Thankfully (!) pain management continues to gain increasing recognition in clinical veterinary practice. In this episode I look at some of the key points made in the following recently published guidelines focusing on those most relevant to ECC and acute short-term pain management:
Epstein M, Rodan I, Griffenhagen G, et al. AAHA/AAFP Pain Management Guidelines for Dogs and Cats. J Fel Med Surg 2015. 17, 251–272.
The ten points discussed in the episode are:

Pain management must be central to our clinical practice
Pain physiology should be considered when implementing our pain management
The patient’s behaviour is key to pain assessment
Pain scoring tools can be useful
Multimodal (balanced) analgesia is another key strategy in pain management
Opioids are the best analgesics in many emergency patients
Non-steroidal anti-inflammatory drugs (NSAIDs) may be contraindicated in emergency patients
Don’t overlook non-pharmacological measures
DON’T OVERLOOK TLC!
Conflicts of interest

 
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2015 AAHA/AAFP Pain Management in Dogs and Cats Guidelines

Small talk and jibber jabber about small animal (canine, feline) Veterinary Emergency and Critical Care (ECC). Hosted by ECC specialist Shailen Jasani, Diplomate of the American College of Veterinary Emergency and Critical care, episodes cover a variety of topics relating to ECC including literature references and evidence-based medicine considerations. So join us for some ECC small talk, why don't you?

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In this episode I am joined by my friends and colleagues, Stacey Davidson and Ru Clements of VetLed, to discuss the role of Quality Improvement (QI) in improving patient care. We discuss what QI is and why you should be engaged with it. We also talk about the role of human factors and workplace culture in QI. A description of many of the terms used in the episode can be found at the website here. Apologies for the sometimes crackly sound quality on this episode. VetLed Facebook page Veterinary Human Factors private Facebook group started by VetLed

Improving Patient Care (QI)

This episode is focused on sepsis. I also talk about the relevance of the glycocalyx. And emphasise how much extrapolation there is from human medicine to veterinary practice. Topics covered include:  Long-standing sepsis definitions and recently suggested updates History of sepsis management in human medicine; including early-goal directed therapy and Surviving Sepsis Campaign Recent large scale human trials: ProCESS (USA), ARISE (Australasia), ProMISe (UK) Key steps for managing the septic veterinary patient The glycocalyx: what it is, what it does, why it is relevant, implications for practice  Click Here For Your FREE Copy of a Transcript of This Episode Click Here for Show Notes  To find out more about my Small Animal Emergency Medicine App (iOS, Android) click here.

Sepsis and the Glycocalyx

Although feline hypertension may be a rare reason for emergency presentation, it is a condition that most small animal practitioners will have encountered both in routine practice and in critical care patients. This episode is based on the 2017 ISFM* Consensus Guidelines on the Diagnosis and Management of Hypertension in Cats which were recently published in the Journal of Feline Medicine and Surgery. The episode discusses the following points: [*International Society of Feline Medicine]  Evidence base behind the Guidelines Secondary versus primary hypertension Target organ damage Monitoring and Underdiagnosis Which cats to monitor blood pressure in Importance of ensuring blood pressure is measured as accurately as possible with a reproducible technique White coat hypertension Defining normal blood pressure Criteria for therapeutic intervention and appropriate therapeutic targets What treatment to use Emergency treatment   The episode is based on: ISFM Consensus Guidelines on the Diagnosis and Management of Hypertension in Cats. J Fel Med Surg 2017. 19:288–303. Click Here For Your FREE Copy of a Transcript of This Episode For show notes for this episode, click here.

Feline Hypertension

Hepatic encephalopathy is a relatively common condition in dogs and to a lesser extent in cats. It is a disorder that all clinical veterinary staff, and especially those working in Emergency and Critical Care, should be aware of. This episode is based on a review article and covers the pathogenesis, clinical presentation, diagnosis, and management of hepatic encephalopathy in dogs and cats including comparisons with human medicine. The episode is based on: Lidbury JA, Cook AK, Steiner JM. Hepatic encephalopathy in dogs and cats. J Vet Emerg Crit Care 2016. 26 (4):471-487. Click Here For Your FREE Copy of a Transcript of This Episode For episode show notes click here. For my Small Animal Emergency Medicine App on iOS click here. Android version coming out in early-mid 2017.

Hepatic Encephalopathy in Dogs and Cats

Activated charcoal is a widely used therapy, especially in dogs, to facilitate gastrointestinal decontamination following toxin ingestion. Points covered in this episode include:  A reminder about what activated charcoal is and how it is meant to work Comments about the use of activated charcoal as a therapy contrasting human and veterinary medicine Contraindications and adverse effects Timing of administration  Click Here For Your FREE Copy of a Transcript of This Episode Click Here For SHOW NOTES of This Episode Click Here For Small Animal Emergency Medicine APP

2015 AAHA/AAFP Pain Management in Dogs and Cats Guidelines

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