Health & Management / Ruminants Pain Management / Techniques and protocols OVERVIEW:
< > Prevention of Pain Associated with Routine and Clinical Surgical Procedures in Ruminants:
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Introduction and General Information

"In cattle systemic analgesia is indicated in the treatment of obviously painful disease (lameness), injury (for example after extensive foetotomy) and during and after surgery whether it is routine (dehorning), occasional (caesarian section, claw removal) or experimental." (P61.62.w1)

Several routine management techniques in domestic ruminants are known to be painful, including castration, tail docking, mulesing, dehorning and disbudding.

  • Less painful methods of performing routine management operations which are known to be painful, including castration, dehorning, tail docking, Mules operation and foot care "must be explored and implemented." (B207.2.w2)
  • Pain associated with these procedures may be prevented or alleviated by a variety of methods including choosing methods which have been shown to cause less pain, use of local or regional analgesia to prevent pain, use of general anaesthesia and combined approaches. (J15.21.w1)
Surgical operations such as caesarean section and digit removal, carried out in response to clinical conditions, are also recognised to cause pain. 
  • Pain associated with such surgical procedures is usually treated at the time of the operation using either general anaesthesia or local/regional anaesthesia, and by attention to good surgical technique in order to minimise tissue trauma. However, there is now increasing recognition that following rapid recovery from anaesthesia there may be intense acute pain, therefore there should be consideration of post-operative analgesia. (J303.10.w1)

The American College of Veterinary Anaesthesiologist has stated in their position paper on the treatment of pain in animals that although the severity of pain produced by procedures in animals may not always be the same as that produced by the same procedure in humans "it is preferable to empirically administer analgesics preemptively if there is any question that a procedure will induce pain in an animal." (J4.213.w2, W513.Jun04.w1)

It is important to remember that pain, and suffering which may be caused by unrelieved pain, are associated with maladaptive physiological responses and behaviours: "there are no beneficial effects of unrelieved pain in animals under veterinary care." (J4.213.w2, W513.Jun04.w1)

Note: For information on alleviation of pain in painful diseases and conditions, in which it is NOT known in advance that pain is likely to occur in the animal, see: Alleviation of Pain Associated with Painful Conditions in Ruminants

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Choice of Age

"Choosing an age when distress responses are least " (J15.21.w1)
  • If the response to a given procedure is less in younger animals than in older animals then application of the procedure at the earlier age may be preferable. (P61.53.w1)
  • Note: it has been presumed that, when subjected to the same procedure, younger animals experience less pain than do older animals. However, although some responses (e.g. cortisol levels) to a particular procedure may change with age, there is no convincing evidence that age affects the pain and distress caused by management procedures such as castration, tail docking and dehorning. (J15.21.w1)
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Avoidance of procedure

Avoiding use of management techniques known to be painful, where possible. (J15.21.w1)

In some circumstances it may be possible to avoid using a particular procedure.

  • e.g. castration of lambs may not be required in flocks where lambs are to be slaughtered at an early age. (J15.14.w3, J35.152.w2, J288.59.w3)
    • It may be necessary to confirm with the abattoir that carcasses will not be marked down if intact ram lambs are sent for slaughter.
  • It is necessary to educate farmers that some routine procedures are not always required. (J288.59.w3)
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Choice of method

Where different methods are available then the method which is associated with the least pain can be chosen. (J15.21.w1, P61.53.w1)
  • For procedures such as castration, tail docking, and dehorning, extensive research has shown that some methods are less painful than are others. (J15.21.w1, P61.53.w1)
  • More invasive surgical procedures cause a greater degree of tissue damage and a greater degree of postoperative pain. (J4.213.w2, W513.Jun04.w1)
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Correct application of chosen procedure

Whatever procedure is chosen it is probable that it is less painful if carried out skillfully and with appropriate, well-maintained equipment than if it is carried out in an unskillful manner with equipment that is not meant for the job or has not been properly maintained. 
  • Appropriate, well-maintained equipment must be used. (J288.59.w3)
    • For example if the Mules operation is to be carried out on sheep the proper modified shears designed for the procedure should be used and these must be kept sharp. (J288.59.w3)
  • Good surgical technique involving minimal tissue trauma will tend to reduce post-operative pain. (P54.2.w4)
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Use of local or regional anaesthesia

Pain-induced distress due to the initial pain impulse barrage (nociceptor input) can be abolished by injection of local anaesthetic agents prior to a procedure being carried out. (J15.21.w1, P61.53.w1)
  • In general, the local analgesic effect wears off while pain impulses due to inflammatory processes are still ongoing. (J15.21.w1)
  • In the case of ring castration/tail docking in lambs, prior injection of lidocaine can abolish pain-induced distress; the constricting rings appear to prevent clearance of the local anaesthetic from the injection site, thereby extending its period of action. (J15.21.w1)

Note: 

  • Administration of local anaesthetic solution may itself cause distress therefore its use may not be appropriate for procedures in which low-grade pain is caused. (P61.53.w1)
  • Injection of local anaesthetic into the scrotum, testes, tail or epidural space of large numbers of animals in practical farm conditions inevitably risks infection (and with epidural injection, spinal abscesses) in some cases, as well as the risk of overdose. (P61.53.w1)
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Use of general anaesthesia and sedatives

