Here’s another post chock-full of fun factoids for all you feline readers. I recently read yet another paper from this past issue’s JAVMA that deals with pain management in cats—at home and after surgery, no less. If you plan on spaying or neutering your cat (and you always will, at some point or another in your kitty career) this study might interest you.
The basic point this study makes is that owners can expect behavioral changes in their cats which we can presumably attribute to pain--if research on dogs and children (curiously) are any indication.
The most commonly associated post surgical behaviors after a neuter or spay include a decrease in activity level, an increase in the amount of time spent sleeping, a decrease in playfulness and less interest in jumping. Hiding and decreased appetite were also evident in some kitties.
Using a 100-point scale, owners were asked to tally up points associated with these behavior changes. Females scored an average of 25 after spay while males ranked an average of 15 after neutering. In case you’re wondering, these girls were about a year old and the boys about 10 months.
The results of the study demonstrate that kitties do indeed act differently after a day at the hospital. They act an average of 20 points differently than they did before. The study, however, fails to tease out whether these differences are actually due to pain, stress or anesthesia. (Sometimes I wonder who makes up these studies and how they manage to get printed).
It’s not that I don’t believe that cats suffer pain after surgery (of course they do!) but cats are so notoriously adept at hiding pain and more likely to demonstrate their stress that I find it difficult to imagine that an owner’s home-style ranking system would manage to separate stress from pain. Then factor into it the five(!) drugs that were administered to each of these 150 cats and you’ve got one very messy study.
What’s the upshot? I think owners perceive pain in their cats through behavior changes. I believe hospital stays and anesthetics are stressful (not to mention the damned E-collar, which would make me not to want to eat or jump, either). I think this study pretty much stinks.
Nonetheless, I will accept the point that owners observe, care and worry about their cats. They watch vigilantly and want to be sure that their kitty doesn’t suffer unduly. Does that mean we need to use more pain medications in our protocol? Maybe. But who’s to say more pain meds might not lead to more changes in behavior?
Ultimately, I think we need a larger-scale study to demonstrate whether cats anesthetized for identical lengths of time under varying surgical conditions, using the same surgeon and the same equipment in the same hospital every time respond differently—and we need to know how that behavior manifests.
Sure, every cat’s going to act weird after being at the hospital. But what’s real pain look like in a cat?—that’s the question.
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My 13-year old cat just had her eye removed (traumatic glaucoma, then infection) last month. When the trauma occurred to the eye, she was in extreme pain, hiding on a dining room chair and not allowing me to pet her. After her surgery, although she was in some pain, that was controlled with medication, and I think her behavior changes were due to a) disgust at our leaving her overnight at the vet's, b) anger at having to wear an Elizabethan collar, and c) nausea from the medication. Unlike her behavior after the iniital injury -- an extreme "loner" attitude -- she was extremely friendly and affectionate after the surgery, when she got to come home. Her main difference was a refusal to eat, even the canned food she likes so much. She had surgery on a Saturday evening, came home late Sunday afternoon, ate a little at the vet's on Sunday morning, but then would not again until Tuesday morning. She talked, napped, and prowled as normal, and even was ready to go through the dog door into the back yard by Sunday evening. She was the same old lap kitty she's always been.
Kathy Dix July 20th, 2007 05:34:00 PM
Tsk, tsk. And to think the money for that research could have gone to something more useful, like studying the effects of Uriah Heep on fish (http://www.reuters.com/article/oddlyEnoughNews/idU...).
abc July 20th, 2007 07:01:00 PM
I think all cats are "off"when they come home from the vet regardless of whether they are in pain or not.
Tool goes into full-blown snob mode and won't go near anybody for atleast few hours. If I try to con him into coming to me, he'll sit with his back turned to me and only move his ears so he can still listen. There are ways around this of course ( food) but usually I just let him be a snot and get it out of his system. Mojo is still too young to give me an attitude over a trip to the vets, so to him it isn't a big deal. Once he's out of his carrier, he runs around the house looking for Tool so he can jump on his head.
As for the study, it doesn't surprise me how it was done. Human studies are just as bad and often lean to only one side of the story as well.
We've all seen and heard the commercials that state that drinking milk helps people lose weight, however, that study was done by dairy farmers. *rolls eyes* This is not to say that dairy farmers do not live a healthy lifestyle, but when their study is looked at for what it is, it has nothing to do with losing weight. It is about pushing product as they know we live in a society where if somebody promises a person something that doesn't involve eating well and exercise, people will buy into it in the name of looking for that magic bullet.
Stacy July 21st, 2007 08:18:00 AM
Does seem like a waste of a study to me too. My cats are so stressed by going to the vets, or even if one of the other cats goes to the vet. My IBD cat is probably the least stressed.
