An updated set of Global Guidelines for the Recognition, Assessment and Treatment of Pain, which incorporate advances in knowledge and novel evidence, have been launched by the World Small Animal Veterinary Association’s (WSAVA’s) Global Pain Council (GPC) during its annual World Congress in Lima, Peru. WSAVA association member representatives gave enthusiastic support to the new Guidelines, with many signing up to support the GPC’s pledge to improve pain management in companion animals.
Following peer-review, the new Guidelines have been published by the Journal of Small Animal Practice (JSAP), the WSAVA’s official scientific journal, and are available for free download from the WSAVA website and from the JSAP website.
A key feature of the Guidelines is an emphasis on the use of pain scales for the assessment of acute and chronic pain in companion animals. They provide guidance, for instance, on selecting the most effective pain assessment tool based on the condition of the patient and scientific evidence, with links to relevant tools also provided.
In terms of pain management, the Guidelines take into account novel evidence regarding the efficacy and safety of both drug and non-drug therapies. For example, they evaluate the performance of new pharmaceuticals, including monoclonal antibodies, or those with new delivery systems, and evidence regarding the use of cannabinoids for chronic pain. They also discuss the use of non-drug therapies, including acupuncture – evidence of efficacy of which has increased in certain pain conditions. The Guidelines also stress that euthanasia should always be considered in cases where pain cannot be effectively managed and quality of life is poor.
Greater attention is paid to the role of emotions on the perception of pain in the Guidelines. It is now recognized that fear and stress can increase the perception of pain in animals so the document includes recommendations as to how to improve the experience of hospitalized patients, as well as giving advice to support the welfare of animals living with chronic pain and primarily managed by their caregivers at home.
The format of the Guidelines has been enhanced for this version to increase the accessibility of information with an increased use of visuals and graphics. Links to recommended tools are provided, as well as links to videos and additional resources for those wanting to further their knowledge.
A priority for the WSAVA is to provide Guidelines that are globally relevant. For the GPC, this means supporting veterinarians in regions with restricted access to analgesic drugs in working around the limitations they face. To help them, the Guidelines offer tiered protocols and highlight the role of local anesthetic techniques that don’t require additional training, together with the role of non-drug therapies to manage pain such as cold/ice therapy and the provision of a comfortable and safe environment to patients. They also discuss the importance of nursing and supportive care.
The Guidelines are currently available in English with translation into Spanish, Portuguese, Chinese and other languages underway.
Commenting on the launch of the updated Global Guidelines for the Recognition, Assessment and Treatment of Pain, Dr Bea Monteiro, GPC Chair, said: “Pain management is an area of veterinary medicine in which knowledge and understanding has expanded dramatically in recent years. Members of the GPC have worked tirelessly to pull together these latest WSAVA Guidelines, which now provide the most comprehensive and state-of-the-art resource available to support veterinary professionals, wherever in the world they are in practice.
“With animal sentience now legally recognized in many countries and jurisdictions, veterinary health professionals have a medical and ethical duty to mitigate suffering to the best of our ability. Despite the advances in pain management, pain still occurs more commonly than it is treated. We hope that these Guidelines will help colleagues understand the importance of pain management for patient health and welfare and that they will commit to:
- Frequently assess pain in every patient
- Taking measures to prevent pain and other negative emotions (such as fear and anxiety)
- Treat pain using drug or non-drug therapies.”
The work of the GPC is generously supported by Zoetis.
“At Zoetis, we are committed to ongoing innovation, and we have long history of providing medications, tools/resources and educational initiatives to help veterinarians diagnose and manage pain in pets more effectively,” said Dr Mike McFarland, chief medical officer at Zoetis. “Pain has broad negative impacts on an animal’s health, causes suffering and lowers quality of life. Because we know that pain can lower quality of life and disrupt the important human-animal bond which benefits people and the pets they love, it’s important to ensure veterinarians around the world have access to solutions that can help better diagnose and alleviate pain in animals.”
The goal of the WSAVA Global Pain Council, comprising a team of global experts, is to create a global environment for companion animals in which pain is considered as the fourth vital sign and addressed appropriately. Its first Global Guidelines were published in JSAP in 2014 and have been downloaded from its website 53,000 times.
The WSAVA represents more than 200,000 veterinarians worldwide through its 115 member associations and works to enhance standards of clinical care for companion animals. Its core activities include the development of WSAVA Global Guidelines in key areas of veterinary practice, including pain management, nutrition and vaccination, together with lobbying on important issues affecting companion animal care worldwide. WSAVA World Congress brings together globally respected experts to offer cutting edge thinking on all aspects of companion animal veterinary care.