General anaesthesia will block conscious perception of nociceptor input. (J15.21.w1, P61.53.w1)
  • General anaesthesia involves a hazard to the animal being anaesthetised and is rarely used in farm ruminants, particularly in large ruminants. (P61.53.w1)
  • This is rarely a practical option particularly when large numbers of animals are involved, due to the requirements to guard against hazards during recovery. (J15.21.w1)
  • General anaesthesia lasting for less than one hour is unlikely to eliminate the pain associated with inflammatory processes, lasting at least eight hours after surgical castration plus tail docking in lambs and seven hours following amputation dehorning of calves. (J15.21.w1)
  • General anaesthesia is commonly used for dehorning goat kids. See: Pain Prevention for Disbudding and Dehorning of Goats and Sheep

Sedatives, due to their effect on the consciousness of the animal, may "blunt" pain-induced distress as well as reducing distress due to handling. (P61.53.w1)

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Use of NSAIDs

Systemic analgesics may be used to reduce pain. (P61.53.w1)
  • Use of NSAIDs prior to application of painful husbandry procedures can significantly reduce overall cortisol responses, but have only a small effect on distress associated with the initial pain impulse barrage. (J15.21.w1)
  • Even when anaesthesia is used during a painful procedure, following rapid recovery from anaesthesia there may be intense acute pain therefore there should be consideration of post-operative analgesia. (J303.10.w1)
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Electro-immobilisation

Electro-immobilisation does not appear to reduce pain or stress in sheep or cattle and is itself an aversive experience. 

Electro-immobilisation restrains sheep or cattle by subcutaneous passage of pulsed low-voltage current to produce tetanic contractions of the skeletal muscles. It has been suggested that some degree of analgesia may result from the use of such a device, and studies have been carried out to test this. (J3.120.w2)

  • A study in cattle being dehorned found that the rise in serum cortisol associated with dehorning was not reduced by use of electro-immobilisation. Further, about one third of cattle bellowed when the immobiliser was applied, and when dehorning was carried out, eye movements and flinching around the head and neck were observed, suggesting a pain reaction. The authors suggested that the immobiliser should not be relied on to produce analgesia and that application of the immobiliser, which produces strong muscular contractions, may itself be painful. (J24.60.w1)

A number of studies have shown that electro-immobilisation is itself an aversive procedure.

  • An experiment comparing the aversiveness of shearing (which involves pulling on the wool and some nicks and scrapes to the skin) in sheep with that of being exposed to noise from a shearing handpiece, found that shearing was more aversive than was exposure to the noise (as indicated by the length of time required to push sheep down a race which had previously led to one or the other treatment). Electro-immobilisation did not decrease the aversiveness of shearing as indicated by this method, "indeed, electro-immobilisation alone seemed as aversive as the removal of the wool." (J3.120.w2)
  • Electro-immobilisation of sheep increased plasma levels of cortisol in sheep and also levels of β-endorphine and β-lipotrophin but did not increase prolactin levels. The results indicated that electro-immobilisation was stressful to sheep. (J21.41.w3)
  • Plasma cortisol levels were significantly (P<0.01) higher in the 10 to 45 minutes following electro-immobilisation (EIM), with or without sham-shearing, compared with those which were sham-shorn or control (handled) animals. The results indicated that electro-immobilisation alone was stressful to sheep and was more stressful than the handling procedures associated with sham shearing. "Therefore, it would seem unreasonable to claim that EIM alleviates the stress of farming procedures in sheep." (J21.43.w3)
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Stress-induced analgesia

This is not an appropriate method by which to reduce pain, since one of the reasons why pain should be reduced is to reduce stress. 
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Benefits of Preemptive analgesia

Administration of analgesics before or soon after pain occurs can prevent central sensitization and thus potentially decrease the total amount of analgesics required. (J4.219.w4)
  • Use of preemptive analgesia may reduce the anaesthetic requirements of patients undergoing surgery. (J4.219.w4)
  • Truly preemptive analgesia can only be utilised when it is known that pain is going to occur, i.e. before carrying out a painful procedure. However use of analgesics soon after an insult has occurred can also reduce central sensitisation. (J4.219.w4)
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Combined Approaches

Combined approaches to pain prevention or alleviation may involve combining methods used and/or combining specific pain relieving strategies. (J15.21.w1)

Because there are so many different sensitisers and central mechanisms involved in pain modulation and amplification, a single-drug analgesic strategy is generally not totally effective. Use of combinations of drugs that act by different mechanisms is often more effective for the treatment of pain. (J4.219.w4)

  • The use of a castrating clamp across the full width of the scrotum after placement of a rubber ring may reduce pain impulses from ischaemic testicular and scrotal tissue by crushing the spermatic cords, including the spermatic nerves and the nerves supplying the distal scrotum. The method appears most effective with week-old lambs but less effective with lambs of 3-6 weeks old. (J15.21.w1)
  • For amputation dehorning of calves, a combination of injection of local anaesthetic prior to the procedure, plus cauterisation of the head wounds immediately after dehorning, has been shown to markedly reduce the cortisol distress response through the usual seven to nine hour acute phase response. (J15.21.w1)
  • For amputation dehorning of calves, a combination of local anaesthetic and use of an NSAID reduces or abolishes pain-induced distress response to dehorning: local anaesthetic blocks sensory input including pain impulses from the horn-skull junctions at the time of the amputation while the NSAID prevents/significantly reduces the development of inflammatory pain. (J15.21.w1)
    • The main disadvantage is the high cost per animal. (J15.21.w1)
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Prevention of Pain Associated with Individual Painful Procedures

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Authors & Referees

Authors Dr Debra Bourne MA VetMB PhD MRCVS (V.w5)
Referee A.B.Forbes BVM&S.,CBiol.,MIBiol.,DipEVPC.,MRCVS (V.w66)

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