But one of my cats urine ph skyrockets at the vets. We have a note on his file that any UA needs to be done the moment he walks in the door. He urinates in his carrier so we have to hope there is still something left. At the vet there is no calming him. And when he comes home, he is stressed the rest of the day. The other cats are then equally stressed by his vet visit for a day longer or so. So, if he were in pain from a procedure it would be very hard to distinguish pain from stress, etc.
My third cat...He had a dental cleaning and three teeth removed this past winter. When he came home after being left at the vets all day, he did not stop purring all night. The next day his energy level was very low and he seemed sad. Was it pain? Was it stress from being at the vets? Was it being depressed that his people left him for the day? Was it that we were stupid enough to leave him alone with the other two cats overnight - luckily I woke up in the middle of the night to find him cornered by one of the cats and brought him upstairs with me. I'm guessing it was all of those things.
jenny July 21st, 2007 10:36:00 AM
Perhaps studies like this can help address how much we take for granted about an animal's tolerance for pain? I doubt levels of pain can really be directly measured -- the methodology compares behavior differences? Even humans reporting their level of pain are sometimes given a range of numbers with high pain at one end and low at the other.
Do cats get anything (the females particularly) for pain after the surgery these days? In the past when I've taken cats to be altered, it was just a matter of keeping them in a crate or quietly resting somehow. I don't know if the vet gave them a painkiller shot or just expected the grogginess to float them through the pain period. Certainly some animals and humans have different tolerance for pain. I know the argument that pain will help keep the animal from moving around more than necessary. Works for me when a pup hurts itself.
I think big dogs in the past often got sent home without any pain killer after a spay, but I think some vets do medicate after spaying.
Semavi Lady July 21st, 2007 11:24:00 PM
I've often wondered myself how much of post-surgical behaviour in my cats is due to what factors. For example, I myself react badly to general anesthesia, becoming very nauseated. How can we differentiate ourselves so much from animals? Since we have similar enough physiological systems to warrant animal testing of so many products, I think we can assume that if the same physiological systems are there, then they feel the same way we do about things like anesthesia, etc. Does not a cat have ears? Does not a cat have eyes? to quote Shylock....
As for pain in particular, I do know that sometimes it may be relative to what they endured prior to the surgery. My one cat Mattie has the feline immune disease that required the removal of all premolars & molars due to massive infection & reaction by the time she was one year old. Her gums became truly a disgusting shade of green & her discomfort was terrible to watch.
When she came home, within a day of the complete removal of 99% of her teeth, she trotted straight over to the other cats' bowl of round dry kibbles & settled down to a good chowdown, gumming her kibbles with no signs of pain & walking away after for a good wash. I assume that her relief from the infection was so great that anything felt better once it was removed!
With her example, & that of an ancient barn cat who had 7 teeth removed also at once, I truly believe that one has to consider how much pain is quietly endured by our cats on a daily basis & balance that with any pain they will suffer from the surgery. The ancient one proceeded to also live the next 6 years on dry kibble (he didn't want tinned food) & very gummed mice that ended up looking like corrugated cardboard by the time he was done with them.
On the subject of optional surgeries, my old vet was very much a believer in pain relief administered both immediately prior to & during surgeries as the cats & dogs came out of the situation MUCH happier & less stressed. her primary example was that of declawing cats. Whilst she fervently attempted to talk cat owners out of doing such barbaric thigns to their cats, if the humans insisted, the vet would apply a small local dab of a lidocaine-like substance to each poor mutilated toe immediately after the surgery before they awoke & the cats were much less stressed about the trauma. So I think that ANY small area to lessen the overall trauma of a hospital visit is worth for the cat or other animal. How could we do any less?
Beth July 23rd, 2007 04:25:00 AM
I think they should stick an IV in every cat having spay/neuter surgery, then observe results. My guess is flushing the anesthesia agents out of the system as fast as possible will have a positive effect.
CathyA July 23rd, 2007 08:02:00 AM
Beth - I've had the same experience with tooth extractions. My little female cat has had gum problems her whole life. When I adopted her she was pretty withdrawn which I attributed to shyness. After her exam and subsequent teeth extractions (3) she perked up quite a bit. I'm sure the withdrawn behavior was due to the pain she was in. Suprisingly, she doesn't mind going to the vet . She's had more teeth extracted over the past several years so I guess she'll be the Toothless Wondercat pretty soon. Last time after I brought her home and gave her some pain medicine she started back stroking across the living room floor. This cat was not in pain.
