Anesthesiology & Pain Management

Pain management in small animal medicine is one of the fastest growing areas of revenue. Veterinarians should be knowledgeable about pain management because not only is it good medicine, clients think we already know about it and are doing something for their pets, our technicians are talking to each other about pain and our treatment of it.

Although age itself is not a disease, advanced age can be a predictor for increased risk of certain disease conditions. Additionally, as our patients age, normal changes occur in their physiology that can change their responses to anesthesia and analgesic medications as well as potentially put them at higher risk of peri-anesthetic complications.

Anesthesia of the pregnant dog or cat falls into two categories, anesthesia of a pregnant animal for a procedure unrelated to the pregnancy and anesthesia of a pregnant animal specifically for a problem related to the pregnancy/cesarean section. Anesthesia of a pregnant animal for procedures unrelated to the pregnancy is often not problematic unless the animal is in a compromised state.

Pain management is a win/win situation for both the patient and the practice. The appropriately analgesed patient has a better quality of life and heals faster, while the practice increases profits and client satisfaction. There is no negative impact of good pain management in the practice and every practice should strive to have the best pain management practices possible.

Help clients understand exactly what's involved before their pet undergoes a surgical or dental procedure.

Dr. Susan Little discusses pain management for cats that undergo onychectomy.

Dr. Mark Epstein reviews local blocks and strategies for effective administration.

Signs of intervertebral disk disease in dogs.

Making pet owners a part of the team.

Adopting a pain management culture can benefit all stakeholders involved in patient care.

In this online on-demand archived Webinar, Fred Metzger, DVM, DABVP, discusses preanesthetic testing best practices and the medically sound reasons for same-day, fasted results to minimize risks, protect your patients against adverse anesthetic events and speed up patient recovery time. (1 CE credit)

A novel form of pain relief for canine osteosarcoma.

Which local anesthetic is best for shorter surgical procedures?

Veterinary pharmacologist Dr. Butch KuKanich gives his thoughts.

Dr. Mark Epstein gives his thoughts on feline pain management.

Let go of these popular misconceptions about opioid use in veterinary patients.

An important consideration for feline onychectomies.

Dr. John Dodam outlines necessary considerations when dealing with the anesthetization of pregnant animals.

What is pain? Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. All potential and actual tissue damage in animals should be considered to cause pain. Pain can be experienced with or without accompanying signs of stress (e.g., tachycardia, hypertension). The first step in treating pain is to recognize the signs and symptoms.

Anesthetizing a patient with cardiac disease requires a plan for the use of supportive measures to maintain adequate tissue perfusion. As in the case of left sided cardiac dysfunction patients, volume administration frequently is not an option to support blood pressure. In these cases, should a positive inotropic or pressor agent be indicated, the volume of the adjunctive agent required should be deducted from the volume of crystalloid administered to maintain a balanced hourly rate.

What is pain? Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. All potential and actual tissue damage in animals should be considered to cause pain. Pain can be experienced with or without accompanying signs of stress (e.g., tachycardia, hypertension). The first step in treating pain is to recognize the signs and symptoms.

The palmar digital nerves are blocked by injecting up to 2 ml of anesthetic over the nerves, along the edge of the DDFT. Much discussion has taken place regarding the proximal to distal level that the injection should occur. The PDN can be blocked anywhere from the proximal margin of the collateral cartilage to the mid pastern region.

As with any trauma patient presented to triage, a thorough pre-operative assessment must be performed and patient assessment begins with the first step inside the door. The traumatized patient will have altered physiological responses that will in turn alter the pharmacokinetics of the agents commonly used to provide anesthesia.

An introduction to the principles of clinical blood gas analysis and interpretation--including two case examples.

An 8-year-old 44-lb (20-kg) spayed female Siberian husky is a poorly regulated diabetic presenting for surgical excision of a grade I fibrosarcoma on the right thoracic wall.

A 5-year-old 37.6-lb (17.1-kg) neutered male border collie has a three-day history of vomiting.

To make a hands-free anesthesia face mask, we place a soft dog muzzle over the front of the mask and then attach the anesthetic hose to the front.

Patient stress is probably a contributing factor in some cases of adverse patient outcome. Stress during induction of anesthesia can increase circulating catecholamine concentration predisposing the heart to arrhythmias.

The capnograph is a noninvasive monitoring device that can provide information on ventilation (pulmonary function), blood flow, and equipment function. Knowledge of respiratory and cardiovascular physiology is essential to the understanding of capnography.

The presence of disease has been shown to be positively associated with increased anesthesia-related mortality. Indeed, the possibility of rapid decompensation when sedative or anesthetic drugs are administered in the presence of respiratory disease makes anesthesia in these patients particularly challenging.