Analgesia and anesthesia for the ill or injured dog and cat

490 Pages·2018·10.05 MB·English

by  Grubb

Analgesia and Anesthesia for the Ill or Injured Dog and Cat
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Analgesia and Anesthesia for the Ill or
Injured Dog and Cat
Karol A. Mathews
Guelph
ON, CA
Melissa Sinclair
Guelph
ON, CA
Andrea M. Steele
Guelph
ON, CA
Tamara Grubb
Uniontown
WA, USA
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This edition first published 2018
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The right of Karol A. Mathews, Melissa Sinclair, Andrea M. Steele and Tamara Grubb to be identified as the authors
of this work has been asserted in accordance with law.
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Library of Congress Cataloging‐in‐Publication Data
Names: Mathews, Karol A., editor. | Sinclair, Melissa, editor. | Steele, Andrea M., editor. |
Grubb, Tamara, editor.
Title: Analgesia and anesthesia for the ill or injured dog and cat / Karol A. Mathews, Melissa Sinclair,
Andrea M. Steele, Tamara Grubb.
Description: Hoboken, NJ: Wiley, [2018] | Includes bibliographical references and index. |
Identifiers: LCCN 2017033962 (print) | LCCN 2017036345 (ebook) | ISBN 9781119036517 (pdf) |
ISBN 9781119036456 (epub) | ISBN 9781119036562 (pbk.)
Subjects: LCSH: Veterinary anesthesia. | Analgesia. | Pain–Treatment. | Dogs–Diseases. |
Cats–Diseases. | MESH: Analgesia–veterinary | Anesthesia–veterinary | Pain Management–veterinary |
Dogs–injuries | Cats–injuries
Classification: LCC SF914 (ebook) | LCC SF914 .A49 2018 (print) | NLM SF 914 | DDC 636.089/796–dc23
LC record available at https://lccn.loc.gov/2017033962
Cover Design: Wiley
Cover Image: Photo credit – Karol A. Mathews
Set in 10/12pt Warnock by SPi Global, Pondicherry, India
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Contents
List of Contributors viii
Preface ix
Acknowledgements x
1 General Considerations for Pain Management upon Initial Presentation and during
Hospital Stay 1
Karol Mathews
2 Physiology and Pathophysiology of Pain 8
Tamara Grubb
3 Physiologic and Pharmacologic Applications to Manage Neuropathic Pain 17
Karol Mathews
4 Physiology and Pharmacology: Clinical Application to Abdominal and Pelvic
Visceral Pain 51
Karol Mathews
5 Physiology and Management of Cancer Pain 64
Karol Mathews and Michelle Oblak
6 Movement‐Evoked and Breakthrough Pain 68
Karol Mathews
7 Pain: Understanding It 70
Karol Mathews
8 Recognition, Assessment and Treatment of Pain in Dogs and Cat 81
Karol Mathews
9 Pharmacologic and Clinical Application of Sedatives 112
Melissa Sinclair
10 Pharmacologic and Clinical Application of Opioid Analgesics 119
Melissa Sinclair
11 Pharmacologic and Clinical Application of Non‐Steroidal Anti‐Inflammatory
Analgesics 134
Karol Mathews
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vi Contents
12 Pharmacologic and Clinical Principles of Adjunct Analgesia 144
Karol Mathews and Tamara Grubb
13 Pharmacologic and Clinical Application of General Anesthetics 165
Melissa Sinclair
14 Local Anesthetic Techniques 171
Alexander Valverde
15 Integrative Techniques for Pain Management 204
Cornelia Mosley and Shauna Cantwell
16 The Veterinary Technician/Nurse’s Role in Pain Management 217
Andrea Steele
17 Optimal Nursing Care for the Management of Pain 219
Andrea Steele
18 Preparation and Delivery of Analgesics 230
Andrea Steele
19 Cardiovascular Disease as a Co‐Morbidity for Anesthesia and Analgesia
of Non‐Related Emergencies 244
Tamara Grubb
20 Kidney Disease as a Co‐Morbidity for Anesthesia and Analgesia of Non‐Related
Emergencies 255
Melissa Sinclair
21 Liver Disease as a Co‐Morbidity for Anesthesia and Analgesia of Non‐Related
Emergencies 263
Melissa Sinclair
22 Managing the Aggressive Patient 270
Andrea Steele and Tamara Grubb
23 Analgesia and Anesthesia for Pregnant Cats and Dogs 279
Karol Mathews and Melissa Sinclair
24 Analgesia and Anesthesia for Nursing Cats and Dogs 294
Karol Mathews, Tamara Grubb, Melissa Sinclair and Andrea Steele
25 Physiologic and Pharmacologic Application of Analgesia and Anesthesia
for the Pediatric Patient 308
Karol Mathews, Tamara Grubb and Andrea Steele
26 Analgesia and Anesthesia for the Geriatric Patient 328
Karol Mathews, Melissa Sinclair, Andrea Steele and Tamara Grubb
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Contents vii
27 Analgesia and Anesthesia for Head and Neck Injuries or Illness 336
Karol Mathews, Melissa Sinclair, Andrea Steele and Tamara Grubb
28 Torso, Thorax and Thoracic Cavity: Illness and Injury 356
Karol Mathews, Tamara Grubb and Andrea Steele
29 Torso and Abdomen: Illness and Injuries 375
Karol Mathews, Tamara Grubb and Andrea Steele
30 Pelvic Cavity/Abdomen, Perineum and Torso: Illness and Injuries Urogenital System
and Perineum 391
Karol Mathews, Tamara Grubb and Andrea Steele
31 Musculoskeletal Injuries and Illness 409
