For the Very Youngest Animals, Pain Management Is Critical
Do animals feel pain? While the answer may seem to be an obvious “yes,” for many years the view was widely held that they didn’t, at least not in the way humans do. As my friend and colleague Dr. Robin Downing says, that view delayed the development of pain management in veterinary medicine.
“Remember that it wasn’t too long ago that even human infants weren’t given pain medications,” says Dr. Downing, owner of the Downing Center for Animal Pain Management in Windsor, Colo. “They did open-heart surgery on infants with paralytic drugs only.”
A Changing Point of View
You’ll find few physicians or veterinarians these days holding the view that pain is acceptable or even beneficial for those who can’t complain about it. Outside of veterinary medicine, however, the infliction of pain on young animals without pain management is widely practiced by those who remove dewclaws and dock tails in newly born puppies at home. And that, Dr. Downing says, is no longer acceptable in light of what we know to be true about how pain affects immature animals.
“We have a unique opportunity to set the stage for what the nervous system is going to do in adulthood by how we treat that nervous system in babyhood,” she says. “We used to be taught that [tail docking] was a minimally invasive procedure and that they hurt for a little while but they got over it really quickly.”
The trauma to the development of the nervous system, Dr. Downing says, lasts well beyond the cries of pain that can be observed in the days-old puppies. She no longer docks tails or removes dewclaws in her practice because she argues that these procedures are entirely cosmetic and not medically necessary. She also insists that any pain event in young animals — including pediatric spay-neuter — must include pain medication. “In a young animal, the nervous system is still developing," she says. “We’re at that sweet spot where the nervous system is changing very rapidly. The simple decision — and I do believe it is a simple decision — to address pain aggressively and comprehensively in the young animal only makes sense when you think about the negative impact on the developing nervous system.”
She adds, “You can make a case that controlling pain in these babies is even more important” than it is in older pets.
More Than Meets the Eye
Traditionalists will argue that performing procedures like tail docking and dewclaw removal at home, without pain medication, is simply the way things have always been done. But Dr. Downing counters that the evidence argues for humane treatment under a veterinarian’s care, for these and all similar procedures.
“For these little teeny-tinies, that means pre-surgical pain relief in the form of a narcotic, intra-operative pain relief in the form of a nerve block and post-operative pain medication,” Dr. Downing says. “It’s not that hard to calculate a safe dose.”
Dr. Downing is in a unique position to consider this issue from all angles; she's not only an internationally recognized expert on pain, but she’s also working toward a master’s degree in biomedical ethics. That meant our discussion dealt not only with the medical aspects of pain in young animals but also with the philosophical underpinning of why we traditionally haven’t used it.
“The Cartesian model,” she says. “René Descartes was brilliant, but he got some things wrong. One of the errors he made was this concept that if you can’t talk, you can’t think, and you can’t have consciousness. That meant if you can’t talk, you can’t have pain.”
For Dr. Downing, pushing the profession forward has become her life’s work.
“Once you know something, you can’t not know it anymore,” she says. “Animals feel pain. For me, it seems self-evident that we need to change our practices. And we will.”
Knowing Dr. Downing as long as I have and watching the work she has done to help animals, I have no doubt that’s the case.
Read more Vetstreet articles on pain management.