Bridging the gap: Integrative pain management in veterinary oncology

Pain can occur in oncological patients from a plethora of sources, from destruction caused by a primary tumour (bone lysis by osteosarcoma), secondary metastasis to effect the nervous system (neuropathic pain) to long lasting chronic pain affecting multiple organs, pain may eventually become worse than the primary cancer itself. Identifying and defining pain types along the patient's oncology journey is essential in avoiding oligoanalgesia and choosing appropriate pain medications. Having an appropriate pain identification and referral has been shown in human pain medicine to optimise patient outcomes to improve both quality and quantity of life. In this section we will go through the science of pain definitions with reference to oncological patients and when referral should be sought.

• Define a mechanisms of pain types (e.g. nociception, neuropathic, nosiplastic) and develop a deeper understanding of language relevant to chronic pain (e.g. hyperalgesia, allodynia, oligoanalgesia)
• Develop an understanding of the pathogenesis of pain in the cancer patient, and the complexity of treatment
• Learn about possible referral systems and when to consult a specialist in anaesthesia and analgesia