AAHA Con Trivia, part deux #2: Who am I?

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Charles Short, DVM, MS, PhD, DACVAA, DECVAA 

 

Session 1: The Use of Music in the Hospital Environment to Help Manage Anxiety and Pain in Animals, Owners, and Staff 

Much progress has been made in the management of animal pain. It is well established that pain is the result of imagined or actual tissue damage. The start of the lecture will compare levels of violence that cause mild to severe pain.  

There are common responses to pain in animals and people. Levels of anxiety, stress, and suffering in both animals and their owners will be discussed. This will include the neurologic responses to trauma and the effects of pain, music, and analgesics on behavior of the patients. 

There are established AAHA guidelines for managing pain. Even so, how can music help as part of established protocols? For example, the pet is injured and needs medical/surgical care. There is additional stress to the pet and concern experienced by the owner on the way to the hospital. Then there is more stress in the reception area where other animals are present. Then it is taken to the exam room for evaluation and perhaps to radiology. Analgesics probably have not been given in most cases so pain levels may be increasing. By then, decisions can be made to treat medically or prepare for emergency or scheduled surgery. The owner, the patient, and the veterinary staff are all involved in developing the treatment protocol and can benefit from the calming effects of music. 

Special music has been proven to relieve stress and anxiety in people suffering from pain. Likewise, animal-specific music has been proven to have a calming effect on dogs and cats in animal shelters. It should be helpful in the hospital environment as well. 

The concept of adding music, combined with analgesics to manage acute and chronic pain, including those needing surgery, will be discussed in Session 2. 

Learning Objectives 

  • Learn to address the contributing factors to the development of anxiety, suffering, and pain in the patient. 
  • Identify contributing factors in the hospital that music can help resolve to provide relief for the patient, owner, and staff. 
  • Explore how music—a nonpharmaceutical—can blend with medications to relieve different levels of mild to severe pain. 

 

Session 2: The Role of Music to Help Manage Pain in Acute and Chronic Conditions Often Requiring Surgery. 

Acute pain in a patient can be the result of direct trauma, developed acute gastrointestinal conditions, or dental issues. Often early action is needed in life-threating conditions to maintain vital functions such as in severe hemorrhage. Pain management may, in those cases, be the preanesthetic pain medication, followed by anesthetic induction, maintenance, surgery, and recovery.  

Severe trauma to the head with fracture of the mandible is definitely not the same as a sore tooth.  

Some cases need to be stabilized before going to surgery with the need to select the analgesic protocol and decide if adding music would help calm the patient. One must be aware, that the drugs used to manage pain before surgery will influence the dosages and concentrations of anesthetics administered for induction and maintenance. The post-surgical management of pain should be based on individual needs. 

Osteoarthritis is a major cause of chronic pain. Fortunately, desired pain medications are available. There is evidence that dogs and cats respond well to soothing music when it is added to the management program. Eventually, the chronic pain may become acute with orthopedic and even spinal surgery necessary to address the cause. Conditions that cause spinal pain can result in severe neurologic complications if not addressed. Not all acute and chronic conditions can be resolved by surgery. Session 3 will address those. 

Learning Objectives 

  • Understand the use of music as part of relieving suffering from acute trauma prior to, during, and post-op surgery. 
  • Learn about the use of music to relieve anxiety in chronic conditions such as osteoarthritis, surgical corrections, and follow-up rehabilitation. 
  • Explore how combining music with analgesics can help provide more comfort from chronic pain in animals and people. 

 

Session 3: The Role of Music in Chronic Incurable Conditions Including End of Life. 

Cancer is a difficult condition in so many ways. It can cause so much pain even during treatments, including chemotherapy, x-ray therapy, surgery, or a combination of these. Not only does the patient have pain caused by the cancer, but there is also the anxiety experienced by the owner (or human patient). Pain medications are available, but the dosage needed to manage the pain can be a real concern. The use of music to help relieve anxiety can help to supplement the effectiveness of pain meds—and may even prolong life. 

There are other long-lasting medical conditions for human patients where animal involvement helps manage their pain and distress. We are most aware of seeing-eye dogs and how we need to make sure any veterinary treatments do not interfere with the dog's functions to help the blind. 

It is important to also consider the pet that needs pain management when it is owned by someone developing dementia. The family pet may play a role for these patients even in palliative care. These patients often can sing along with their favorite music from childhood and the dog may develop a sense of comfort as well. 

We now have many patients with artificial leg replacements resulting from military combat. Service dogs are filling a very important need for them with strong emotional attachment. It would be interesting to know the role music plays in their lives.  

Regardless of our efforts, all pain cannot be managed toward the end of life. There comes a time when the dosages of analgesics required to control animal pain will end the patient’s life. It is the final step in pain management, but as it takes place, listening to the owners' favorite music may relieve the patient’s anxiety and provide comfort. On the other hand, the service dog may need to hear the owner's favorite music to help relieve their anxiety when the owner has passed away first. 

Learning Objectives 

  • Learn how adding music reduces anxiety, stress, and suffering when combined with analgesics in cancer treatment. 
  • Learn about the role of music in relieving anxiety related to the mental and physical deterioration of the animal and owner. 
  • Learn about the role of music for all involved, with consideration for the owners’ spirituality in end-of-life conditions, the final step in pain management.  
     

Register at aaha.org/aahacon! 

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