Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) •...

33
Mitigating Pain is Not a Pain in the Neck Dr. John Campbell Western College of Veterinary Medicine

Transcript of Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) •...

Page 1: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)

Mitigating Pain is Not a Pain in the Neck

Dr. John Campbell

Western College of Veterinary Medicine

Page 2: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)
Page 3: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)
Page 4: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)
Page 5: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)

What was the most difficult issue to come to consensus on?

PAINFUL PROCEDURES

a) Dehorning

b) Branding

c) Castration

Page 6: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)

How can we measure pain in cattle?

Page 7: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)

Measuring Pain: Biological responses

Production responses a) Feed Intake, Average Daily Gain

Heart rate

EEG Responses (Brain waves)

Cortisol (Stress hormone) a) Blood, saliva, hair

Neuropeptide Substance P

Thermography (Heat and inflammation)

Page 8: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)

Measuring Pain: Behavioural Responses

Stride length

Pedometers (steps taken)

Accelerometers (Standing and Lying time)

Chute behaviour (Strain gauges)

Exit Speed from Chute

Vocalization

Videography to measure behaviour a) Count tail flicking, head shakes etc.

Visual Scoring Systems

Page 9: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)
Page 10: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)

Anesthetics A substance that causes lack of feeling or awareness,

dulling pain to permit surgery and other painful procedures

In cattle we primarily use local anesthetics: eg: Lidocaine

Page 11: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)

Analgesics Medicines that relieve pain

a) Non steroidal Anti-inflammatory Drugs (NSAIDS)

• Drugs similar to aspirin or ibuprofen

b) Products licensed for cattle in Canada:

• Ketoprofen (Anafen)

• Flunixin (Banamine)

• Meloxicam (Metacam)

• Oral Meloxicam solution

c) Sedatives such as xylazine (Rompun) also may provide some pain control (analgesia)

Page 12: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)
Page 13: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)
Page 14: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)

Dehorning and Pain Control

Page 15: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)

Requirements

Dehorning must be performed by competent personnel using proper, clean, well maintained instruments and accepted techniques

Seek guidance from your veterinarian on the availability and advisability of pain control for disbudding or dehorning beef cattle

Disbud calves as early as practically possible, while horn development is still at the horn bud stage (<2-3 months)

Effective Jan 1, 2016: Use pain control, in consultation with your veterinarian to mitigate pain associated with dehorning calves after horn bud attachment

Page 16: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)

Horned Cattle

Proportion of beef cattle with horns has been steadily decreasing

Availability and adoption of polled (hornless) genetics has increased

Most common beef breeds have polled lines available

Eliminates the need for dehorning

Page 17: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)

Noordsy’s Food Animal Surgery, Wiley Blackwell

Page 18: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)
Page 19: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)
Page 20: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)

Dehorning Take Home Messages Use polled bulls if possible!

Dehorn as young as possible, before horn bud attachment

Lots of dairy calf research showing benefits of combination of local anesthetic + meloxicam

Ideal situation: Sedation + local anesthetic wait 10 minutes… Dehorn and give meloxicam

I use local anesthetic and meloxicam in beef calves and don’t wait long after administration…I still can see obvious differences in behaviour

Page 21: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)

Branding

Page 22: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)

Recommended Practices

Brand size must be appropriate to size of animal

Avoid re-branding cattle

Consult your veterinarian for advice on the availability and feasibility of controlling pain associated with branding

Page 23: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)

Anecdotally, producers using Meloxicam suggest that calves reunite

with dam faster and are easier to move post branding/castration

Page 24: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)

Take Home Messages for Branding Branding is still a necessary form of ID in some parts of

Canada but is decreasing in prevalence

Research clearly demonstrates pain associated with branding (both hot and cold)

Freeze branding causes less acute pain at the time of the procedure

There is no practical method for local anesthesia available

NSAID’s probably significantly help with post-branding pain

Page 25: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)

Castration

Page 26: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)

Requirements

Castration must be performed by competent personnel using proper, clean, well maintained instruments and accepted techniques

Seek guidance from your veterinarian on the optimum method and timing of castration, as well as the availability and advisability of pain control for castrating beef cattle

Castrate calves as young as practically possible

Page 27: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)

Requirements Effective January 1, 2016

Use pain control, in consultation with your veterinarian, when castrating bulls older than 9 months of age

Effective January 1, 2018

Use pain control, in consultation with your veterinarian, when castrating bulls older than 6 months of age

Page 28: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)

51% 44%

4%

1% [PERCENTAGE]

Age at Castration: % of all bull calves

< 1 week 1 week-3 months 3-6 months 6-9 months > 9 months

Moggy, Windeyer et al, Western Canadian Cow-calf Surveillance Network

Page 29: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)

Castration Local anesthesia probably would significantly help, but

difficult to practically administer

Give an epidural injection….wait for 5-10 minutes

a) Xylazine epidurals work really well in older animals

b) Perhaps local anesthetic injected into cord?

c) Some Australian research on topical anesthetic gels

Significant amounts of research on use of NSAIDS with castration

a) Complicated by age, type of castration, drugs used etc.

Castration should be done at as young an age as practically possible!

Page 30: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)

Castration Take Home Message As young as possible minimizes pain and stress

Local anesthesia is difficult and not easily performed in large herds but probably provides significant benefits in terms of pain control

Promising results for both flunixin and meloxicam (both injectable and oral) as pain control in terms of behavior and biological responses

More studies needed for young beef calves

Page 31: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)

Where else do we need to consider pain control? Post surgery

Post difficult calving? (cow and calf?)

Lameness and injuries

Other potentially painful conditions?

a) Mastitis

b) Arthritis

Page 32: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)

Conclusions Pain control is becoming more of a priority within our

industry as part of our animal welfare mandate

Do the simple things first:

a) Use polled bulls if possible

b) If necessary, dehorn before horn bud attachment

c) Local anesthesia is practical for dehorning and easy to learn

d) Castrate at a young age

e) Consider use of NSAID’s for post castration, branding, dehorning pain control

Stay tuned: Major focus of research

Page 33: Mitigating Pain is Not a Pain in the Neck · • Ketoprofen (Anafen) • Flunixin (Banamine) • Meloxicam (Metacam) • Oral Meloxicam solution c) Sedatives such as xylazine (Rompun)