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Which pain scoring system do you recommend for clinical veterinary practice?
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Congratulations on publishing a great paper concentrating on subject matter which is relevant and fundamental to every day veterinary practice - iatrogenic surgical pain. Some very surprising results also! Based on your use of the four different pain scoring systems, which would you use for routine day to day clinical practice? As you mentioned the Glasgow Composite Pain Scale is the most validated, but would you advise trailing one of the other other scoring systems?

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Carl,

I think it depends a little on who is doing the evaluation and how consistent you want to be. I think the modified Colorado scale works well for everyday use (published in Gaynor and Muir's book) but for ease of use if you have a well trained person who is doing most of the assessments the VAS seems to be the most sensitive.

Thanks,

Peter

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I agree with Dr. Pascoe, Carl; Amanda Shelby and I have also reproduced (with permission) the CSU pain scale in our book "Small Animal Anesthesia Techniques" (Wiley) because of the ease of use. I will also add that I've used the modified Glasgow composite pain scale with veterinary students, and in general it takes them less than 5 minutes to complete. Many national meetings have speakers who discuss this topic (i.e. pain assessment), and it's worth sitting in one of their seminars to hear about the comparison.

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I'll look into attending a national meeting. The modified Glasgow composite pain score is quick and easy to use - as you highlight its the importance of having the same individual scoring an animal. Many thanks for directions towards the CSU pain scale.

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Carl, - apologies for the delay. I second Peter and Carolyn's comments. Just to add, in work performed by Bernie Hansen at NC State(as yet, unpublished), it appeared that section C of the Glasgow short form is most sensitive. On the basis of this, I'd also like to suggest the use of a simple numerical rating scale based on the response to palpation of the wound / surgical site. Any system must be comparative - comparing the response elicited before surgery to that elicited following surgery. I believe future work looking at response to mechanical pressure will inform us of a sensitive assessment method for acute pain in practice. Thank you for your interest, Duncan Lascelles

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I agree. But note that theses scores must be always interpretated as indirect measures. These permit to evaluate defensive behaviors (supposed to be 'nocifensive' behaviors) linked to the stimulus. In fact, we cannot 'measure' pain.

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