Pain assessment and pain management

Pain is not just a welfare issue — untreated pain delays healing, increases stress and can worsen the patient's overall condition. But animals often don't show pain clearly; many species hide it as a natural survival strategy. Therefore, the ability to read pain is an important professional skill.

§Signs of pain

Signs of pain vary from species to species and from animal to animal, but some patterns repeat. It's rarely a single sign alone, but an overall change from the animal's normal behavior that reveals pain.

• 01Changed body posture: hunched back, tense belly, protects an area.
• 02Changed behaviour: restlessness, lack of appetite, withdrawal, aggression at touch.
• 03Sounds: whining, hissing, growling, or notably complete silence.
• 04Physical signs: rapid breathing, increased heart rate, dilated pupils, limping.
• 05Missing self-care or excessive licking of a particular spot.

§Systematic pain assessment

To make assessment consistent and documentable, pain scoring scales are used, where behaviour and physical signs are systematically assessed and given a combined score. Use the same scale each time and score at fixed intervals so you can follow progress and see whether treatment is working.

§Principles of pain management

Pain treatment is prescribed by the veterinarian, but the nurse administers the medicine, monitors the effect and reports back. Two principles are worth knowing:

• 01Preventive (preemptive) pain relief: pain is easier to keep down than to catch up with, so relief is often given before and during a procedure, not just afterwards.
• 02Multimodal pain management: combining multiple types of painkillers that work in different places can give better effect with lower doses of each.

§Non-medical relief

Pain relief is not just medication. A quiet, warm and soft bed, gentle handling, calm around the patient and good positioning that doesn't burden the surgical site all contribute to the animal feeling better — and can reduce the need for medication.

§Involve the owner

The owner must know what pain signs to watch for at home, when to contact the clinic, and how to give medication correctly. Make the signs concrete — the owner is the one who sees the animal for the rest of the day.

“To assume that a quiet animal does not hurt is one of the most dangerous mistakes in care. Silence can be pain that is hidden.”