A global survey of attitudes and practices of veterinarians about pain management in cats

This study investigated the attitudes and practices of veterinarians about pain management in cats and how they could be influenced by demographic data.

An online survey in English, French, Chinese, Spanish, Portuguese and German was disseminated by iCatCare and several veterinary associations after content validity (April-July 2024). Participation recruitment was through convenience sampling. The survey was structured as follows: 1) demographic data, 2) drug availability and administration including 2.1) acute pain (pain assessment, NSAIDs, opioids, local anesthetic/locoregional anesthesia, adjunct analgesics and non-pharmacological modalities) and 2.2) chronic pain (pain assessment, NSAIDs, adjunct analgesics, feline-specific anti-nerve growth factor monoclonal antibodies and non-pharmacological modalities), and 3) analgesic use in common conditions. Multiple correspondence analysis was used for statistical analysis (P <0.05).

A total of 2,194 were received from 88 countries (74.9%, 23.7% and 1.1% female, male and other, respectively). Most answers were from Europe (38%) and Asia (23.4%) but with high representation from Brazil (11.7%) and China (11.6%). Most individuals rated their knowledge of acute and chronic pain assessment as good (49.3% and 40.7%), respectively. The Feline Grimace Scale (43.6%) is the most used acute pain scoring instrument. A total of 40.8% of respondents do not use a chronic pain assessment instrument. Meloxicam (76.4%) and buprenorphine (48.1%) are the most used analgesics for acute pain management. Meloxicam (62.6%) and robenacoxib (25.2%) are the most used anti-inflammatories for chronic pain management. Limited knowledge of pain assessment was commonly reported in Asia, Africa, and South America. The administration of NSAIDs and opioids preoperatively was associated with Europe and North America, while postoperative use of opioids and NSAIDs was linked to Asia, South America, and Africa. Recommendations for NSAIDs, lifestyle changes, and non-pharmacological interventions were associated with mild pain, compared to moderate or severe pain. Recommendations for Gabapentin, Pregabalin, and anti-NGF were associated with severe pain compared to moderate or mild pain.

This study identified gaps of knowledge and provide an understanding on how pain management in cats has evolved in the last years. Limited knowledge and drug availability and geographic areas specific influence the use of analgesics in cats.