JUDY MCRAE, CVT
Even during routine exams, when there are no obvious signs of injury or illness, your pet will be evaluated for pain. It is considered the fourth vital sign, following body temperature, pulse, and respiration.
Your veterinarian will measure your pet’s pain using a three-step observation process. First, when entering the exam room, the doctor will watch your pet’s movement and behavior without interacting. Next, your veterinarian will observe your pet while interacting verbally but without making physical contact. During the third and last step, your veterinarian will touch your pet, concentrating on the areas where injury or disease are suspected or already known.
During each observation, the doctor will score the level of discomfort by comparing your pet’s behavioral responses to responses that are listed and scored on a pain scale. The highest of the three scores becomes your pet’s overall pain score.
Jennifer Trembley, DVM, at AAHA-accredited Community Pet Hospital in Thornton, Colo., says that any pet with a pain score of 3 or higher is given medication immediately. If your pet’s score is 2 or less, your veterinarian will discuss treatment options with you, which may include medications, supplements, and physical therapy and rehabilitation.
At AAHA-accredited hospitals, pain assessment is considered part of every patient evaluation, so whether it is a trip to the veterinarian for a routine examination and vaccine appointment or an emergency, you can be assured that appropriate pain management will be provided for the anticipated level and duration of your pet’s pain.
What Is a Pain Scale?
Pain scales used by veterinarians are adaptations of scales developed to assess pain in young children, explains Jennifer Trembley, DVM, of Community Pet Hospital in Colorado. Typically they are based on a scoring grade of 0-4 or 1-5.
Because veterinarians score pain by looking at body posture and physical reactions, pain scales are difficult to use when a pet is unconscious or not acting like it normally would, possibly because it has ingested a toxin. “Problems can also arise when trying to evaluate [cats] in a clinical setting, due to their inherent nature to hide pain and disease,” says Trembley.
Sample Pain Scale
Step 1: Non-interactive behavior scoring
Grade 0 — no pain or hint of discomfort
Grade 1 — seems in comfortable position in room
Grade 2 — shifting positions but quiet
Grade 3 — restless, anxious, and unsettled
Grade 4 — vocalizing / becomes stiff / guards with body parts or thrashing
Step 2: Interactive behavior scoring
Grade 0 — shows greeting behavior / wagging tail / approachable
Grade 1 — curious / approaches but hesitates with movement
Grade 2 — hesitates to approach / restricted interaction / not moving comfortably
Grade 3 — wary / slow movement usually away from person / guarding
Grade 4 — unaware of surroundings / not moving / vocalizing
Step 3: Palpation / touching patient
Grade 0 — can palpate or touch — no negative response
Grade 1 — can palpate or touch — no resistance / may look at or sniff area
Grade 2 — may slightly object to gentle palpation / may lick lips or affected area / holds body still
Grade 3 — withdraws immediately / mild vocalization / tense or guarding / stiffness Grade 4 — tries to escape / bites / grinds teeth or grimaces / ears are back / hides affected area / loud vocalization
This article originally appeared in PetsMatter April 16 - Volume 4 Issue 2, published by the American Animal Hospital Association. Copyright © 2009 AAHA. Find out more.