The Pain Clinic delivers a unique, genuinely multimodal approach to the management of chronic pain in dogs and cats.
The service provides:
An in-depth initial assessment of pain and suffering, based on the presenting sign/condition; the behavioural changes of the individual; the gait, where relevant; and examination, which includes a detailed search for signs of central sensitization and for muscle pain;
An individualised approach to treatment based on the outcome of the initial assessment, the owner’s concerns and the most significant presenting problem. For example, the main problem in some cases may not be the degree of pain but the frustration caused by exercise restriction; in others, the pain may be relatively easily controlled by conventional NSAIDs but the owner is ambivalent about the use of medication and needs more a detailed explanation of pain and the potential side effects of drugs than can be usually given.
The degree of suffering and the sources of suffering determine the management plan. Severe pain of neuropathic origin will need a logical and systematic approach to medications; behavioural frustration will need an imaginative approach to environmental and lifestyle changes; medical complications/drug side effects/poor efficacy and/or muscular pain may prompt the use of acupuncture; and sometimes the pain service acts as triage, directing patients and owners to the best service for diagnosis and treatment.
The importance of owner involvement and understanding should not be underestimated when treating chronic pain. The initial assessment takes ninety minutes and is followed by a detailed report to the owner, copied with a second, overview report to the referring veterinary surgeon. Follow up appointments are thirty minutes and will involve re examination and assessment, changes of medication, additional measures for the owners, teaching of simple physiotherapy techniques and discussion of further treatments such as hydrotherapy where appropriate.
The chronic pain service is appropriate for:
- Patients with chronic pain that is not well controlled or whose source may not be obvious despite intensive investigations; this pain may be of musculoskeletal, spinal or visceral origin
- Owners who need time and support to help them cope with their pet’s pain problem and/or who are asking “Is there nothing more we can do?”
- Patients with chronic pain for whom conventional analgesia is contraindicated or poorly tolerated
- Patients with chronic pain whose medication must be withdrawn because of concurrent treatment for other disease (e.g. dermatological cases, chemotherapy patients)
A free Vet helpline service is offered, giving advice to practices about cases – please contact Samantha on the number below.
Appointments and referrals
Clinics are offered throughout the week by arrangement. Referral may be arranged by completing the appointment or advice request form and faxing it to 0141 330 3663.