Pain Assessment and Treatment Flashcards
What are some behaviors K9’s exhibit when in pain?
Lameness, praying position, head tilt, guarding, behavior change
What are some behaviors felines exhibit when in pain?
Hiding, decreased appetite, decreased grooming, excessive licking, missing the box, squinting eyes and aggression
What are some behaviors equines exhibit when in pain?
Lameness, standing at back of stall, decreased social interaction, decreased appetite, pain face
What is “pain face” in equine?
Low ears, angled eyes, dilated nostrils, tension of muzzle
What are ruminant pain behaviors?
Teeth grinding, hypersalivation, abnormal facial expression, decreased rumination/appetite, decreased milk production and isolation from herd
What are biomarkers for pain?
Cortisol, glucose, catecholamines, endorphins, and lactic acid
Signs of pain under GA are?
Movement, trembling, increased HR, increased RR, and increased BP
How do local anesthetics help with pain management?
Block Na-gated channels preventing action potential
What is used for perioperative pain treatment?
Opioids
What receptors do opioids act on?
Mu, Kappa and delta
What receptors do these drugs act on? Morphine, hydromorphone, oxymorphone, fentanyl, methadone and meperidine
Mu agonists
What receptor does buprenorphine act on?
Partial mu agonist
What kind of receptors do butorphanol act on?
Mu antagonist and kappa agonist
Which drug is a weak mu opioid inhibiting serotonin reuptake?
Tramadol
What do NSAIDs work on?
COX-1 and COX-2 enzymes
Which COX enzyme is constitutive and which is inducible?
COX-1: constitutive –> prostaglandin production for GI/renal protection and platelet function
COX-2: inducible- produce prostaglandins in response to pain and inflammation
Where are the NMDA receptors located?
Spinal cord
What would you use for a ASA I K9 OHE?
Pure mu agonist with premed and one injectable NSAID (continue 4-5 days post-op)
What would you use for ASA I feline OHE?
Pure mu agonist or buprenorphine with premed. One injectable NSAID after recovery from anesthesia. Continue buprenorphine 3 days post-op
What would you use for ASA I K9 neuter?
Same as spay but add lidocaine for testicular block. NSAID 2-3 days post-op
What would you use for dental extractions?
Pure mu agonist (pre-med), injectable NSAID if no systemic disease, local blocks with bupivicaine and post-op NSAID
