Cats deserve pain relief too

Provision of analgesia post-neutering in cats: are we doing enough?

Introduction

Neutering is a surgical procedure and therefore associated with pain. However, in a UK-based study published in 2013, while perioperative analgesia was widely used in both dogs and cats, only 33% of cats received post-operative analgesia following neutering compared with 75% of dogs, and neutering was considered more painful in dogs than in cats.1  iCatCare's veterinary division, the International Society of Feline Medicine (ISFM), encourages the routine assessment and treatment of pain in cats. However, recognition of pain is not always straightforward and the perception that cats experience less pain than dogs with neutering may largely reflect different behavioural responses to pain between the two species rather than genuine differences in the experience of pain. This campaign highlights the reasons many cats are not receiving post-operative analgesia, and aims to encourage clinics to review their policies on prescribing analgesics for routine neutering procedures.

Do cats feel less pain?

For some vets there may be a perception that neutering cats is less painful than neutering dogs, but it makes physiological sense that both species are likely to feel pain for several days after a surgical procedure. Studies have shown that cats do show behavioural changes indicative of pain for 3 days or more after neutering,2 but we know that this species are less demonstrative and less likely to show overt signs of pain such as vocalization. 

Additional reasons why cats receive less analgesia post-operatively than dogs, may include the following:

  • Cats are discharged post-neutering relatively rapidly, often before pain scoring is carried out, and when they are still benefiting from peri-operative analgesic injections. This means they may remain comfortable while under veterinary care but may become more painful when in the home where assessments such as wound palpation are not carried out.
  • Owners may be unaware of the subtle signs of pain cats demonstrate, such as lethargy and decreased social interaction, or may consider such behaviour ‘normal’ post-surgery and not seek further veterinary treatment.
  • Vets may have a misconception that owners are unwilling to pay for, or administer, analgesic drugs to cats, however, a survey indicated that 78% of owners expected analgesia to be provided routinely for surgery (including neutering), and 61% would expect animals to be discharged with analgesics.3

What analgesia should be provided following neutering?

The WSAVA pain management guidelines,4 strongly recommend the use of preventative/multimodal analgesia, along with careful tissue handling and adherence to good surgical principles. The guidelines additionally suggest that analgesia following castration or ovariohysterectomy/ovariectomy may be required for up to 3 days after surgery using non-steroidal anti-inflammatory drugs.

Want to learn more?

Watch our free to view webinar 'Neutering in practice: are your anaesthesia, analgesia and surgical protocols up to scratch?' presented by David Yates (Manchester RSPCA) and Jo Murrell (Reader in Veterinary Anaesthesia, Bristol University, UK). 

> Watch now

To access your CPD certificate of attendance and powerpoint slides from the webinar – Veterinarians click here and nurses click here.

References:

  1. Hunt JR, Knowles TG, Lascelles BD and Murrell JC. Prescription of perioperative analgesics by UK small animal veterinary surgeons in 2013. Vet Rec 2015; 176:493.
  2. Vaisanen MAM, Tuomikoski SK, Vainio OM. Behavioural alterations and severity of pain in cats recovering at home following elective ovariohysterectomy or castration. J AM Vet Med Assoc 2007; 231:  236-242.
  3. Demetriou JL, Geddes, RF and Jeffery ND. Survey of pet owners’ expectations of surgical practice within first opinion veterinary clinics in Great Britain. J Small Anim Pract 2009; 50: 478-487.
  4. Mathews K, Kronen, PW, Lascelles D et al. Guidelines for recognition, assessment and treatment of pain. Journal of Small Animal Practice 2014, 6: E10-E68