eliminate pain. Analgesic drug categories include opioids, nonsteroidal antiinflammatory drugs, α-2 agonists, and local anesthetics. Other useful drugs include tramadol, gabapentin, NMDA-receptor antagonists, acepromazine, bisphosphonates, palliative radiation, and preemptive and multimodal analgesia. Different therapeutic combinations are used in various clinical conditions, and such targeted analgesic treatment unique to disease type must be part of an overall therapeutic plan for our patients.
COMMENTARY: Pain is a multifaceted, individualized experience and beyond that, is not static. This article provides an excellent overview of the strategies available for "rescuing" a patient in which monotherapy no longer alleviates pain.