'The strain of pain lies mainly in the brain'
More than half of the behaviour cases referred to Samantha are pain-related.
In more than 50 per cent of the behaviour cases referred to Samantha Lindley, pain is found to be the cause of the patient's behavioural issues, she revealed during a lecture at BSAVA Congress today.
While it does not necessarily follow that over half of the behaviour cases seen in practice are pain-related, "this is still a scary statistic", she added.
Delegates attending the packed nursing lecture were encouraged to consider pain in the assessment of behaviour cases, even cases where there is no obvious lameness or dysfunction, bearing in mind that an examination that finds no pain does not mean there is no pain.
A medical component should be considered when the behavioural change is sudden in onset or when the behaviour is genuinely unpredictable or extreme for the breed, age or temperament of the individual dog.
Most cases of pain-associated behaviour seen in practice will be due to chronic pain, Samantha explained, which is defined as pain that continues after healing and has been present for an arbitrary period of time. Unlike acute pain, which is necessary and life saving in highlighting a medical problem, chronic pain is not useful.
Pain is divided into several components, two of which are sensory pain (no emotional quality) and emotional pain, which is linked to suffering and involves the limbic system. As you can have one without the other, it is worthwhile differentiating between the two.
Describing pain is almost impossible and vets and nurses have the added challenge of assessing pain levels in patients with no verbal communication, something on which we are heavily reliant. Deciding on the appropriate use of analgesics would not be a problem "if we could say absolutely how much pain our patient is suffering," Samantha noted.
However, "animals tell us loud and clear that they have a problem but we are not always looking," she added, though interpreting the signs involves a continual learning curve and Samantha said she is "still discovering new behaviours associated with pain."
The types of behaviour shown will be affected by the quality and severity of the pain. Furthermore, pain levels are affected by the temperament of the animal, past experiences and socialisation and the opportunity to do something about the pain.
Without the ability to escape or modify the situation, pain becomes much more frightening. As the saying goes: "The strain of pain lies mainly in the brain."
The RCVS has announced a new version of its 1CPD mobile app, with enhanced features for veterinary surgeons and veterinary nurses to record their continuing professional development.
