Recognising and Quantifying Pain Flashcards
Give 5 ways behaviour can be assessed wrt pain
Spontaneous behaviour Qualitative assessment (description) Ethogram Change in behaviour with analgesia Evoked behaviour eg MNT
What types of quantitative testing exist? What are the problems associated with quantitative sensory testing?
> Threshold testing
- Acceptibility in clinical cases (especially thermal testing) Although widely used in humans
- Difficult to interpret meaning, though withdrawal CHANGE useful
Phyiological measurement
- HR and HR variability, resp rate, temp
- not pain specific, mounting evidence to suggest not useful in pain appraisal though still used
Neurophysiology and cortical activity measurement
- Not feasible clinically
- Interpretation hard
- Difficult in awake animals (EEG electrodes under skin)
- Not immediate - requires processing and interpretation
What novel methods of quantifying pain exist?
Facial expression - limited application to actual clients, duration of expressions
Attentino as a biomarker
Judgement bias and anhedonia for chronic pain - time consuming and difficult to interpret, not validated
What type of behaviours can be looked at to understand pain states in animals?
Complex behaviours eg. burrowing in rats
CPPT paradigm
What is the CPT paradigm?
Continuous performance task/test paradigm - measure of attention
Why may over estimating pain also have sever consequences?
Overdose of analgesia
- Opioids - sedation/excitation/nausea
- NSAIDs - gastric ulcers
Why do attitudes towards pain medication differ between species?
eg. Cattle - it is physically possible to restrain them, won’t show many overt signs of pain
eg. Cats less likely than dogs to be given pain medication as overt behavioural signs are less obvious
How does anxiety affect pain perception? What other confounding factor may affect these results?
^ pain severity
- also confounds behavioural and physiological analysis of pain in animals
> envorinmental modification to reduce stress important
- sedation and effects of drugs may also confound
What is a DIVAS?
Dynamic interactive VAS
- mportant as outwardly may not appear in pain but gentle palpation -> detection of 2dry hyperalgesia
Why are drugs developed in animals models often not effective?
Don’t combat emotional side, only nocicpetive thresholds
Why have grimace scales been more effective in some species than others?
Mouse - succesful as lab mice effectively clones
Less successful in horses and dogs
> lesions to rostral interior insula attenuate pain face behaviour but did not affect other measures of noccipetion
Give 4 examples of pain scales
SDS - simple descriptive score, linear scale
NRS - numerical
VAS - diagrammatic
- moving away from unidimensional -> CPS - composite pain scales
What are the issues likely to confound pain appraisal?
Differentiating between pain, anxiety and sedation
Why is detection of chronic pain in animals challenging?
- detecting dyaesthesias eg. neuropathic pain
- pain states, better/worse at different times?
- owners don’t know what signs to look for
- treating pain should be a separate mission to treating the disease itself
Give an example of a study on analgesic drug attitudes wrt farm animals
Fajt 2011 - 70% calves being castrated do not receive analgesia
cf. Waran 2011 - 70% horses DO receive analgesia for castration
