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Your Singapore, the Tropical Garden City
Pain is an abstract construct so there is no gold standard for measurement and since the goal is to measure the affective component of pain (i.e. how it makes the dog feel), this is a real challenge. This is further compounded by the use of an observer to rate the dog’s pain. Few
of the scales available for use in dogs have been fully validated. Simple uni-dimensional scales, including
the Numerical Rating Scale (NRS), the Visual Analogue Scale (VAS) and the Simple Descriptive Scale (SDS) (Figure 5), have been used.12,13 These scales require
the user to record a subjective score for pain intensity. When using these scales, the observer’s judgment can be affected by factors such as age, gender, personal health and clinical experience, thus introducing a degree of inter-observer variability and limiting the reliability
of the scale. However, when used consistently, these are effective as part of a protocol to evaluate pain as described above. Of the three types of scales described (and there are others in this category), the NRS (0 to 10) is recommended for use due to its enhanced sensitivity over the SDS and increased reliability over the VAS.
Composite scales include the Glasgow Composite Measure Pain Scale and its short form (CMPS-SF),14,15
and the French Association for Animal Anaesthesia and Analgesia pain scoring system, the 4A-Vet.15 The CMPS- SF, validated for use in measuring acute pain, is a clinical decision-making tool when used in conjunction with clinical judgement. Intervention level scores have been described (i.e. the score at which analgesia should be administered), thus it can be used to indicate the need for analgesic treatment. The instrument is available to download online.16 The 4A-Vet, which is also available online,17 is available for use in cats and dogs, although evidence for its validity and reliability have not yet been demonstrated. The Colorado State University (CSU) acute pain scale for the dog18 combines aspects of the numerical rating scale along with composite behavioural observation, and it has been shown to increase awareness of behavioural changes associated with
pain. The University of Melbourne Pain Scale combines physiologic data and behavioural responses.19 Japanese Society of Study for Animal Pain Canine Acute Pain Scale (written in Japanese) is a numerical rating scale combined with behavioural observation and can be downloaded from the website.20 All of the composite scales above are easy to use and include interactive components and behavioural categories.
Figure 2. (A) Post-laparotomy (B) severe dermatitis
  Fig 4A Fig 4B
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