Chronic pain is more complex than we realise, but it's also one of my favourite things to talk about with pet owners.
In the last decade or two, pain science has made massive inroads in our understanding.
(And fun fact, I think that Australian pain researchers are in many ways, truly some of the best in the world).
When we are talking about maladaptive pain, it really helps to think about it as a disease in it's own right. Why? Well, any pain stimuli is no longer needed for protection or healing, but the pain experience continues to exist. The result is chronicity of pain, windup and all sorts of other complex variations on the pain condition.
I've spent a lot of time deep in the human pain literature and where I always learn the most is when I'm reading about the experience of doctors and clinicians who work with non-verbal patients.
Who is this in human health? Well, it's mostly in paediatrics, sometimes intensive care (chronic more so than acute), and in end-stage patients where people are less able to acurately describe their pain experience.
As a vet, where all our patients are 'showing' us, rather than 'telling' us about the way they feel their pain, this stretches our skills and requires a unique patient perspective, but we can absolutely get better at identifying pain!
At end stage, there are also factors such as frailty, fatigue and layers of compensatory changes that can cloud the clinical picture so it is a bit of an artform.
But I love that as we learn more, we are rethinking much of our traditional approach to pain in older patients.
Thanks for the #bluntmonday reminder CANINE ARTHRITIS MANAGEMENT . I love advocating for this alongside you all!
#sunsetvets #veterinarypalliativecare #nopain
A patient’s verbal report of pain is the single reliable indicator of pain (Yildirim et al., 2015).
Human healthcare KNOWS we are reliant on verbal description for true understanding of another person’s pain.
Dogs cannot speak to us to let us know when they are in pain, so its up to us to understand the signs and behaviour changes they show us instead.
We are the our dog's voices - let's advocate for them as much as we can!
Executive Director of Business Development at Culinary Depot/Founder of the Hope Organization
2wNicky sounds like an absolute joy! Love that UNC Health is spotlighting these amazing therapy dogs.