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Review
. 2019 Nov 18;7(1):43-54.
doi: 10.1080/23144599.2019.1680044. eCollection 2019.

Review of different methods used for clinical recognition and assessment of pain in dogs and cats

Ismael Hernandez-Avalos  1 , Daniel Mota-Rojas  2 , Patricia Mora-Medina  3 , Julio Martínez-Burnes  4 , Alejandro Casas Alvarado  2 , Antonio Verduzco-Mendoza  5 , Karina Lezama-García  2 , Adriana Olmos-Hernandez  5
Affiliations
Review

Review of different methods used for clinical recognition and assessment of pain in dogs and cats

Ismael Hernandez-Avalos et al. Int J Vet Sci Med. .

Abstract

In light of the need to perform surgical techniques and the importance of animal welfare because of acute pain, the objectives of the veterinary anaesthetists are to manage muscle relaxation and adequate analgesia in order to conserve a balance in the autonomic nervous system, enhance the action of the parasympathetic system in the face of the emerging action of the sympathetic portion provoked by the surgeon, and maintain a balance among them. The aim of the present review is to describe different evaluation criteria for acute pain using unidimensional and multidimensional scales, correlating these findings to parasympathetic tone activity (PTA) and bispectral index (BIS) assessment, to conduct an objective evaluation of pain that patients (dog or cat) perceives, in order to administrate an adequate analgesic treatment in each case. In conclusion, this integral, objective evaluation will allow veterinarians - especially anaesthesiologists - to improve the management of pain in the patients.

Keywords: Analgesia; acute pain; animal welfare; bispectral index; cats; dogs.

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Figures

Figure 1.
Figure 1.
The nociceptive pathway transmits, modulates and integrates signals at different levels of the nervous system, from peripheral nociceptors to higher brain centres (thalamus and cortex). Own elaboration, using information from Stafford [32]; Lemke [33].
Figure 2.
Figure 2.
Diagram of the pain pathway. Own elaboration, using information from Lamont [34].
Figure 3.
Figure 3.
(a) Third eyelid protusion, miosis and messy coat are clinical signs of pain in cats. (b) Avoiding contact or isolating themselves are classic manifestations of stress and pain in cats; coprostasis and anorexia may also be present during painful experiences. (c) Depression, reluctance to move, loss of appetite, and disinterest in surroundings are typical signs of pain in dogs. (d) Dogs with acute abdominal pain commonly adopt an unusual posture, known as the “prayer position”. Own elaboration, using information from Reid et al. [54]; Essner et al. [56].
Figure 4.
Figure 4.
A PTA monitor, which uses the ECG signal to evaluate heart rate variability as a non-invasive method for assessing the autonomic nervous system. Recordings are characterized by two components: low frequencies (LF) (0.004–0.15Hz) influenced by the sympathetic system, and high frequencies (HF) (0.15–0.5Hz), which are related only to parasympathetic activity. In the image, the PTA interpretation concluded that the patient was not feeling pain. Own elaboration, using information from Aguado et al. [84].
Figure 5.
Figure 5.
Clinical interpretation of PTA values in dogs, cats and horses. Own elaboration, using information from Mansour et al. [14].
Figure 6.
Figure 6.
(a) BIS Monitor. In the image, a value of 91 indicates patient awareness after a surgical procedure, preventing an earlier extubating time. (b) BIS device consisting of an adhesive electrode sensor strip placed on the patient’s forehead. Own elaboration.
See this image and copyright information in PMC

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