Use of the Short Form Glasgow Composite Measure Pain Scale in the Assessment of Canine Patients Presenting in Shock

• Main Author: Coucelo, José Miguel Carreira Revez Pereira
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01-01-2015
• Subjects: Adenosine; Animal sciences; Animal training; Blood pressure; Catheters; Critical care; Cytokines; Dogs; Drug dosages; Emergency medical care; Immune system; Immunology; Inflammation; Intensive care; Management; Medical personnel; Medicine; Metabolism; Morphology; Mortality; Narcotics; Nervous system; Nonsteroidal anti-inflammatory drugs; Nurses; Pain management; Peptides; Pharmaceutical sciences; Pulmonary arteries; Surgery; Veterinary medicine; Veterinary services
• ISBN: 9798480634433

The short form of Glasgow Composite Measure Pain Scale (CMPS-SF), a previously validated decision-making tool is increasingly used in practice for the assessment of pain in dogs. However, few studies have considered the application of a pain scoring system in patients presenting in emergency situations.This study aimed to evaluate if pain scoring with the Glasgow CMPS-SF was effective in identifying pain in patients in shock.A prospective study (November 2014 to January 2015), within a first opinion and specialty intensive care service was developed. A total of 31 client-owned dogs (16 females and 15 males) that presented as primary emergencies or transfers. When admitted to the study, all dogs were examined by a veterinarian or registered veterinary nurse. Patients were classified and grouped as Shock (S) or Not Shock (NS) on basis of their shock index (SI). The shock status was defined a priori if the SI was higher than 1.0. Regardless of group, all patients had their pain assessed with the Glasgow CMPS-SF and by a Board Eligible Internist or a Emergency and Critical Care specialist, blinded to both pain score and SI values.Dogs in shock numbered 18/31 dogs within the not shock group numbered 13/31. Mean age of dogs in the S group was 4.6 years (0.2 – 10) and in the NS group was 8.3 years (1 – 16); a significant difference existed in age between groups (p-value<0.05). Median pain score of the S group was 5 (0 – 17) and on the NS group was 3 (1 – 15). There was no significant difference on pain scores between the groups (p-value>0.05) and between the clinicians’ perception of pain between groups (p-value>0.05). A significant difference was present between pain scores and the clinicians’ opinion on pain (p-value=0.014), including within the shock group (p-value=0.0021). Cohen’s kappa statistic within the shock group was 0.47, which can be interpreted as weak to moderate agreement between the Glasgow CMPS-SF and the clinician opinion on pain. Within the NS group the differences between the pain scores and the clinician’ opinion on pain were not statistically significant (p-value>0.05). These results do not support an acceptable agreement between the Glasgow CMPS-SF and an experienced veterinarians evaluation of pain in patients presenting in shock. Therefore, further investigation into the relevance of the used pain assessment tool in emergency and shock patients is recommended before use in the objective monitoring of this subset of patients.