Position Statement
Published: July 2019
Introduction
This Position Statement communicates the expectation of the College of Veterinarians of Ontario regarding the management of pain in animals in the delivery of veterinary medicine. While respecting the veterinarian’s professional judgement in relation to specific scientific evidence and case context, this Position Statement provides broad guidance to veterinarians and reinforces their professional obligation to the prevention and alleviation of animal pain and suffering.
Background
The prevention and relief of pain and suffering in all animals (small and large) is one of the professional pillars of veterinary medicine as clearly stated in the Canadian Veterinary Oath 2018. Experts, such as the American College of Veterinary Anesthesia and Analgesia, outline animal pain (acute or chronic) and suffering as a clinically important condition and promote the prevention of such as a singularly important and therapeutic goal.
The effective prevention and treatment of pain in animals, across the vast spectrum of veterinary medicine, is complex. Pain prevention and management includes considerations of constantly evolving standards of care, inter-species differences in standards of care, ethics, the application of a veterinarian’s clinical judgement, and informed client consent and education. In formulating its position, Council acknowledges that particular species groups differ in pain management options and choices, and concludes that in certain circumstances the complete elimination of pain in individual animals may not be obtainable.
Definitions
Pain: Pain is the unpleasant sensory and emotional experience associated with actual or potential tissue damage. It is a complex phenomenon involving pathophysiological and psychological components that may be difficult to interpret in animals. An individual animal’s response to pain varies with many factors inclusive of age, sex, health status, species variation and breed differences, and evidence concludes that pain in animals occurs with the same intensity and feeling as that which occurs in humans with a similar problem.3
Suffering: Suffering is a term frequently used in conjunction with pain, implying the conscious endurance of pain or distress. Suffering may refer to a wide range of intense and unpleasant subjective states that may be of physical or psychologic origin.
Integrative Therapy: Integrative therapy describes the combination of complementary and alternative therapies with conventional care and is guided by the best available evidence,4
Position Statement
Deliberate attention to the prevention, recognition and management of animal pain and suffering is a cornerstone to the provision of ethical and humane veterinary medicine. This obligation applies to all animals, in all cases, medical or surgical, where the potential for pain exists.
A veterinarian is expected to maintain current knowledge and skill in the prevention, recognition, and management of pain in animals served within their scope of practice. The prevention and alleviation of animal pain and suffering is considered an essential therapeutic goal with therapeutic strategies aimed at improving an animal’s ability to cope with pain, thereby decreasing suffering. Appropriate treatment is inclusive of pharmacological therapy, integrative therapy, and environmental adaptation.
References
Canadian Veterinary Oath
"As a member of the veterinary medical profession, I solemnly swear that I will use my scientific knowledge and skills for the benefit of society. I will strive to promote animal health and welfare, prevent and relieve animal suffering, protect the health of the public and environment, and advance comparative medical knowledge. I will practise my profession conscientiously, with dignity, and in keeping with the principles of veterinary medical ethics. I will strive continuously to improve my professional knowledge and competence and to maintain the highest professional and ethical standards for myself and the profession."5
All science, inclusive of appropriate anesthesia and analgesia in a particular circumstance, evolves over time. Some suggested references include:
- WSAVA Global Pain Council Guidelines available for download.
- International Veterinary Academy of Pain Management Pain Information and Guidelines available at https://ivapm.org/professionals/.
- Karol A. Mathews, Melissa Sinclair, Andrea M. Steele, Tamara Grubb. Analagesia and Anesthesia for the Ill or Injured Cat and Dog, 2018 WILEY Blackwell, NJ, USA. Table of Contents and complete Index available for download.
Veterinarians are urged to access a broad source of current and credible resources to assist with their competency in the management of pain in the animals they have the privilege to treat.
College publications contain practice parameters and standards which should be considered by all Ontario veterinarians in the care of their patients and in the practice of the profession. College publications are developed in consultation with the profession and describe current professional expectations. It is important to note that these College publications may be used by the College or other bodies in determining whether appropriate standards of practice and professional responsibilities have been maintained. The College encourages you to refer to the website (www.cvo.org) to ensure you are referring to the most recent version of any document.