Pain management clinics are becoming more common and increasingly popular with owners of animals suffering with chronic pain. In recent years, there has been more research into the physiology of pain, as well a wider variety of treatment options, meaning many animals could benefit from this type of service. What does a clinic involve and how can it help our pets?
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The widely used definition of pain is ‘an unpleasant sensory and emotional experience, associated with actual or potential tissue damage’. While it mostly has a protective function, if not well controlled it can lead to additional stress and suffering. Chronic pain can be particularly debilitating to an animal’s life and can be difficult to manage.
It’s far more difficult to tell when an animal is in pain, as they can’t explicitly tell us. We tend to rely on behavioural changes, including:
- Limping and mobility changes
- Reduced appetite
- Lethargy and depression
- Hiding away
- Increased grooming
What is a pain management clinic?
The aim of these types of clinics is to provide gold standard care for patients with chronic painful conditions, using a multi-modal approach. Pain clinics are often run out of referral hospitals, generally by the anaesthesia team, with specialists in Veterinary Anaesthesia and Analgesia, working alongside orthopaedic, neurology, imaging and physiotherapy teams to provide bespoke treatments for each patient.
What happens during a consultation?
The initial consultation will involve taking a really thorough history to get a good picture of what kind of pain an animal is experiencing. This includes exercise regime, diet and current medications. A thorough clinical examination will also be performed. It is also important during the consultation to discuss the owner’s expectations
Depending on the patient, they may need frequent rechecks to make sure that their treatment plan is working for them, but this may reduce down once an animal is stable. Managing chronic pain can be a bit of a journey, but the clinician will guide you throughout.
Which animals could benefit from a pain clinic?
These clinics may be useful for a variety of reasons, including:
- Chronic conditions like osteoarthritis, pancreatitis and back pain
- Neuropathic (nerve-related) pain
- Mobility issues and other age-related changes
- Pain associated with cancer
- Aiding in recovery from surgery, particularly orthopaedic surgery
What treatment options are available?
Pain clinics tend to take a ‘multi-modal’ approach, meaning that several treatment approaches will be used in conjunction with each other.
There are several types of medication that can be used in the management of chronic pain. What works for one animal may not work for another. Any previous treatments will be taken into account. Doses and medications used may need to be altered over time depending on the animal’s response. More advanced treatment options include regional nerve blocks and spinal injections.
This adjunctive therapy has got more and more recognition in modern medicine. Research suggests acupuncture works by stimulating repair mechanisms in the nervous system, immune system, and hormonal and cellular systems. It may only be performed by an appropriately qualified veterinary surgeon. Often, clinicians that run pain management clinics are qualified to carry out acupuncture. Treatments often take around 30 minutes and may need to be repeated every 2-4 weeks.
Teams of qualified animal physiotherapists are experts in biomechanics, anatomy and physiology, and can aid in the management of chronic pain by encouraging normal movement of joints and muscle development. It may be particularly useful for joint conditions and in recovery from injury and surgery.
This may mean making changes within the home, such as ramps or rugs on slippery floors. Weight management may also be vital for an animal suffering with chronic pain. Specific diet may be recommended depending on the underlying cause of pain.
If you think your animal may benefit from a consultation with a pain management clinic, discuss this with your primary care vet first. If deemed appropriate, a referral can be made.