How NSAIDs improve pain control - Veterinary Practice
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InFocus

How NSAIDs improve pain control

Assuming they are used appropriately, NSAIDs can decrease suffering, increase profitability, and decrease use of antimicrobials

I don’t think anyone would disagree that preventing and treating pain in livestock can only be a good thing. There are many ways of doing this, such as breeding for better limb conformation, having good handling facilities and prompt treatment of wounds; however, use of nonsteroidal anti-inflammatory drugs (NSAIDs) during routine procedures and in painful conditions plays a key role.

As vets, we use NSAIDs wherever appropriate – but this is just the tip of the iceberg. How do we encourage farmers to use them more? Firstly, it helps to understand their motivations. In 2016, Norbrook completed a survey of vets and farmers to find out what current practices and attitudes were around analgesia. When asked why farmers would use pain relief, an overwhelming 83% said better welfare was the main reason for controlling pain – not profitability.

Despite this, a recent survey by Hambleton and Gibson (2017) showed that only 14% of farmers are using NSAIDs for disbudding and 14% are not using local anaesthetic. Further to this, 49% of vets in the same survey said they thought NSAIDs should be compulsory for this procedure.

If it is widely agreed that NSAIDs should be used more often, why aren’t farmers using them? Perhaps they need more training on which conditions and procedures are painful, how to recognise the signs of pain, and how to treat pain effectively.

Farmers recognise lameness, and the AHDB Dairy Healthy Feet Programme goes some way to help record and manage it properly, but how many farmers are good at picking up signs of pain other than lameness, including inappetence, increased lying down or an altered facial expression? And how many know how to choose between the various licensed NSAIDs (carprofen, meloxicam, flunixin, ketoprofen) or NSAID/antimicrobial combinations available, which differ in their speed and duration of action, potency, withdrawals, licensed indications and additional properties (e.g. anti-endotoxic effect)?

Granted, they are all prescription products and ideally there will be standard operating procedures in place as part of a health plan, stating what to use and when, but if farmers understand the products better, they are likely to use them more.

Farmers want to relieve pain – we need to help them do this rather than threaten them

It is useful to be able to tell farmers what evidence there is behind production benefits of treating pain and inflammation. Examples include: dehorning, where NSAID use can result in quicker weight gain post-procedure; calf diarrhoea, where animals treated with NSAIDs alongside other therapies, such as fluid therapy and anti-invectives, may start eating and drinking earlier and eating more, resulting in faster bodyweight gain and therefore earlier weaning; mastitis, where administration to cows with E. coli mastitis could result in higher milk yields after treatment and reduced somatic cell counts; and bovine respiratory disease, where there is a negative correlation between animals’ average daily weight gain and the extent of lung lesions due to BRD.

I haven’t mentioned the law, on the basis that the carrot tends to work better than the stick. Farmers want to relieve pain – we need to help them do this rather than threaten them. However, farmers should be aware of their obligations under the Animal Welfare Act 2006, and also procedures where they are specifically obliged to use pain relief. According to the Mutilations (Permitted Procedures) (England) Regulations 2007, among other procedures, anaesthetic must be used in cattle for castration (cattle over two months old), disbudding/dehorning and removal of supernumerary teats (cattle over three months old).

To help farmers better recognise the signs of pain, understand what conditions and procedures are likely to be painful and how to manage pain, Norbrook has produced a ‘Best Practice Guide for Pain Management in Livestock’. It covers some of the evidence available around use of NSAIDs in farm animals. Vets can order free copies, and it is available to download from www.norbrook.com.

References

Hambleton, S. and Gibson, T.

2017

Animal Welfare, 26, 322-333.

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