Abstract
In this issue of JFMS we are excited to publish the 2022 ISFM Consensus Guidelines on the Management of Acute Pain in Cats. As with all ISFM Guidelines, we have brought together leading experts in the field who are passionate about cat welfare. Working closely with ISFM over the past year they have amassed the latest research on feline acute pain management, presenting it in a practical and accessible form for busy practitioners.
A cat’s sleeping position can reveal a lot about its physical and mental wellbeing.
Courtesy of Paulo Steagall
Almost all cats will experience acute pain in their lifetime, because of surgery, trauma or illness. Good pain management has to be an integral part of feline practice.
The challenge in veterinary practice is to recognise the subtle expression of pain in cats, in what can be a stressful and fearful environment, and intervene to improve patient welfare. Thankfully help is at hand with developments in pain recognition and the availability of assessment tools that can be routinely used in every veterinary clinic treating cats.
The authors of these Guidelines were also keen to involve owners/caregivers in pain assessment at home. Observation of changes in behaviour, as simple as a lack of grooming or eating, or the cat no longer curling into a relaxed ‘bagel’ or ‘pretzel’ shape for sleeping, can indicate pain, which owners can report on to their veterinarian. ISFM has produced a ‘Cat Carer Guide to Acute Pain’ to accompany these Guidelines, which can be used to help owners and caregivers to be a part of the ‘team’ involved in the cat’s pain management.
In the past, concerns about comorbidities, such as kidney disease, combined with a wary approach to the cat’s unique drug metabolism, have resulted in avoidance of certain analgesic drug groups and, in turn, in inadequate pain management. These Guidelines explain that best practice with respect to analgesia and anaesthesia is particularly important, and that a preventive and multimodal analgesic approach can avoid adverse drug reactions.
The Guidelines discuss the use of analgesic drugs, presenting dosages in accessible formats, including easy-to-use tables. They explain how to build an analgesic plan, incorporating layers of analgesia in a multimodal fashion involving local anaesthetic blocks, opioids and nonsteroidal anti-inflammatory drugs (NSAIds). They also cover equally important factors such as anxiolysis, non-pharmacological therapy, antiemetics and nursing care. Throughout, the authors emphasise that managing pain requires an appropriate environment, both in-clinic and at home; and that key to stress reduction is a quiet environment, free from dogs, with a comfortable bed, good nutrition and gentle handling.
We are proud that the Cat Friendly ethos runs through these Guidelines, influencing pain assessment and management, environmental modification and handling, and confirming that treating cats with knowledge, understanding, kindness and respect improves their physical and mental wellbeing, as well as aiding healing. Developing the ability to recognise and successfully treat acute pain in cats is a fundamental obligation for the veterinary care team, but is also tremendously satisfying, and ultimately transformative for the welfare of cats in the clinic.
Cat Carer Guide
Information for owners and caregivers on acute pain in cats accompanies the guidelines as supplementary material, and is also available at: icatcare.org/advice/cat-carer-guides.
