Section: Diagnosis and Treatment
An important part of evaluating pain is to localize the pain, which involves determining what part of the body is painful. A thorough history and physical examination are performed. These must be done with care in order not to worsen the animal's pain and to avoid injury to the veterinarian and the veterinary assistants. Depending upon the outcome of the examination, further diagnostic tests may include the following:
Complete eye examination
Complete neurologic examination
Complete orthopedic examination
Thorough oral examination
Thorough examination of the ears
Thorough examination of the external genitalia
Complete blood count (CBC)
Biochemical profile
Urinalysis and urine culture
X-rays of the chest, abdomen, spine or any area identified as painful
An ultrasound of the abdomen or heart
Cytology and/or biopsy of tissue or fluid
Serologic tests for certain infectious diseases
Bacterial culture of any infected tissues
Cerebral spinal fluid (CSF) tap
Computed tomography (CT scan) or magnetic resonance imaging (MRI)
Treatment
The goals of treatment are to identify the source of pain and remove it, and to use medications to alleviate the pain. Initially the pain must be localized to a specific site, then a diagnosis made as to the cause of the pain. Specific therapy is designed to alleviate the underlying cause.
Alleviation of pain involves the use of analgesics (drugs that numb the pain sensors) and anti-inflammatories. Whenever possible, a diagnosis of the cause of the pain and therapy for that cause should be instituted prior to administration of pain medications. Administration of analgesics and anti-inflammatory drugs as an empirical, symptomatic treatment can be dangerous.
Cats are highly susceptible to the effects of certain analgesic drugs, and such drugs must be used cautiously. Injectable pain medications that may be used in the cat include butorphanol, buprenorphine, hydromorphone, fentanyl, morphine, and oxymorphone. The only oral analgesic drug that is commonly available for use in cats is butorphanol. The oral analgesic acetaminophen should never be used in cats because it is highly toxic to cats.
Cats are also highly susceptible to anti-inflammatory agents, and their use is restricted to just a few products. Anti-inflammatory agents are divided into two categories, steroidal and non-steroidal drugs (NSAIDs). Steroidal agents, such as prednisone and dexamethasone, are reserved for the treatment of certain specific diseases or conditions. Two non-steroidal anti-inflammatory agents that can be used safely in the cat are aspirin and ketoprofen. The dosages of these medications are much smaller than that used for people or dogs, so these drugs should never be given without consulting with your veterinarian. Overdosage with these medications may result in serious illness and side effects.
Supportive care may also be indicated during the period of diagnostic testing and the initiation of therapy. Supportive care may include the use of intravenous fluids, supplemental nutrition, keeping the animal quiet and confined, the use of cold or warm compresses, and altering the temperature of the environment.
Home Care
Administer any prescribed medication as directed by your veterinarian. Observe your pet's general activity and appetite, and watch closely for improvement in the signs believed to be associated with the onset of pain. If signs should worsen, contact your veterinarian immediately.
