WSAVA Global Pain Council (GPC)
World Small Animal Veterinary Association World Congress Proceedings, 2014
Bonnie D. Wright, DVM, DACVAA

Pain management is an important topic in companion animal medicine and there exists a wide variation in pain assessment, pain management, and their consistent implementation. The result is often a gap between pain incidence and adequate treatment. Eliminating this "pain incidence-pain treatment gap" is the focus of the WSAVA Global Pain Council (GPC). While access to pain treatment modalities may vary from country to country, the ability to diagnose pain should not. Both assessment and treatment would benefit from educational efforts that encompass all members of the veterinary healthcare team and consider availability of local and regional treatment options.

GPC Vision

An empowered, motivated, and globally unified veterinary profession that effectively recognizes and minimizes pain prevalence and impact.

GPC Mission

To raise global awareness and provide a call to action based upon the understanding that all animals are sentient and can therefore feel pain and suffer from it. Through identification of regionally specific resources for targeted education on recognizing and treating pain, the Global Pain Council strives to elevate the level of confidence and competence in applying pain treatments.

GPC Action Plan

The GPC objectives will be accomplished in three phases, with phase I dedicated to the pain treatise development and global inventory of products and attitudes. Phase II will be focused on developing a prioritized program of pain assessment and management CE while popularizing and broadly disseminating the pain treatise. Phase III will look to update the treatise where needed, refine and further implement the CE plans, and expand into owner education.

GPC members include:

 Karol Mathews, DACVECC; VCNA pain issue editor; Canada

 Peter Kronen, DECVAA; President AVA; Member of the Board of Directors IVAPM; and Honorary Secretary IASP SIG Non-Human Species; Switzerland

 Duncan Lascelles, DACVS; pain researcher and author; USA

 Sheilah Robertson, DACVAA, DECVAA; feline pain management and author; USA

 Andrea Nolan, DECVPT, DECVAA; pharmacology + pain research; Scotland

 Paulo Steagall: anesthesia; IVAPM board; pain researcher and author; Canada

 Bonnie Wright, DACVAA; anesthesia, emergency medicine, physical rehabilitation, alternative pain modalities; USA

 Kazuto Yamashita: anaesthesiology + pain research; Japan

 Walt Ingwersen, WSAVA Honorary Secretary, liaison WSAVA Executive Board liaison

The WSAVA Global Pain Council realized their primary goal of Phase I of their activities with the publication of the WSAVA Global Pain Treatise by the Journal of Small Animal Practice. The Treatise is a succinct overview of pain assessment and management in small animals, including sections on pain pathophysiology, pain assessment for dogs, cats, acute and chronic pain, and one-page overviews of various therapeutic modalities. Its distinct features are tiered analgesic protocols that take into account the variable access to certain pain treatment modalities around the globe. The Treatise and an accompanying JSAP editorial by Dr. Derek Flaherty is available for free access at http://onlinelibrary.wiley.com/doi/10.1111/jsap.12200/abstract

Section 1: Introduction to Pain, Its Recognition and Assessment

1.  Understanding pain

2.  Physiology and pathophysiology of pain

3.  Recognition and assessment of acute pain in cats

4.  Recognition and assessment of acute pain in dogs

5.  Recognition and assessment of chronic pain in cats

6.  Recognition and assessment of chronic pain in dogs

7.  Assessing response to treatment of pain in cats and dogs

8.  Neuropathic pain

9.  Perceived level of pain associated with various conditions

10.  Common pain misconceptions

Section 2: Pain Management

11.  General approaches to the treatment of pain

12.  Opioids

13.  Nonsteroidal anti-inflammatory drugs

14.  Alpha2 adrenoceptor agonists

15.  Local anaesthetics

16.  Analgesic delivery techniques and tools

17.  Adjunctive drugs

18.  Non-analgesic drugs: management of the painful patient

19.  Physical rehabilitation

20.  Diet and supplements

21.  Nursing and supportive care

22.  Acupuncture

23.  Medical massage

24.  Salvage surgical procedures

Section 3: Pain Management Protocols

25.  Castration and ovariohysterectomy/ovariectomy in cats

26.  Castration and ovariohysterectomy/ovariectomy in dogs

27.  Orthopaedic surgery

28.  Soft-tissue surgery

29.  Locoregional techniques

30.  Ophthalmic procedures

31.  Dental procedures

32.  Emergency and critical care patients

33.  Medical pain

34.  Pregnant or lactating patients

35.  Neonatal or pediatric patients

36.  Neuropathic pain

37.  Degenerative joint disease

38.  Cancer-related pain

39.  WSAVA humane euthanasia

The Treatise will be married to the outcome of the Global Pain Survey, which provided a snapshot into pain management attitudes, treatment protocols, and therapeutic modality access from various regions around the globe. Results of the survey can be freely accessed at the GPC pages on the WSAVA website (www.wsava.org/educational/global-pain-council). Findings indicated an overall high degree of knowledge over the occurrence and goal to treat pain, but implementation was hampered by the ability to properly recognize pain, limited product access and user knowledge as to appropriate modality use, particularly for the perioperative setting.

Together, the GPC treatise and Global Pain survey will be the foundation for the GPC Phase II activities: generating and implementing a focused and prioritized continuing education program that provides clinically applicable and relevant information. GPC tracts are already embedded in the WSAVA World Congress scientific program and will also be included within the WSAVA CE Committee activities. The above resources are available on the GPC pages of the WSAVA website and will be enhanced by various clinical tools (www.wsava.org/educational/global-pain-council).

The WSAVA and GPC would like to thank the following sponsors of their activities:

 Phase I: Boehringer Ingelheim Animal Health, Elanco, Novartis, Vétoquinol, and Zoetis

 Phase II: Novartis, Vétoquinol, and Zoetis

  

Speaker Information
(click the speaker's name to view other papers and abstracts submitted by this speaker)

Bonnie Wright, DVM, DACVAA
USA


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