GPC Vision
An empowered, motivated, and globally unified veterinary profession that effectively recognizes and minimizes pain prevalence and impact.
GPC Mission
To raise global awareness and provide a call to action based upon an understanding that all animals are sentient and can therefore feel pain and suffer from it. Through the identification of regionally specific resources for recognizing and treating pain, and targeted education, the Global Pain Council strives to elevate the level of confidence and competence in applying pain treatments.
The Team
Background of authors included certification in anesthesiology, animal welfare, small animal surgery, emergency and critical care, pharmacology, physical rehabilitation and acupuncture.
Treatise
The guidelines for recognition, assessment and treatment of pain were published in 2014 in the Journal of Small Animal Practice. It is free for download at http://www.wsava.org/sites/default/files/jsap_0.pdf
The Document Has Three Main Sections
Section I - Introduction to Pain, Its Recognition and Assessment
In general, this section provides an overview physiology and pathophysiology of pain, recognition/assessment of acute/chronic pain and some common pain misconceptions. An introductory chapter helps the reader on how to use the document.
These chapters are separated by species (dogs/cats) including figures to illustrate painful versus pain-free animals. They also include a list of validated pain assessment tools in dogs and cats for acute and chronic pain with a brief description of their advantages and disadvantages. The information is concise and sometimes presented as bullet-points to facilitate reading. It also highlights the importance of assessing the response to the treatment. A table is provided at the end of Section I with perceived level of pain associated with different conditions so the veterinarian is aware of common medical/surgical conditions that lead to severe, moderate and mild pain.
Section II - Pain Management
This section describes the general approach to the treatment of pain and information about analgesic drugs and non-pharmacological therapies. For each class of analgesic drug (opioids, NSAIDs, alpha-2 adrenoreceptor agonists, local anaesthetics and adjunctive drugs), there is a description of the mechanism of action, indications, adverse-effects, contra-indications and drug interactions. Tables are presented with suggested dosage regimens and comments.
Some analgesic techniques and "tools" are included such as sustained release or infusion systems, wound infusion device, electrical nerve locators and epidural catheters. A brief presentation of ketamine, amantadine, gabapentin, imipramine and amitriptyline, duloxetine and prednoleucotropin is shown on the chapter on "Adjunctive Drugs".
Physical rehabilitation, diet and supplements, nursing and supportive care, acupuncture, medical massage and some salvage surgical procedures are described as non-pharmacological therapies for pain relief.
Section III - Pain Management Protocols
This section includes analgesic (and sometimes anaesthetic) protocols for castration and ovariohysterectomy/ovariectomy, and orthopaedic and soft tissue surgery. There are different options including ideal protocols, or protocols without controlled drugs or with limited availability of analgesic drugs. Examples of analgesic regimens are given in boxes.
A series of loco-regional techniques with figures are listed including anatomical landmarks, drugs, techniques and areas to be desensitised after a local block. There is also emphasis on dental and ophthalmic patients, emergency and critical care, medical pain, pregnant/lactating and neonatal/paediatric patients. The treatise ends with an overview of humane euthanasia and a list of references and acknowledgements to the sponsors.
More than 60 veterinary associations affiliated to the WSAVA have endorsed the GPC treatise. The full treatise has been translated into Polish. Pain management protocols have been translated into Spanish and Portuguese and also reproduced separately from the WSAVA GPC treatise. They have been tiered to ensure global relevance and these "one-pagers" protocols can be downloaded at http://www.wsava.org/guidelines/global-pain-council-guidelines.