Pain Management and Analgesia
Domain focus
Pain Management and Analgesia tests recognition and treatment of acute and chronic pain using multimodal therapy. The exam expects species-specific drug choices, safe combinations, and reassessment.
Core rules and concepts
- Pain is assessed by species-typical behavior, posture, facial expression, activity, appetite, and response to palpation. Use a validated scale and record scores before and after treatment.
- Multimodal analgesia combines opioids, NSAIDs, local anesthetics, and adjuncts such as gabapentin or ketamine when appropriate. This reduces individual drug doses and improves relief.
- NSAIDs are contraindicated with concurrent corticosteroids, dehydration, renal compromise, or gastrointestinal ulceration. Cats metabolize some NSAIDs slowly; follow label dosing.
- Opioids provide visceral and somatic analgesia but can cause respiratory depression, ileus, and excitement in some species.
- Local blocks require correct landmarks and dose calculation by weight; calculate the maximum volume before injecting.
Worked example
A 4 kg cat is prescribed meloxicam at 0.1 mg/kg for the first day. Dose = 4 × 0.1 = 0.4 mg. The oral suspension is 0.5 mg/mL, so volume = 0.4 ÷ 0.5 = 0.8 mL. The technician confirms the cat is eating and hydrated, checks that no corticosteroid was given, and records the dose and time.
Traps that cost marks
Combining an NSAID with prednisolone; giving human ibuprofen or acetaminophen; assuming a quiet patient is pain-free; and failing to reassess after analgesia.