Pain Assessment and Treatment

Question 1

Describe the reasons we treat pain - associated with the neuroendocrine system

Answer 1

Pain can cause:
- Hypoglycaemia
- Weight loss
- Decreased wound healing
- Impaired immune system

Question 2

Describe the reasons we treat pain - associated with the cardiovascular system

Answer 2

Pain can cause:
- Fatigue
- Immobility
- Weakness

Question 3

Describe the reasons we treat pain - associated with the respiratory system

Answer 3

Pain can cause
- Decreased lung volume => atelectasis (partial collapse of a lung) and hypoxaemia

Question 4

Describe the reasons we treat pain - associated with the GIT and urinary system

Answer 4

Pain can cause
- Decreased bowel motility
- => constipation, anorexia, ileum, urinary retention

Question 5

Describe the reasons we treat pain - associated with the MSK system

Answer 5

Main can cause
- Decreased muscle function and spasm
- => weakness, immobility and fatigue

Question 6

Describe the reasons we treat pain - associated with the psychological system

Answer 6

Pain can cause
- Fear
- Anxiety => poor sleep
- Decreased coping

Question 7

Name some of the clinical signs of pain

Answer 7

Tachycardia and tachypnoea
Hypersalivation
Mydriasis (slated pupils)
Sweating
Changes in stress hormones (cortisol, glucose, insulin, adrenaline)

Question 8

Give 3 examples of unidimentional pain scales

Answer 8

1. Simple descriptive scale
2. Numerical rating scale
3. Visual analogue scale

Question 9

Give an example of a multidimensional pain scale

Answer 9

Glasgow composite pain scale (canine or feline)

Question 10

What pain scales are available for horses

Answer 10

A different one for different types of pain e.g. orthopaedic, abdominal etc
Pain faces - ear position, eye position, nostrils, tension

Question 11

What type of enzymes are the target of NSAIDs

Answer 11

COX enzymes
Commonly COX2

Question 12

Name the 3 common NSAIDs used in equine

Answer 12

Phenylbutazone
Meloxican
Flunixin meglumine

Question 13

Name the 2 common NSAIDs used in cattle

Answer 13

Meloxicam
Ketoprofen

Question 14

Name some of the contraindications of NSAIDs (x9)

Answer 14

Concurrent use of steroids
Renal or hepatic insufficiency
Hypovolaemia
Congestive heart failure
Active haemorrhages
Gastric ulceration
Spinal injuries
Pregnancy
Shock/trauma

Question 15

Name 3 side effects of NSAIDs

Answer 15

Vomiting/diarrhoea
Renal diarrhoea
Clotting disruption

Question 16

What receptor does grapiprant (Galliprant) target, and what conditions is it good for

Answer 16

EP4 receptor antagonist
Canine osteoarthritis pain and inflammation

Question 17

Which species is paracetamol licensed in, can use off licence in and should never use in

Answer 17

Licensed in - Dogs and pigs
Can use off licence in - horses
NEVER use in - cats

Question 18

Name 2 opioids which are both agonists and antagonists against different receptor

Answer 18

Buprenorphine - agonist mu receptor, antagonist kappa receptor
Butorphanol - agonist for kappa, antagonist for mu

Question 19

Name the 2 groups of drugs which are used as local anaesthetics and give an example of each

Answer 19

Amides - lidocaine
Esters - procaine