BARKS from the Guild July 2017

Page 43

Pain Underlying


Dr. Lynn Bahr discusses the ability of cats to hide chronic pain, and the potential this

ost people who work professionally with cats know what stoic creatures they are and how well they can hide their pain. There are many different theories as to why this is. Until relatively recently, it was thought cats did not experience pain at all, based purely on the fact that they tend not to show it. Some people -- including some feline professionals -even still believe this, despite significant advances to the contrary. It is an astounding reality that, in the year 2017, we still find the subject of pain sufficiently mysterious and elusive that we are only just beginning to acknowledge its existence in animals. Pain is a complex subject even in human medicine, despite the fact that people are able to communicate how they feel, and the complexity is only magnified when working with animals, given that they lack the ability to communicate verbally. We cannot change what we do not know and there is so much in veterinary medicine that we have not learned yet. Just because animals do not complain about headaches we might assume they do not suffer from them like we do. Is it possible that cats living with chronic congestion and deep sinus infections feel just as badly as people with the same ailments? These people still manage to work and live their lives as normally as possible. However, many are miserable, exhausted and even depressed. Medical conditions known to contribute to chronic pain in people also exist in animals, but are often overlooked or ignored. Because animals often suffer in silence it is easy for their pain to go unnoticed and untreated.

What Do We Know About Pain?

Pain is considered to consist of three key components: a sensory-discriminatory component (temporal, spatial, thermal/mechanical), an affective component (subjective and emotional, describing associated fear, tension and autonomic responses), and an evaluative component, describing the magnitude of the quality (e.g. stabbing/ pounding; mild/severe) (World Small Animal Veterinary Association, 2014). Pain can be classified as acute or chronic. Acute pain typically has a sudden onset and is usually the result of a clearly defined cause such as an injury. It is the body's normal response to damage such as a cut, an infection, or other physical injuries. Acute pain is usually short lived (under six months) and resolves with the healing of its underlying cause. Chronic pain is viewed more as its own disease rather than as a symptom of another health problem. It can be affected by physical (sitting or standing), environmental (weather changes), and psychological (stress) factors. Chronic pain signals remain active in the nervous system for weeks, months, or years. In people, physical effects include tense muscles, limited mobility, a lack of energy, and changes in appetite. Emotional effects include depression, anger and anxiety

It is believed that hiding pain is an integral part of a cat’s survival strategy

Š Can Stock Photo Inc./Elizabetalexa


has to cause behavior problems

(Cleveland Clinic, 2017). In cats, we know a lot more about acute pain than chronic. In general, responses to acute surgical and traumatic pain are likely to be more marked and readily recognizable than clinical signs associated with chronic pain. The veterinary profession has pain scoring scales like the Glasgow Feline Composite Measure Pain Scale and the UNESP-Botucatu Multidimensional Composite Pain Scale for Assessing Postoperative Pain in Cats, but despite all the research, data and recommendations, the consensus remains that assessing acute pain in cats is difficult, subjective and extremely underutilized. Recognizing chronic pain is even more elusive, and assessing it in cats is virtually non-existent amongst most veterinary professionals.

Why Do Cats Hide Their Pain?

We know that hiding pain and discomfort from illness or injury is a natural feline behavior. It is believed to be an integral part of their survival strategy for several reasons. Perhaps it is due to their feeding pattern and need to hunt even when injured or in pain, or the fact that they would be preyed upon more easily if weak or sick. Rarely will a cat vocalize his pain because, instead of calling for help, it would simply alert a larger predator to his vulnerability. Within colonies, weaker cats lose status and power, and often have to give up the best hunting grounds. Hiding weakness is a natural way for cats to avoid the threat of displacement by stronger members of the colony. BARKS from the Guild/July 2017