We buy stock photos for many posts, and TRY to choose seems to go with the story. And inexact science, as you’ve pointed out.

Here’s information for all on the GCMPS. Facinating stuff.

The thing is, though, it’s better to pre-medicate and ease off than to “chase” pain. Since in the latter case, you can’t catch it without higher doses.

Although there has been some heated discussion in this thread, I’m happy for it. We’ve had good, thoughtful discussion, and we’ve certainly raised awareness of the pain-management issue. Maybe some pet-lovers will now feel more empowered to discuss the issue with their veterinarians, and that’s always good.

That is why I went looking on the internet to see if a picture of Jazz was available. I was interested to see what her actual general demeanor was after surgery if possible.

I don’t think anyone suggested that Jazz would not have had any pain given the surgery she went through. I certainly did not say that. What I did say is that animals react differently to pain, just as humans do. And I said that we do not have enough information about this case to know what her condition was post-surgery. Her owners pulled her from Dr. Seeman’s care, which was their right to do. We do not know from the article at what point they pulled her. Was she still somewhat drugged from the anesthesia? Was she howling in pain? We don’t know. The newspaper article does not tell us. Which is why I said that we can’t make assumptions here about her care.

As far as having surgery myself, I have had. Following my most recent surgery I was in a room with another patient who had essentially the same surgery on the same day. We were both on the same pain medication. She kept asking for more medication which they gave her, while I kept reducing the dose. Again, individuals react differently to pain.

I would like to see this discussion go beyond the simple pain meds vs. no pain meds. If this discussion is about pain management, then I would like to see discussion about the management part. To me, that includes discussion about establishing a common standard, about using the scientific method to determine when and how and which meds are used, about actually being able to measure pain in animals so that we can use both subjective AND objective methods to better help our pets, and how to manage the drugs that are sent home with pets to ensure the pets are getting them, and that vets are not being taken advantage of by drug abusers. These are all serious issues. Personally, I do not want to see the veterinary profession follow the same swinging pendulum that human medicine has followed in pain management, but we seem to be doing that. I think we can do better.

I’m curious… When this discussion was started a few weeks ago, I posted a link to the Glasgow Composite Measure Pain Scale. Did anyone read that? Did anyone have occasion to utilize it to measure any of their pet’s pain? I’m always interested in feedback on it. Since we started to use it in our clinic, the reaction from clients has been terrific. When we give people pain meds, they often ask “How will I know if she’s in pain?” They are grateful for an objective way to make that evaluation.

Bernie, I never said that “old is not equal to bad” and I thoroughly disagree with you in that “Most of us would prefer accumulated wisdom over the young and inexperienced.” Are you kidding? Do not presume to know what MOST people want. In fact, I’d wager that MOST people would WANT pain meds for their pets.

Why would anyone choose to a dentist who uses a drill and other equipment from 40 years ago? It’s all about CEU’s to keep up to date. I wonder when this vet last attended a seminar? If he has trouble making a diagnosis or prognosis while an animal is on pain med, he may need to go back to school. I’ll say it again: I would rather the animal have pain meds. Why would I want to frighten him?

Too, you need to consider the psychological ramifications of NOT having pain abated. To animals incapable of understanding what is happening, it borders on cruelty to allow them to remain in pain.

I’ll throw this out there - though I don’t know if this is the case: Sometimes older people, practicing in a field where technology has made great strides, feel left behind and are intimidated by their own lack of knowledge compared to their peers. These older people often become stubborn, hanging on to old beliefs and practices. We see this everyday.

I’m a frequent flier when it comes to orthopedic surgery. All I can say is for the kind of surgery that dog had……..well, my heart bleeds for him.

[Sorry, Gina, I had to respond.]

I don’t think there’s anything wrong with the photo. The story is not about that dog, but about shifting standards of care with regard to pain management, at least in companion animal care.

Anyone who thinks an animal who went through the surgery the Labrador in the story did wouldn’t have been in pain afterward … well, you’re invited to have the surgery yourself and let us know how it feels.

As for the idea that pain “helps” an animal more than it hurts him, Christie has already addressed that point above. Educated practitioners who remain up-todate on their continuing education think the idea is total bunk — including surgical specialists.

But again, you’re welcome to go cold turkey after your next orthopedic surgery and let us know.

Those who refuse pain meds for their hurting pets … we’re aware of that situation (Christie covered it in an earlier post, referenced above). If they’re choosing pain for their pets to save money, well, that makes me sick to my stomach, to be honest with you. If it’s because of a lack of understanding, fear of side effects, etc., that’s entirely different.

