210 Pinebush Rd., at the corner of Pinebush & Franklin.

Pets Deserve Pain Medication Too!

February 21st, 2018 Posted in Uncategorized

From Dr. Langlais’ column in The Record
November 20, 2007

Mrs. Brown, who owns a cat named Hurley, thinks I’m an idiot.

She felt Hurley did not need any pain medication after his surgery. I told her that castrating a cat is a painful procedure and, in my opinion, Hurley should have some.

Mrs. Brown (not her real name) retorted that her previous dogs and cats did not get anything for pain after being spayed and neutered, so why should Hurley? She thought it was ridiculous that I was prescribing something for her to give him after he got home.

Yes, until fairly recently, vets did not recommend post-op analgesics for animals. Our profession wrongly felt that our patients did not feel pain. Or at least not to the extent that humans do.

We were wrong. Science has shown us that. Studies have been done to prove that animals do feel pain. And why not? They have the same anatomical structures that we have. They have nerves, blood vessels, skin, a heart, lungs, livers, and so on. How could we think that they were so anatomically and physiologically similar to us and yet not feel what we do?

I remember the old days when my patients would have “stormy” anesthetic recoveries. They would thrash or vocalize. We assumed it was the anesthetic and that they were just hallucinating. However, when we started instituting better pain management protocols for our surgical patients, we noticed that these kinds of wake-ups became less common. In hindsight, those pets were in pain!

One of the things that convinced me animals are more uncomfortable after surgery than we realize was a “hidden video” shown to my staff and I by a pharmaceutical representative. The video showed two dogs after a routine surgery. One was given pain medication, one was not. Both were wagging their tails and appeared happy whenever someone came into the room. However, when no one was around, the video showed a different story. The dog who had received medication slept peacefully throughout the night but the dog that did not get any was restless and obviously uncomfortable. That video made a strong impression on all of us.

I asked one of my friends, who had a vasectomy, if he was sore after the procedure. He told me not at first, but once the drugs that had been given at the clinic wore off, the pain was horrible. He was glad to have some oral medication to take for the first few days. Castrating a cat is certainly a bigger procedure than a vasectomy, in my opinion, so how can we say they won’t hurt after the surgery? Why shouldn’t they have something to make them feel better too?

I don’t think the rationale that we used to do things a certain way is a good reason to continue to do so. Many many years ago cats were castrated by sticking their heads into a rubber boot and cutting their testicles off without any anesthetic. Yes, it was done that way and yes, it worked. But it was cruel.

Perhaps in some cases we may be overmedicating, but I would rather err on the side of caution than to let an animal feel pain. A dog and cat will not tell us it is feeling badly. Animals have been programmed to hide signs of pain as a survival mechanism. Survival of the fittest is the way of the wild. Our pets have retained that instinct.

I am pleased to say veterinary medicine has evolved and that we are learning how to do better on an ongoing basis. We are now at a point where we can offer the same level of care that we receive for ourselves.

Dogs and cats can now get pre-emptive pain medication. This means we give them something even before we start the procedure, to prevent windup pain. If we give the medication before the nerves are given a stimulus to “make them angry,” they do not react as much and we do not have to give as high of a dose post-op to calm them (the nerves) down. And, the drugs are already in effect when the patient wakes up.

Veterinarians are also using multi-modal pain management. We can use NSAIDs (non-steroidal anti-inflammatory drugs), local anaesthetics, and narcotics to give better effect than any of these pharmaceuticals given alone. Our patients are much more comfortable once they wake up and their anesthetic recoveries are very smooth.

Hooray for progress.

For his neuter surgery, Hurley got a mild narcotic and an NSAID as pre-op injections. I also infused some local anesthetic into his incision, to provide six to eight hours of “freezing,” so he would feel OK when he woke up. I prescribed an additional few days of pain medication, to make sure he was also comfortable once he went home. I’m not sure if Mrs. Brown gave it to him, and I lost a client by advocating for Hurley, but at least I did what I thought was right.

Note: Not all veterinarians feel the same way about pain medication for pets. Some feel the same way Mrs. Brown does. Others may give medications after the surgery, but none beforehand as pre-emptive pain management. Make sure you ask before you assume your pet is getting what it needs and deserves. Not all clinics practice the same level of medicine. And unfortunately, some clinics offer inexpensive spays and neuters because they’re doing something to cut costs.

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