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an unpleasant sensory and emotional experience associated with actual or potential tissue damage
What are the two different results of pain?
What are some benefits for an animal experiencing pain?
- limit exposure to situations that damage tissue
- learn to avoid the situation in the future
What is pathologic pain? Is pathologic pain detrimental or beneficial?
- pain that is produced by tissue injury, inflammation, or direct damage to the nervous system
Is unrelieved pain a stressor? What does it do to the body?
- triggers sympathetic nervous system, including the release of cortisol
- slows recovery and healing
- produces a catabolic state (tissue breakdown)
What does detrimental pain trigger?
exaggerated inflammatory response
Does detrimental pain increase blood pressure?
Do anesthetized animals experience conscious pain?
Even though anesthetized animals do not experience conscious pain, what still happens?
their nociceptors (pain receptors) are stimulated by surgery
What will happen if a patient does not receive pain medication before surgery?
they will be in more pain when they recover
Do nociceptors fatigue with continued stimulation like owther sensory receptors do?
What happens to a nociceptor that is continuously stimulated? What does this result in?
- it transmit a nerve impulse every time
- develops increased sensitivity by lowering the pain detection threshold
- this results in heightened pain sensation (hyperalgesia) and can lead to long term pain and debilitation
What is acute pain? How long does it last?
- relatively short pain
- lats minutes, hours, days, sometimes weeks but goes away as tissue heals
Does acute pain happen suddenly?
yes and is localized to the affected site
Does acute pain usually have an identifiable cause?
What can acute pain be associated with?
soft tissue trauma or inflammation assoicated with surgery, injury, or disease
Is acute pain a warning sign?
What is chronic pain?
pain that persists beyond the time required for healing after tissue trauma or is associated with chronic or degenerative disease
Is chronic pain have a sudden onset or a more gradual onset?
Can chronic pain be continuous or sporadic?
What are some common causes of chronic pain?
- degenerative disk disease
Is chronic pain debilitating?
yes, provides no survival advantages
What is "wind up"?
when spinal neurons are subjected to repeated or high-intensity nociceptive impulses they become more and more excitable and take less to "set them off"
What is "central sensitization"?
these neurons remain excitable even after the painful stimuli stop
Because of wind up, untreated acute pain can lead to _____.
Which is harder to treat, chronic pain or acute pain?
Is pain easy to assess in an animal patient?
- no, they can not talk and tell us how bad it hurts
- the owner will usually be the best judge of the level of pain the animal is in
How do we do an assessment of pain on a patient?
- do a good PE
- be familiar with the behavior of the species, breed, and individual
- know the degree of pain to expect with particular surgical procedures and illnesses
- recognize the behavior and physiological signs of pain
Do some animals hide pain? Why or why not?
yes, survival mechanism or may not act painful around to people because they want to please them
What are some examples of procedures/conditions that we can anticipate being severe pain?
- cervical disc herniation
- extensive inflammation
- fracture repair
- limb amputation
What are some examples of procedures/conditions that we can anticipate being moderately to mildly painful?
- cruciate repair
- laparotomy (including spays)
- mass removal
- dental procedures
Do we need "proof of pain" before we start treating pain?
no anticipate the level of pain the procedure may cause and treat the animal before it becomes painful
What are some patient behaviors that indicate pain?
absence of normal behavior
What is the most dependable gauge of an animals pain?
the animal's response to analgesic therapy
What are some ways dogs and cats express pain?
- facial expression
- self- awareness
- response to palpation
- withdrawing, scratching, escaping
What are some ways a dog vocalizes when they are in pain?
What are some facial expression a dog gives that expresses pain?
- fixed stare
- glazed appearance
What does a dog do that is considered "self-awareness" when they are experiencing pain?
- protecting wound or limb
- licking, chewing or rubbing wounds, surgical site or painful area
What is the dogs activity like when they are painful?
- restricted movement
What is the dogs attitude like when they are painful?
- increased aggression
What is a dogs appetite like when they are painful?
What happens to a dog's housetraining when they are painful?
- increased urination
- decreased frequency of urination
- failed housetraining
What is a dog's posture like when they are painful?
What are some ways a cat vocalizes when they are in pain?
What are some facial expression a cat gives when they are in pain?
- furrowed brow
- squinting eyes
What does a cat do that is considered "self-awareness" when they are experiencing pain?
- protecting wound or limb
- licking, chewing, or rubbing wounds, surgical site, or painful area
What is the activity level like for a cat who is in pain?
- restricted movement
- repeated meaningless movements
What is the attitude of a cat like when they are in pain?
What is the appetite like for a cat who is in pain?
What happens to housetraining for a cat who is in pain?
failure to use the litterbox or go outside
What is grooming like for a cat who is in pain?
- failure to groom
- unkempt appearance
What is the posture like for a cat who is in pain?
- lying on chest or abdomen
What are the physiologic signs of pain?
- sympathetic stimulation
- clinical signs
What is sympathetic stimulation?
pain, especially acute pain, activates the symathetic nervous system - fight or flight physiologic responses
What are some clinical signs of pain?
- increased heart rate and blood pressure
- peripheral vasoconstriction (blanched mucous membranes)
- increased respiratory rates
- muscle splinting
- stress leukogram
- dilated pupils, anxiety, fear
What should be our pain management plan?
- start pain meds as soon as possible
- use more than one class of analgesics
- provide adequate analgesia
- evaluate patient's response to analgesic treatment
- provide analgesia for the expected duration of pain
When is acute pain (due to surgery, trauma, and disease) the most intense?
during the first 24 - 72 hours following tissue injury