My male cat had a bizarro attack after his teeth cleaning (no extractions). We're pretty sure that it was due to the anesthesia but my most friendly, people loving cat turned into a hissing spitting mess. He's been terrified of going to vet ever since.
2CatMom July 23rd, 2007 02:30:00 PM
2CatMom - I would guess that your cats' experiences actually may be right on the money for the variability of surgical effects & the pain vs anesthesia effect. I know I'm a hissing spitting mess after general anesthesia!
As an aside, I have seen so many instant improvements on tooth/teeth removal that it became a standing joke around the place....Feeling poorly? Time for an extraction, regardless of species!
I am having an ongoing battle with a new vet who believes in tooth cleaning only & tries to save teeth, regardless of how infected they are, & my one cat has had 6 months of recurrent infections that have progressed to permanent chin abcesses while the vet continues to subject him twice to anethesia & tooth cleaning & antibiotics which are not solving the underlying problem. So much for "kindness"!
Here's to Toothless Wondercats everywhere & their gummed mice.....
Beth July 23rd, 2007 02:55:00 PM
(I'm hoping that this isn't a repeat - but either I hit cancel or my post got lost in cyberspace).
Beth please take your cat to another vet. When my vet (new) started pulling teeth on a 1 year old cat - i got a second opinion from a cat only vet. The second vet confirmed that her teeth were so bad that there was no saving them. She also confirmed that the cat would probably loose all her teeth by age 5 or 6. Her feeling was that the risk of absesses was too high and she was particularly concerned about infection traveling to the brain! And if my original vets ego was too large to deal with this, that would have been his problem. I would have gotten my self another vet.
The cat is now 4 and has had a total of 9 teeth pulled (not including those little front ones which had mostly fallen out before I adopted her). I wipe her gums with a special solution every night (as best I can) and so far so good. She didn't need any additional extractions last year, her breath is fine so I'm hoping for the best.
However, my male has stinky mouth. I am not looking forward to him having another dental cleaning. I'm sure the vet office isn't looking forward to a psycho cat either - but they seem pretty good about it.
2CatMom July 23rd, 2007 04:17:00 PM
I'm loving this dentistry sideline. And i agree--dentistry can be sooo rewarding when done right. Finding a vet who really cares about teeth is important. Bad teeth and gums can mean a lifetime of pain and suffering when (not-so-simple but necessary) extractions can solve the problem forever. We know it's true of humans so why don't we extend the same courtesy to animals?
Dr. Patty Khuly July 24th, 2007 09:29:00 AM
Dr. Pat - I have to confess that I was initially appalled when the first vet said she was going to lose all her teeth - probably sooner rather than later. Obviously, I've come to terms with this reality and you'd be suprised that what a good eater she is. She can break kibbles - she just uses her front gums rather than her teeth. Soft food just gets inhaled.
With humans (at least in my family) we go to great lengths (filling, crowning, implanting) to try to save natural teeth. It doesn't seem that this has caught on in the pet world - though I wouldn't be suprised if 25 years from now pet owners and vets won't think we were all barbarians for pulling rather than saving pet teeth. Hey, 25 years prior to now, I had cats and no vet ever mentioned routine cleaning.
2CatMom July 24th, 2007 05:56:00 PM
2CatMom: At our hospital we do root canals with crowns and all kinds of fancy dental work. But it's true--we have few takers for our most advanced services (they're long procedures and they use lots of expensive equipment and materials). Maybe it'll catch on someday. in the meantime, those who can afford it have it available to them.
Dr. Patty Khuly July 25th, 2007 10:52:00 AM
I have a 1 year old male cat.His mother abondoned him at birth,so we handraised him.We discovered when we had him neutered at 6 months that his ribs are deformed.The recommendation was to have him put down.I refused and he is now a healthy 1yr old but sleeps upside down on our couch,with head hanging over side.This is how he breathes when he sleeps.Baby Blue now hates being taken out of house.He sees carrier and freaks,has to be sedated before vet visits.I think it's because he knows and heard vet talking about killing him.I live in small town with only one vet.I was hoping he would get over this,but I think the combination of the pain of neutering(was not given any pain meds after surgery)and hating this vet is going to cause a lot of problems in future.Baby Blue may be a cat but it's inhumane to think they don't feel pain as we do.If I had the choice,he would never go back to this inhumane vet ever again.
BabyBlueMom July 28th, 2007 02:46:00 PM
I worked with a woman who was a OTJ-trained tech in the 80s. She would knock out cats for spay and neuter. She told me it was found out many years later that the drugs administered to male cats only immobilized them, and did not anesthesiaze at all. It was a really horrifying story. This study was certainly a mess, but I should hope there will be better efforts on the subject in the future.
Agnes August 1st, 2007 12:14:00 PM
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