Pain Assessment

Question 1

Name clinical signs of pain

Answer 1

• Tachycardia
• Tachypnoea
• Hypertension or

hypotension (extremes)

• Cardiac arrhythmias
• Pale mucous membranes
• Hypersalivation
• Mydriasis (dilated pupils
• Sweating, trembling
• Increased urination or defaecation
• Poor body or coat condition e.g. long nails in an elderly cat

Question 2

Why are stress hormones unreliable to measure?

Answer 2

Retrospective - tells us 12 hours ago

Question 3

Name some pain behviours

Answer 3

•Abnormal postures

–Hunched up, guarding abdomen, praying position

• Abnormal activity (increased or decreased)
• Abnormal movement

–Restlessness, circling (esp. visceral pain: colic)

• Abnormal gaits: stiffness, lameness
• Reluctance to move

–Plant to a spot

• Aggression
• Paying attention to injured area or wound, hyperalgesia when palpated
• Vocalisation (more common in dogs than cats)

–whining, crying, howling

• Head hanging down, low tail carriage
• Animals will still wag tails if in pain – through an interaction with the owner
• Depression, inappetance, dullness
• Manic behaviour
• Not grooming
• Trembling
• Poor interaction with people, hiding
• Unaware of surroundings

Question 4

Other than pain, what else may pain behaviour indicate?

Answer 4

–Poor general health

–Medical problems

–Anxiety or fear

–Normal behaviour for that animal (eg. aggression)

Question 5

What is SDS?

Answer 5

Simple descriptive scale

Question 6

What is NRS?

Answer 6

Numerical rating scale

Question 7

What is VAS?

Answer 7

Visual analogue scale

Question 8

What is DIVAs?

Answer 8

Dynamic interactive visual analogue scale

Question 9

How do you score numerical rating scale?

Answer 9

1-10

Question 10

What do simple pain score scales measure?

Answer 10

They only consider the intensity

Question 11

What do multidimensional scales measure?

Answer 11

The sensory and affective qualities of pain

Question 12

What is the Glasgow Composite Pain Tool?

Answer 12

Original validated scale – dogs only

Uses a series of expressions and descriptions of behaviour

Specific words or phrases

Reduces inter-observer variation and bias

Doesn’t have a “score” so harder to assess changes over time

Question 13

What are the 6 behavioural categories Glasgow Pain Scale?

Answer 13

–Vocalisation

–Attention to wound

–Mobility

–Response to touch

–Demeanour

–Posture/Activity

Question 14

How do we score for the Glasgow Pain Scale?

Answer 14

0-3/4/5

Question 15

Glasgow Pain Scale:

A) What is the toal score?

B) What happens if the mobility can’t be assessed?

C) What is the pain interveention score?

Answer 15

A) 24

B) 20

C) 6/24 or 5/20

Question 16

What pain scale is useful for cats? (3)

Answer 16

Colorado Pain Scale

‘Botucatu’ pain scale

Glasgow CMPS-feline including pain faces

Question 17

What is the experimental Analgesiometry?

Answer 17

Use of a repeatable stimulus to measure analgesia

Application of heat or pressure

May not relate well to clinical analgesic potency