I bet we’ll be having a different discussion on this in a few years. As the article says, the times are changing.

And thank heavens.

Bernie, the dog in question is Jazz, a yellow labrador retriever. So, no, the dog pictured above is not the actual dog. I looked for and could not find, Jazz’ picture on the internet, so I guess the owners have not made it available for publication. I bet Gina would have used it if she could have found it, right Gina??.

This case is causing a stir here in Minnesota, primarily because there is not one accepted standard for managing pain. Every clinic develops their own protocol. Research is continuing, but meanwhile pain management is a moving target. Even Glasgow University, which is on the forefront of pain management research, does not suggest intervention until the animal demonstrates a certain level of pain (5 out of 20, or 6 out of 24 on the Glasgow Composite Measure Pain Scale).

For purposes of this discussion we have no information to tell us whether Jazz did or did not demonstrate that level of pain. Individual animals do react differently to pain just as people do and there is nothing in the newspaper article that describes Jazz’ behavior and overall condition. We also do not know what anesthesia was used. Some anesthetics take 12-24 hours to completely leave the body and even though the animal is awake and alert, they are still somewhat sedated and comfortable during that time. So without more specific detail, I can’t make assumptions about this dog’s treatment.

At our clinic we give pain meds with every surgery and send pain meds home with each patient, explaining why to the clients.

But even our clients are all over the map when it comes to pain management. For every client that wants it for their pet, there is a client that does not. Reasons why not vary from clients who cite past pets who never needed pain meds, gender differences (men take a pass on the pain meds more often than women do), a reluctance to see their pet drugged (fear of adverse effects), and financial considerations. Some clients flatly refuse to purchase the meds, others purchase them reluctantly and then do not administer them at home. Obviously, we deal with a lot of different attitudes and opinions and try to be sensitive to them all.

Yes, Bernie, Lucinda is the only one making a “rational” argument—an argument purely from authority, an argument that says that the licensing board has no business passing judgment on whether the vet is adhering to a professional standard of care, an argument that says that the dog’s owners must have been irresponsible and ignorant or they’d know it’s not their place to question the godlike vet, that the rest of us should just shut up.

Quite the rational argument, there.

I worked for several years for a law firm that did a lot of medical malpractice defense. “Standard of care”—which the failure to maintain can land a doctor in serious trouble—is not solely a matter of officially adopted mandatory rules or even officially recommended guidelines. It’a also a matter of what’s in the medical literature, what’s widely done in clinical practice, what the medical schools have started teaching (even if they weren’t teaching it when you were in school.) “Standard of care” at the time the incident occurred can protect a doctor who adhered to it even if, in the time between the incident and the case coming to court, the standard of care has changed. And it can whack a doctor pretty hard, if he didn’t adhere to the standard of care at the time of the incident, even if what he did do was the accepted, recommended practice—the standard of care—for his entire forty- or fifty- or sixty-year career prior to that.

Human doctors are expected to keep up with changing medical knowledge and standards. It’s fair to say that vets have a tougher job, having to be medically knowledgable about many different species. That’s not an excuse for not keeping up with stuff that appears to affect, at a minimum, all mammals.

Lynn, old is not equal to bad. Most of us would prefer accumulated wisdom over the young and inexperienced.

I think LauraL has about the best attitude here. But lets consider just exactly what constitutes “as much as you can”. Does that mean that more is always better? Lets let the vet speak for himself.

“I don’t want animals to suffer, that’s why I became a veterinarian,” Seemann said. “But you can’t just obliterate all pain until you’ve made a diagnosis, and with some conditions, if you block the pain, you can’t tell if they’re getting better.”

Read this phrase again “…until you’ve made a diagnosis…” And then “with some conditions”.

In other words he is NOT saying that he does not use pain medication. He is reading the actual condition of the animal to determine 1) if the treatment is working and 2) if further treatment is required.

I see no cavalier prohibition of pain medication here! I hear an experienced veterinarian who knows and cares for his patients with all of his accumulated wisdom and skill. And, that is the way it should be, not a practice managing modern who is doing more the treat the angst of an overly empathetic owner than the patient itself.

I also take exception to the picture posted at the top. Is THIS the actual animal in question or a stock photo chosen for its shock value? Anyone who looks at that certain imagines the pain that poor dog is likely to feel. In the end I think this is the battle Im fighting here. It is NOT about good and wise treatment, it is about what we IMAGINE an unidentified animal MIGHT have felt.

Much like the Congo controversey, none of us were there. We dont know the animal. We dont know the owners. We do not have the specifics of the case and very few of us are qualified to judge.

Take two valium and call me in the morning.