2022 AAHA Pain Management Guidelines for Dogs and Cats

Abstract

These updated guidelines present a practical and logical approach to the assessment and management of acute and chronic pain in canine and feline patients. Recognizing pain is fundamental to successful treatment, and diagnostic guides and algorithms are included for assessment of both acute and chronic pain. Particularly for chronic pain, capturing owner evaluation is important, and pain-assessment instruments for pet owners are described. Expert consensus emphasizes proactive, preemptive pain management rather than a reactive, “damage control” approach. The guidelines discuss treatment options centered on preemptive, multimodal analgesic therapies. There is an extensive variety of pharmacologic and nonpharmacologic therapeutic options for the management of acute and chronic pain in cats and dogs. The guidelines include a tiered decision tree that prioritizes the use of the most efficacious therapeutic modalities for the treatment of acute and chronic pain.

Enflicoxib for canine osteoarthritis: A randomized, blind, multicentre, non-inferiority clinical trial compared to mavacoxib

“…The clinical metrology instrument used for the owner’s assessment, the CBPI, can assess response to treatment especially in chronic pain [ 58 , 59 ]. However, there is an element of inherent subjectivity which has been limited by keeping the owners also blinded to treatment to avoid any bias and by using this validated tool [ 44 , 45 ].…”

“…Moreover, similar veterinary assessment tools have previously been used in the evolution of NSAIDs efficacy evaluation [39][40][41][42][43] and the possible subjectivity has been minimised by maintaining the veterinarian always blinded to treatment. The clinical metrology instrument used for the owner's assessment, the CBPI, can assess response to treatment especially in chronic pain [58,59]. However, there is an element of inherent subjectivity which has been limited by keeping the owners also blinded to treatment to avoid any bias and by using this validated tool [44,45].…”

Perioperative pain management protocols of veterinarians in the United States for horses undergoing routine orchiectomy (castration)

“…Pain management guidelines for dogs and cats are provided by professional organizations in the US with regular updates. (Gruen et al, 2022) Evidence-based guidelines for equine analgesia, including perioperative analgesia for horses undergoing routine castration, were published by the British Equine Veterinary Association (BEVA) in 2020. (Bowen et al, 2020) These guidelines included recommendations for administration of pre-castration NSAIDs with a high level of overall certainty and administration of post-operative NSAIDs for at least 3 days after surgery with a moderate level of overall certainty.…”

A survey on anesthetic procedures for elective surgeries in small animal practices in Flanders

“…It should be stressed that providing analgesia in the peri-operative setting, even in minor surgical procedures, is important from an ethical point of view and because it improves patient recovery on the short and long term. Because of the inflammatory pain caused by the tissue injury, NSAIDs remain the mainstay of analgesia for acute post-operative pain relief (Berry, 2015;Gruen et al, 2022;Mathews et al, 2014). They should be administered for a duration that is in relation to the amount of tissue damage that was afflicted by the surgery.…”