Multi-disciplinary Approaches to Pain Management
The creation of two interdisciplinary pain-management organizations signals a growing demand for expertise in a field that crosses specialty lines. The groups provide a knowledge pool for general practitioners, who handle the majority of pain-management cases, and an opportunity to manage difficult cases from a variety of perspectives, from oncology to acupuncture.
“This is not just an anesthesiologist’s thing … It’s a natural evolution of what’s going on in our hospitals – dealing with pain issues,” said William Tranquilli, DVM, MS, DACVA, who formed Veterinary Interdisciplinary Pain Services (VIPS) in July 2003. The multidisciplinary task force comprises University of Illinois at Urbana-Champaign faculty members who field inquiries from veterinarians and pet owners. “VIPS was designed to help us deliver better pain-management services to patients at the teaching hospital,” Tranquilli said. “We’re doing this for ourselves as much as anybody else at this point.”
On a larger scale, the International Veterinary Academy for Pain Management (IVAPM) , which was created in October 2003, comprises 300 general practitioners, specialists, veterinary technicians, acupuncturists and physical therapists who share an interest in raising the standard of care for animals in pain, said founding member Peter Hellyer, DVM, MS, DACVA, president of the American College of Veterinary Anesthesiologists. “As cases become more complicated, you end up pulling in specialists from different areas,” Hellyer said.
For veterinarians like Charles E. Short, DVM, PhD, who has been involved in developing pain management curriculum and protocols since 1970, the creation of IVAPM and VIPS heralds a strong future. “The Academy is very exciting. It’s going to beat some very nice marching drums in a parade that the American Veterinary Medical Association, American Animal Hospital Association and lab groups have joined,” said Short, an adjunct professor at the University of Tennessee’s Center for Management of Animal Pain and IVAPM member. “It shows that there’s not just a sporadic interest in pain management.”
Interest in the field has mounted over the last several years and VIPS is one of a growing number of academic groups to gather specialists from dental, ophthalmology, critical care, anesthesiology and oncology to prescribe pain-management therapies. Universities across the country have added pain management to anesthesia departments and four pain centers – modeled after human centers – are being developed at veterinary teaching hospitals.
Historically veterinary approaches to pain management have paralleled developments in human medicine said Hellyer, who cites the amendment of the Animal Welfare Act in 1985 as a benchmark for the clinical practice. Those legislative revisions acknowledged that animals and newborn babies experience pain. Since that time, demand for veterinary pain-management data has grown rapidly, Tranquilli said.