Post op pain relief caesarean

Re: Post op pain relief caesarean

Zita Okarina — Fri, 06 May 2011 19:41:58 GMT

[quote user="chris jones"]

surgery is surgery and pain will naturally be the end result so I would give nsaids in most cases unless contraindicated. I think any surgery likely to produce pain should result in the use of pain relief irrelevant whether the surgery went smoothly or not.

Cats being cats would usually just get on with it, doesn't mean they arent in pain though as we all know.

[/quote]

Coming off from the surgery can be very unpleasant. But I just want to make sure we reduce the risk side effect of medication, especially for the kittens/puppies.

Well anyway, it's a NICE input! :)

Re: Post op pain relief caesarean

Bob Russell — Thu, 05 May 2011 11:19:39 GMT

[quote user="Mark Holmes"]

[quote user="chris jones"]I had an eyelid mole remove 2 weeks ago under local, the surgery went well but it still bleeding hurt after so I took nsaids[/quote]

That is interesting because I have had a few moles removed and would say they are almost painless. I also had my finger sutured up a few years ago and told the Dr just to get on with it as I didn't imagine te needle being any more painful than the local ring block he intended to use. It wasn't intollerable.

I do wonder if we all have not just a different pain threshold (ie the point at which you make a fuss) or a genuinely different sensitivity to pain. My little boy squeels like hell at the most minor insult. Maybe I need to be more understanding and less Yorkshire about it. I normally tell him to stop making so much fuss.

[/quote]

The eyelids are very sensitive and I am not surprised it 'bleeding' hurt! No comparison with surgery on many other parts of the body.

We give 'normal' low-dose pre-med (metacam and lower end ACP) - not had a problem. I doubt the NSAID's have been tested in lactation so this may be the reality of the contra-indication.

Re: Post op pain relief caesarean

Martin Atkinson — Thu, 05 May 2011 09:56:37 GMT

Isn't this just another example of us allowing the fear of litigation override common sense and good practice. I would routinely give an NSAID injection, probably carprofen, peri/post op for a caesarian and wouldn't think to get informed consent from the client, thats the last thing I'd have time for when I'm occupied dealing with the surgery and the aftermath. But this discussion also raises another argument: as a couple of correspondents have pointed out: post operative discomfort is not percieved by each individual equally. We can make the decision ourselves as to whether we want post op pain relief and some have a higher pain threshold than others. I'm of the school of thought that I'd rather put up with the pain than risk side effects from medication, especially opioids which make me feel very ill to the extent that when I have orthopaedic surgery (which is surprisingly frrequent given the number of injuries I inflict upon myself from sporting activities) I tell the anaesthetist not to give me any. Of course the bitch can't tell us but given the choice would she rather put up with some post-op pain than risk her pups being affected by the medication?

Re: Post op pain relief caesarean

Judith Joyce — Wed, 04 May 2011 15:36:29 GMT

[quote user="Mark Holmes"]

I do wonder if we all have not just a different pain threshold

[/quote]

As granny used to say, " Where there is no sense, there is no feeling"

Re: Post op pain relief caesarean

Mark Holmes — Wed, 04 May 2011 14:54:32 GMT

[quote user="chris jones"]I had an eyelid mole remove 2 weeks ago under local, the surgery went well but it still bleeding hurt after so I took nsaids[/quote]

Re: Post op pain relief caesarean

Anonymous — Wed, 04 May 2011 14:44:59 GMT

surgery is surgery and pain will naturally be the end result so I would give nsaids in most cases unless contraindicated. I had an eyelid mole remove 2 weeks ago under local, the surgery went well but it still bleeding hurt after so I took nsaids, I know i have no pain threshold because I am a man but I think any surgery likely to produce pain should result in the use of pain relief irrelevant whether the surgery went smoothly or not.

Cats being cats would usually just get on with it, doesn't mean they arent in pain though as we all know. I would use metacam in cats but I would tell the owners about the licence problem, most would be happy, in dogs I tend to use rimadyl. I havent had any probs using this. I tend to give buprenorphine iv once the kittens/pups are out then post op rimadyl (dogs) and metacam (cats)

I think anyone who has had a cx themselves will say nsaids are quite nice to use because it hurts

Re: Post op pain relief caesarean

Zita Okarina — Wed, 04 May 2011 14:33:12 GMT

we've been using rimadyl, meloxicam without a problem

but if the surgery's going well and quick, so we don't jab any painkiller. antibiotic only will do

Zita

Re: Post op pain relief caesarean

Andrew Kent — Thu, 28 Apr 2011 22:08:01 GMT

I used to always avoid giving analgesia to caesareans until I had got the puppies/kittens out but have recently changed that practice. This was based on a CPD I went on that discussed that it is the level of gaseous anaesthetic that has the most implication for puppy survival and so giving pre-op analgesia is likely to allow gaseous levels to be lower. The advice was to give IM Pethidine pre-op and I have found this to be very effective. I still only give a one off NSAID injection post op rather than an oral course.

Andy

Re: Post op pain relief caesarean

James Allsop — Wed, 27 Apr 2011 16:36:07 GMT

I remember phoning pfizer about this a few years ago and they said that a single dose perioperatively of carprophen should be fine for bitch and pups

Re: Post op pain relief caesarean

Heather Toft — Sat, 23 Apr 2011 18:21:20 GMT

I use carprofen routinely for bitch caesars. Extrapolating from other species: Rimadyl cattle has nil milk withdrawal following subcut administration - I take that as meaning it doesn't get into milk in significant quantities. I guess it's just not cost effective for the drug companies to do the studies on lactating bitches. I'd feel a bit guilty not giving them any pain relief at all but I will admit to just giving cats a one-off shot of carprofen & no follow-on analgesia. I think meloxicam has been shown to be excreted in milk in other species, it has a 5 day milk withdrawal in cows anyway.

Re: Post op pain relief caesarean

Mark Holmes — Sat, 23 Apr 2011 16:15:03 GMT

I would agree I use metacam and have not had problems and the hospital dispensed Diclofenac to my wife post partum. I suspect they just haven't done the studies. On balance of risk to bitch and pups pain is likely to be greater than the drug. Poor feeding, squashed pups and self trauma to the wound spring to mind.

Re: Post op pain relief caesarean

emma_j — Sat, 23 Apr 2011 15:30:30 GMT

Agreed I also use metacam post-op against the data sheet, explain to the owners and obtain off-licence consent.

Boehringer have been good about data of off-licence use of meloxicam in exotic species so may well be worth giving the technical department a ring to see what data is known about use during lactation.

Re: Post op pain relief caesarean

Clive Ansell — Sat, 23 Apr 2011 14:21:29 GMT

I tend to use vetergesic, given during anaesthesia and after the kittens are removed. I feel post op analgesia is necessary so I usually use metacam too, although I know it is contraindicated on the data sheet, and have never had any problems. I'm not sure whether the contraindication is because of a known specific risk or whether it has just not been tested during pregnancy and lactation?