Clients do not want their pets to be in pain; staff hates to see an animal in pain. How do you get awareness in your practice about pain management so the human-animal bond does not get stressed? Establish a pain scoring system where everyone participates every day! No patient goes unscored during any trauma presentation and inpatients are minimally tracked for changes in a t.i.d. basis.

We endorse the Pain Scoring system that was described in the February 1998 Compendium on Continuing Education for the Practicing Veterinarian, pp 140-153; the 8 factors with 0-3 scoring for each factor is the most thorough assessment tool available. In the revised AAHA Standards, published in 2003, three years after the first edition of this text, pain scoring became a standard expectation (but they did not give a set program to follow). However, some practices like a simpler system, so here is a "10 count and you are out" system. All pain scored 2 or higher should have intervention and the practice protocol cannot override a pain score by a staff member!

Of course, the clinician must make a medical determination on the exact pain medication used, but here are some guidelines that are widely accepted:

 Lower Scores - Torbutrol +/- Acepromazine, Rimadyl, Ascriptin, Feldene, Phenylbutazone

 Moderate Scores - Codeine, Ketoprofen

 Higher Scores - Fentanyl patch, Oxymorphone, Morphine, Spinal Injection