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Assessing pain and emotional wellbeing in feline patients with chronic kidney disease
Abstract
Pain is both a sensory and emotional experience and can be measured with the use of pain scoring charts. Pain scoring is seen as a valuable tool especially as an aid to post-operative nursing care. Currently pain scoring systems are designed for assessing acute post-operative pain and have been validated for use in dogs. However they can be useful in assessing pain experienced in cats suffering from diseases such as chronic kidney disease, and can assist the nursing care provided to patients hospitalised for treatment of the disease. Patient care could be improved if a more holistic approach to nursing was adopted which encouraged veterinary nurses to not only consider the physical aspects of pain but also the emotional side.
Cats are increasingly living much longer lives; it is now not uncommon for cats to live into their late teens. Consequently this means older cats are more frequently presented into veterinary practice for treatment and care. One of the more common conditions seen in older cats is chronic kidney disease (CKD) (International Cat Care, 2013).
Nursing care of patients with CKD is well established but it is the author's opinion that this is currently limited to the management and nursing care of the disease process. Patients with CKD are also likely to experience pain — both physically and emotionally. Pain is a complex process and as well as being in physical pain from the disease process, patients with CKD may also be experiencing emotional pain during periods of hospitalisation and during diagnostic tests. The emotional side of pain may be experienced as a consequence of physical pain but it could also be experienced independently (McMillan, 2003). This is referred to as emotional pain, in humans this type of pain can be caused by conditions such as anxiety and grief. While animals may not experience grief in the same way as humans they are likely to suffer from anxiety and a decreased level of mental wellbeing when suffering from chronic conditions such as CKD.
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