CVC Highlight: How I assess postsurgical pain in cats

This clinician uses a hybrid system to help score pain in cats that takes into account the type of procedure performed.
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Dec 01, 2010


Mark E. Epstein, DVM, DABVP, DAAPM
Cats have historically been a difficult species in which to assess pain. Since pain is a multidimensional experience (encompassing both physical and emotional components), an observer must be astute to pick up signs of moderate or mild pain in cats. These signs may be exhibited not only by the onset of new behaviors, but also by the absence of usual behaviors. A few tools are available to help practitioners score pain in cats postoperatively.

THE SUBTLE SIGNS OF PAIN


Table 1
Cats in severe postoperative pain may become aggressive, tearing at their bandages or acting frantic and vocalizing (Table 1). However, some cats lie very still or may even purr when they are distressed or in pain.


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In addition, cats exhibit many of the signs that dogs do when they are in pain, but they are more likely to become extremely ill-tempered and may twitch their tails as a sign of agitation and remain in a crouched, hunched position. Also, cats may be unwilling to use the litter box and are more likely than dogs to exhibit withdrawn behavior such as hiding in the back of the cage. Some research attempting to correlate facial expressions in cats to their level of pain is currently under way.

PAIN SCALES

A standardized self-rating pain scale is routinely used in human medicine, and a validated acute pain scale (the Glasgow Composite Measure Pain Scale) is available in dogs.1,2 No validated acute pain scale exists for cats (although the Glasgow group is working on one at this time), but one pain scoring tool in common use is the Colorado State University Pain Scale. (Download a PDF of this pain scale at http://www.ivapm.org/attachments/097_CSU%20Acute%20Pain%20Scale%20-%20Feline%20v.2.pdf.)