Pain and pain relief are massive topics which can – and do – fill several textbooks. It’s way beyond the scope of a blog to go into all of the detail surrounding the use of painkillers, and so all I really want to do is to outline some of the different types of pain control that we can use, both in the surgery and as day-to-day treatments.

Pain relief is one of the great success stories in medicine, and it’s no coincidence that some of my favourite drugs of all time are painkillers. Our advances mean that pain in our patients shouldn’t be accepted, and although sometimes we fail to control it, we should never stop trying.

We use a number of different types of painkiller:

* Non-steroidal anti-inflammatory drugs (NSAIDs)
* Steroids
* Opioids and opioid-like drugs
* Others

NSAIDs

These are the most widely-used type of painkiller and include (for humans) aspirin, ibuprofen and paracetamol. They act by stopping inflammation…….

Also known as Bloat, Twisted Stomach, Gastric Dilatation-Volvulus or GDV, this condition is one of the most serious emergencies in small animal practice, and it can make all the difference to the outcome if it is recognised immediately.

There are two parts to this condition, the bloat and the torsion. Bloat is when the dog’s stomach fills up with gas, fluid, froth or a mixture of all of these, to a far greater size than normal. Torsion (volvulus) is when the whole stomach twists inside the abdomen so that it is closed off at both its entrance and its exit, just like a sausage which is twisted closed at both ends.

They may both occur together, or one may lead to the other. If bloat occurs first, the enlarged stomach is at greater risk of torsion. If torsion occurs first, bloating will definitely result….

Pain. Everybody knows what it feels like, and – apart from a few determined individuals – we tend to avoid it. But what is it? The International Association for the Study of Pain (IASP) defines it as:

“an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”

Or, in other words, when you damage yourself it hurts. And if you’re feeling down already, it hurts more. And if you’re not feeling down already, then pain may make you feel down. And then it will hurt more.

The IASP mainly looks at pain in humans, but it’s a long time since we stopped trying to pretend that animals either don’t feel pain like we do, or else don’t get upset about it. They do, and their inability to communicate pain effectively (or else our inability to properly listen) means that for a lot of animals, pain is a chronic, miserable constant in their lives, despite help being close to hand.

There are tiny pain receptors all over the body, inside and out, attached to nerve fibres. When a tissue is damaged, they’re triggered to send impulses up to the brain, which senses them and registers the feeling we call pain. Hard to describe, but we all understand what it is and we’ve all got experience of it. Pain receptors are usually well embedded in tissues, and usually need a fair bit of triggering – otherwise, any form of touch would be painful.