Sir James Dunn Animal Welfare Centre, Atlantic Veterinary College, University of Prince Edward Island
Charlottetown, PE, Canada
In 1994, a national randomised survey of Canadian veterinarians (response rate 76%) indicated low usage of postoperative analgesics for some procedures in dogs and cats. We repeated the survey in 2001/2, to monitor changes in usage.
A random sample of 652 veterinarians was sent a pretested questionnaire by post. Unlike in 1994, the questions distinguished between preincisional and postincisional usage. Questions concerned: demographic information; analgesic usage for common surgeries (proportion of cases given analgesia; drugs; dosages); veterinarians' perceptions of the pain caused by surgery without analgesia (PSWA) (on a scale of 1 to 10); veterinarians' agreement with statements about the risks of using different analgesics (on a scale of 1 to 10); and the preferred form of continuing education. Descriptive statistics were generated. Predictors of postincisional analgesic usage and of PSWA, for canine ovariohysterectomy, were identified by logistic and linear regression respectively, using the appropriate model-checks.
The response rate was 63.8%.With the exception of taildocking in puppies, at least 80% of respondents gave preincisional analgesics, and 30-85% gave postincisional analgesics, to all patients. Butorphanol was the most commonly used drug for all surgeries (mean dosing interval 6.9 h +/- SD 6.2 h). Fifty percent of veterinarians considered their knowledge of perioperative analgesia to be adequate, including veterinarians who did not provide analgesia to their patients. Factors affecting postincisional analgesic usage included the presence of at least one animal health technician per 2 veterinarians (AHT) (OR=1.77, P=0.05), and the veterinarians' PSWA (OR=1.46, P<0.001). Factors affecting PSWA were: AHT (coefficient=0.46, P=0.018) and the number of years since graduation (coefficient=-0.074, P<0.001).
Analgesic usage was higher than in 1994 (1), but was not universal. For example, extrapolating conservatively from the data, some 5300 dogs per month were spayed without preincisional or postincisional analgesia. Gender and concerns about side effects no longer prevented drug use (2). As in 1994, employment of animal health technicians increased the odds of a veterinarian being a postincisional analgesic user. However, the reliance on butorphanol for all surgeries meant that many animals were unlikely to have received adequate perioperative analgesia. Continuing education lectures, and review articles in journals would be the most effective ways to educate veterinarians about these issues. The data also indicate the need for a collective professional policy, to help ensure that patients receive adequate perioperative analgesia.
1. Dohoo S, Dohoo I. 1996. Can Vet J 37:546-551.
2. Dohoo S, Dohoo I. 1996. Can Vet J 37:552-556.