Leading Off: Putting the new pain management guidelines into practice - Veterinary Medicine
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Leading Off: Putting the new pain management guidelines into practice


Some veterinarians still say that surgical pain management is optional and that the pet owner should decide whether to administer it. I disagree. Relieving pain is a medical decision that must be made by a medical professional. Our patients need and deserve mandatory pain management in the perioperative period.

3. Assess pain in every patient at every visit, and document it.

Apply your chosen pain scoring system. At every outpatient visit, assess the animal for pain, and record the finding in the medical record. Each pain assessment is important, but trends are even more important for patients with chronic pain—are they improving or worsening?

Similarly, surgical patients with acute pain need to be assessed at regular intervals during their hospital stays and need to have their results recorded in their medical records. Seeing trends allows the practice team to understand the success of a perioperative pain management plan.

4. Remember the three Rs of chronic pain management: recheck, reassess, and revise.

For patients with chronic pain, pain management is often a moving target. Patient pain management needs may change with the seasons, the temperature outdoors, and the patient's activity level. Managing chronic pain remains a dynamic process that relies on the three Rs:

  • Recheck the patient at regular intervals. Schedule the next recheck before the client leaves at the end of a visit;
  • Reassess the patient's comfort level, based on the current therapeutic plan;
  • Revise your pain management plan according to the patient's needs.

5. Join the International Veterinary Academy of Pain Management (IVAPM).

The entire veterinary healthcare team is welcome to join the IVAPM. IVAPM members have access to sections of the Web site containing downloadable pain management training programs and links to articles of interest. And members can subscribe to Veterinary Anaesthesia and Analgesia at a discounted rate. The members' list serve actively discusses pain cases of interest, new applications of old medications, and nonmedical pain management.

The IVAPM is developing a credentialing pathway for interested veterinarians and veterinary technicians to demonstrate expertise in pain management.


Making pain management a priority in your practice means every team member has an important role to play in identifying pain in every pet. Since the team walks in the shadow of the leader, a commitment to pain management and prevention starts at the top. Relieving pain is compassionate care at its best and is both a quality-of-care and a quality-of-life issue. Inspire your team to share your passion for doing the right things right for pets in pain!


1. The path to high quality care: practical tips for improving compliance. Lakewood, Colo: American Animal Hospital Association, 2003.


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