Karol Mathews, Melissa Sinclair, Andrea Steele and Tamara Grubb
32 Vertebral Column (Vertebrae and Spinal Cord) 423
Karol Mathews, Tamara Grubb and Andrea Steele
33 Integument Injuries and Illness 439
Karol Mathews, Tamara Grubb and Andrea Steele
34 Environmental Injuries 454
Karol Mathews, Tamara Grubb and Andrea Steele
Index 465
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viii
List of Contributors
Shauna Cantwell, DVM, MVSc, Dipl.ACVAA, CVA, Melissa Sinclair, DVM, DVSc, DACVAA
CVSMT/CAVCA, CTN Associate Professor, Department of Clinical
Medicine Wheel Veterinary Services, Inc. Studies
Ocala, FL, USA Anethesiology, Health Sciences Centre,
Ontario Veterinary College, University of
Tamara Grubb, DVM, PhD, DACVAA Guelph
Associate Clinical Professor, Anesthesia & Guelph, Ontario, Canada
Analgesia
College of Veterinary Medicine Andrea M. Steele, MSc, RVT, VTS(ECC)
Washington State University ICU Technician
Pullman, Washington, USA Emergency & Critical Care, Health Sciences
Centre
Karol A. Mathews, DVM, DVSc, DACVECC Ontario Veterinary College, University of
Professor Emerita, Department of Clinical Guelph
Studies Guelph, Ontario, Canada
Emergency & Critical Care, Health Sciences
Centre Alexander Valverde, DVM, DVSc, DACVAA
Ontario Veterinary College, University of Associate Professor, Department of Clinical
Guelph Studies
Guelph, Ontario, Canada Anesthesiology, Health Sciences Centre,
Ontario Veterinary College, University of
Cornelia Mosley, Dr.med.vet., Dipl.ACVAA, CVA Guelph
Anesthesia and Integrative Pain Management Guelph, Ontario, Canada
VCA Canada, 404 Veterinary Emergency and
Referral Hospital
Newmarket, Ontario, Canada
Michelle Oblak, DVM, DVSc, DACVS, ACVS
Fellow of Surgical Oncology
Assistant Professor, Department of Clinical
Studies
Institute for Comparative Cancer
Investigation
Ontario Veterinary College, University of
Guelph
Guelph, Ontario, Canada
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ix
Preface
All injured, and many ill, patients are in pain, but deciding on how painful the patient is, and
the best pain management strategy for many, can be challenging. General considerations for
pain management upon presentation are detailed and, as many patients will require anesthesia
to manage their problem or to facilitate further diagnostics, basic information gathering is also
outlined. Selecting an appropriate, safe analgesic and anesthetic regimen can be difficult,
compounded by the anatomical location involved and associated co‐morbidities. This book
addresses these concerns, detailing pharmacologic and physiologic mechanisms applicable to
groups (pregnant, nursing, pediatric, geriatric) and etiologies of pain. In addition to a step‐by‐
step approach through various scenarios based on anatomical location of illness or injury, the
veterinary technician/nurse’s role in managing these patients, and the methods of analgesic
delivery, are detailed.
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Acknowledgements
While the authors have years of experience managing ill or injured cats and dogs, specific
details of a colleague’s practice, or publications, were sought and shared. For their contribution,
we would like to thank: Drs. Alexa Bersenas, Alice Defarges, Robin Downing, Mark Epstein,
Steve Escobar, Bernard Hansen, Fiona James, Mark Papich, Bruno Pypendop, Marc Raffe,
Margie Scherk, Kelly St. Denis, Bob Stein and Bonnie Wright.
As a target audience test, we would like to thank Dr. Felicia Uriarte, McLean House Call
Veterinary Services, Barrie, Ontario, Canada for reviewing the approach to the scenarios.
We would like to thank Dr. Kathrine Lamey, Metro Animal Emergency Clinic, Dartmouth,
Nova Scotia, Canada, for contributing photographs of patients presenting to her clinic. These
are included in many scenarios to illustrate some of the injuries our patients’ experience, and
to highlight the degree of pain experienced.
For pharmaceutical assistance and researching details of usage, global availability, approval
of veterinary analgesics and government controls, we would like to thank Heather Kidston,
RPh, FSVHP, Pharmacy Manager, Ontario Veterinary College Health Sciences Centre,
University of Guelph, Guelph, Ontario, Canada. We would also like to thank Greg Soon
BSc(Pharm), Pharmacist  –  ICU, Peterborough Civic Hospital, Ontario, Canada for his
assistance in contributing publications and specific details on human‐only‐approved analgesics
used in various scenarios in this book.
Where specific information is not available in the veterinary literature, we would like to
thank Lorne Porayko MD, FRCP(C), CIM Consultant in Critical Care Medicine &
Anaesthesiology, Victoria, BC, Canada, for sharing the information available for humans, and
his experiences with some aspects, which are incorporated for human comparison into the
various topics.
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