5 – Behavioural Aspects of Pain

Question 1

Pain

Answer 1

• An unpleasant sensory and EMOTIONAL experience associated with, or resembling that associated with actual or potential tissue damage
• Verbal description is ONLY one of several behaviours (ex. if quiet does NOT mean they aren’t painful)

Question 2

Pain and behaviour

Answer 2

• Personal experience
• Affected by past experiences

Question 3

Spontaneous pain behaviours

Answer 3

• Usually always associated with changes in normal animal behaviour
• Difference between acute and chronic pain
• Owner’s assessment are valuable aids (knowing animal’s normal behaviour)

Question 4

Assessing pain behaviour is difficult in

Answer 4

• Stress
• Anxiety
• Fear
• Sedation

Question 5

Common observational indicators of pain are changes in:

Answer 5

1. Attitude
2. Appearance
3. Body posture
4. Orientation in cage/stall
5. Activity level
6. Locomotor activity
7. Facial expression
8. Vocalization

Question 6

Attitude

Answer 6

• Act out of character
• Irritable, aggressive
• Anxiety
• Depression
• Reclusive (non interactive)

Question 7

Attitude changes in dogs

Answer 7

• Decreased social interaction (depressed)
• Anxious or glazed expression
• Submissive behaviour
• Aggression, biting
• Refusal to move (stubborn, lazy, old)

Question 8

Attitude change in cats

Answer 8

• Aggressive
• Indifferent: no interaction or less curiosity
• Stupor, learned helplessness
• Fear: hid, attempt to escape

Question 9

Attitude changes in horses

Answer 9

• Not cooperative
• Aggressive
• Kicking, striking, biting
• Escaping
• Docile, listless

Question 10

Attitude changes in bovine

Answer 10

• Less focused on environment
• Less interested in social interaction
• Aggressive, charging, kicking

Question 11

Altered appearance: (more chronic pain or stress)

Answer 11

• Dull, unkempt appearance
• Cats: stop grooming (dry hair coat)

Question 12

Body posture

Answer 12

• Reluctance to move
• Tense, stiff, rigid
• Lower head
• Hunched back or tucked abdomen
• Reduced weight bearing
• Tail bearing

Question 13

Body posture change in dogs

Answer 13

• Praying position

Question 14

Body posture change in cats

Answer 14

• Sphinx or statue like (ridged) position

Question 15

Body posture changes in horse

Answer 15

• Stretched out stance

Question 16

Body posture changes in cattle

Answer 16

• Head below spinal column
• Moves and arches back when standing
• Hind limbs extended causally when standing
• Lying down: full or partial extension of 1 or both hindlegs
• Head close to ground
• Extend neck and body forward when lying down

Question 17

Orientation in cage/stall

Answer 17

• Lack of interest in surroundings (DISCONNECTION)
• Withdrawing/hiding
• Facing back of cage

Question 18

Activity level

Answer 18

• Reluctance to move or lie down
• Frequently changing body position
• Anxious and restless
• Aggression to acute onset, severe pain
• Licking, chewing at site of pain
• Kicking/foot stamping
• Wagging tail abruptly and repeatedly

Question 19

Recognizing colic in horses

Answer 19

• Stretch hind legs
• Look at abdomen
• Kick at belly
• Rolling
• Up and down constantly
• Pawing
• Inappropriate sweating and rapid breathing

Question 20

Locomotor activity

Answer 20

• Limping, lame
• Standing to one side
• Unwillingness to rise
• Slow, unstable
• Reluctance to jump
• Decreased stamina
• Urinary or fecal accidents

Question 21

Facial expressions

Answer 21

• Head down
• Fixed gaze, depressed expression
• Looking away
• Orbital tightening
• Ear position
• Cheek flattening
• Nares drawn vertically
• Whiskers extended horizontally or drawn towards cheeks
• *hard to get a grimace scale for dogs

Question 22

Horses’ facial expression

Answer 22

• Orbital tightening
• Tense stare
• Tense facial muscles
• Nostrils are dilated
• Lips pressed together

Question 23

Vocalization

Answer 23

• Often listed as most common sign of pain
• Acute pain or flare-up of chronic pain
• Whine, whimper, cry, groan
• Not very sensitive for pain
• May be increased anxiety or drug side effects

Question 24

Acute pain

Answer 24

• Spontaneous pain behaviours

Question 25

Chronic pain

Answer 25

• Often missed in early stages
• Often absence of normal behaviour=indicator of pain
• Changes in daily activities
• *rely on OWNER

Question 26

Limitations to pain behaviours for assessment

Answer 26

• Need knowledge of animals normal behaviour
• Individuals manifest pain in different ways
• Same pain may have different behaviours
  o No behaviour in isolation is pathognomic for pain

Question 27

Tail wagging

Answer 27

• Does NOT mean it is happy and NOT PAINFUL

Question 28

Dog sensitivity testing

Answer 28

• Highest: German shepherd
• Lowest: Maltese, chihuahua, border collie

Question 29

Factors influencing the assessment of pain behaviors

Answer 29

• Species- breed
• Environmental factors
• Concurrent diseases
• Anxiety
• Drugs
• Evaluator

Question 30

Anxiety

Answer 30

• Recognize relationship between pain and anxiety
• Predisposes animals to worse pain
• Treating it is an important part of pain management

Question 31

Small mammals (Rodents)

Answer 31

• Prey species
• Absence of normal behaviour
• Loss of appetite
• Decreased alertness and mobility
• Change in posture
• Reduced grooming
• Piloerection
• Grinding teeth
• Increased aggressiveness when handled