Attitudes and concerns of French veterinarians towards pain and analgesia in dogs and cats

Objective To compare the attitudes of French veterinarians to pain, and their provision of analgesia to animals, with that reported from other countries. Study design Epidemiological study. Methods In June 1999, 379 French veterinarians were surveyed to ascertain their views on pain evaluation and control in dogs and cats, and their use of analgesics in daily practice. Survey results are expressed as a percentage of responses. Results The questionnaire was returned by 189 veterinarians (49.9%). The response rate was influenced by age (younger veterinarians were more likely to respond) but not gender. A majority (99.5%) expressed moderate to extreme concern over pain in their patients. Pain evaluation was based on the animal's attitude (88.3% dogs, 82.5% cats), interaction with the caregiver, response to palpation of the painful area (66.5% dogs, 62.7% cats) and inappetence (29.3% dogs, 46.3% cats, p < 0.001). Only 14.3% of respondents considered their knowledge of pain recognition to be inadequate. Many (58.8%) considered their methods of pain quantification and control (47% dogs, 59% cats) to be inadequate. Difficulties in recognizing pain (58.3%), a lack of knowledge in the appropriate use of analgesics (41.7%) and fear of drug side effects (30%) were used to explain inadequate provision of analgesia. Only 16.1 and 8.1% used opioids in dogs and cats, respectively. This low level of use resulted from the imposition of French narcotic legislation (79.9%) and lack of knowledge of opioid pharmacology (73.7%). Nonsteroidal anti-inflammatory drugs (NSAIDs) and glucocorticoids were the most commonly used analgesics in both species (100% (dogs) and 96.7% (cats)). The most popular NSAID used in France was tolfenamic acid, followed by meloxicam (dogs), ketoprofen, nimesulide (cats) and carprofen (dogs). The type of surgery performed influenced the use of analgesics, from 17.2% for castration to 83.7% for orthopaedic procedures. Nonsurgical conditions believed to warrant analgesia included osteoarthritis (97.8%), trauma (97.3%) and bone neoplasia (93.4%). Female veterinarians were more likely than males to evaluate pain and provide analgesia. Conclusion French practitioners demonstrate a level of interest in analgesia, which appears to be at least equivalent to that reported from English-speaking countries. The signs used to indicate the presence of pain do not, in general, appear to differ. Excessive confidence in their ability to recognize pain (despite a general ignorance of the subject), the minor role of animal health technicians in pain management and misconceptions about analgesics (mainly opioids) are French pecularities.