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Pain management involves considering pain, recognising pain, and managing pain. Part One looked at assessment and recognition of pain. This discussed the physiological and behavioural signs that ca...

Pain management involves considering pain, recognising pain, and managing pain. Part 1 looked at assessment and recognition of pain. This discussed the physiological and behavioural signs that can ...

Pain management involves considering pain, recognising pain, and managing pain. This three-part article will focus on recognition and management of pain in rabbits. Part One (this article) will loo...

Patients that are in the fifth life stage (end-of-life) often present with multiple problems, which makes them challenging cases. Often, these patients are very vulnerable, and this is sometimes overlooked. This article aims to provide a brief and basic overview of looking after the end-of-life patient, whether at home or in hospital, by utilising a framework adapted from the 2016 International Association of Animal Hospice and Palliative Care, and American Animal Hospital Association Guidelines (IAAHPC/AAHA).

Pain is an under-recognised, under-diagnosed and under-treated condition in animals. Chronic pain is a significant welfare concern in our fifth life stage (or end-of-life) veterinary patients. This article aims to look at three common conditions that can adversely affect end-of-life patients: osteoarthritis, dental disease, and cancer. It will then look at how the pain in these conditions can be effectively addressed and managed.

Reptiles are very likely to have the same pain experience as mammals, as the structures involved with nociception and processing are homologous. However, there is a big difference in expressive beh...

Pain assessment and management in animals is still a new and growing field of research. Although it is still early days for pain research in birds, this article aims to provide information on the p...

Without the ability to effectively recognise pain and assess its severity in animals, there is no way of assessing the efficacy of analgesia administered. Therefore, we have no way of ensuring that pain is adequately managed. Despite the extensive use of rodents in medical research that often involves the assessment of pain and distress, translation of this knowledge to veterinary medicine has been relatively neglected, and original veterinary research in pain assessment in rodents is lacking. This article aims to provide a broad overview of common behaviours that could be used to assess pain in rodents.

[Graphic][1] Aneesa Malik qualified as a veterinary nurse from Warwickshire College in 2008. Her main interests include veterinary ethics and welfare, emergency and critical care patients, end of life care and exotics. #### The dilemma Your veterinary practice has been presented with an orphaned grey squirrel that was found by a member of the public. On examination, you estimate the squirrel to be four weeks old – it weighs 60 g and its eyes are not yet open. It has no visible injuries and is well hydrated. The squirrel has a good chance of being successfully hand-reared to adulthood and could subsequently be released back into the wild. The wildlife rescue centre that you have taken squirrels to in the past is experienced in hand-rearing grey squirrels and has an almost 100 per cent success rate with squirrels of this age surviving until they are old enough to be released. However, they recently had their licence to release grey squirrels revoked, in accordance with the Invasive Alien Species (Enforcement and Permitting) Order (2019). What should you do next? Grey squirrels can be syringe-fed a kitten milk replacement every two hours, toileted, and kept warm until their weaning age – between 10 to 12 weeks – before then being gradually introduced to a natural diet. Juveniles can be transitioned gradually to … [1]: /embed/inline-graphic-1.gif

[Graphic][1] Aneesa Malik qualified as a veterinary nurse from Warwickshire College in 2008. Her main interests include ethics and welfare, emergency and critical care patients, end of life care, and exotics. #### The dilemma It is a busy morning in the clinic and the vet asks you, the practice nurse, to weigh a pet shop-owned Syrian hamster who, for the past two months, has been suffering from intermittent diarrhoea and conjunctivitis. The vet decides that it is best to calculate another course of antibiotics and send it back to the store. During your examination, the patient feels cold, is skin tenting, facially grimacing, reactive to abdominal palpation and her back end is stained and wet. She is bradycardic, hypothermic and has lost 13 per cent bodyweight since her last visit. You believe that the patient is sick and requires urgent attention. The vet has limited skills, interest and knowledge with exotic species, and, in addition to this, the practice is understaffed and ill-equipped for such cases. You explain to him that the … [1]: /embed/inline-graphic-1.gif

Analgesia is underused within the small animal veterinary clinic (Flecknell, 2008), despite the fact that all of the commonly presented conditions are painful (Nielson, Dean, Robinson, Massey, & Br...

Concerns over interactions between analgesics and experimental outcomes are a major reason for withholding opioids from rats undergoing surgical procedures. Only a fraction of morphine injected intravenously reaches receptors responsible for analgesia in the central nervous system. Intrathecal administration of morphine may represent a way to provide rats with analgesia while minimizing the amount of morphine injected. This study aimed to assess whether morphine injected intrathecally via direct lumbar puncture provides sufficient analgesia to rats exposed to acute surgical pain (caudal laparotomy).In an initial blinded, randomised study, pain-free rats received morphine subcutaneously (MSC, 3mg.kg-1, N = 6), intrathecally (MIT, 0.2mg.kg-1, N = 6); NaCl subcutaneously (NSC, N = 6) or intrathecally (NIT, N = 6). Previously validated pain behaviours, activity and Rat Grimace Scale (RGS) scores were recorded at baseline, 1, 2, 4 and 8h post-injection. Morphine-treated rats had similar behaviours to NaCl rats, but their RGS scores were significantly different over time and between treatments. In a second blinded study, rats (N = 28) were randomly allocated to one of the following four treatments (N = 7): MSC, 3mg.kg-1, surgery; MIT, 0.2mg.kg-1, surgery; NIT, surgery; NSC, sham surgery. Composite Pain Behaviours (CPB) and RGS were recorded as previously. CPB in MIT and MSC groups were not significantly different to NSC group. MSC and MIT rats displayed significantly lower RGS scores than NIT rats at 1 and 8h postoperatively. RGS scores for MIT and MSC rats were not significantly different at 1, 2, and 8h postoperatively. Intraclass correlation value amongst operators involved in RGS scoring (N = 9) was 0.913 for total RGS score. Intrathecal morphine was mostly indistinguishable from its subcutaneous counterpart, providing pain relief lasting up to 8 hours in a rat model of surgical pain. Further studies are warranted to clarify the relevance of the rat grimace scale for assessing pain in rats that have received opioid analgesics.