Clean Run - March 2014 - 44

Finding a Vet Qualiﬁed in the Diagnosis
and Management of Chronic Pain
By Michael C. Petty, DVM, CVPP, CMAV, CCRT, Dipl. AAPM

All veterinarians are qualified to practice all aspects of veterinary medicine. As we go through veterinary school, we are
taught the basics of everything a veterinarian might encounter
in a practice of any type (large animal, food animal, small animal) as well as the basics for specialties like ophthalmology,
anesthesiology, and surgery. It is only in the final semesters of
school that we have some choice to concentrate on those areas
of veterinary medicine that are of the most interest to us. Even
so, no one graduates as an expert in any one field.

top of that, they may have non-painful issues such as liver disease. In cases like these, it is much better to have a practitioner
with a broad overview of many different types of painful conditions and how to treat them. So where do you look?

For veterinarians who advance their education to one of the
specialties, they most often learn about pain conditions but only
those related to their specialty. For example, oncologists know
a lot about cancer pain, anesthesiologists know a lot about acute
pain, ophthalmologists know a lot about eye pain, and so on.
However, there is not a single boarded specialty that is taught
the entire spectrum of pain diagnoses and treatments. As much
as anesthesiologists know about acute pain, they don't necessarily know about the management of the pain of osteoarthritis
beyond what they might have learned in veterinary school. This
same principle applies to all of the boarded specialties.

There are several organizations dedicated to improving the
quality of pain management. Foremost among these is the International Veterinary Academy of Pain Management (IVAPM).
Members belong to the IVAPM because they have recognized
the importance of treating pain in animals and have joined the
organization in an effort to improve their knowledge and skills
in this area. Some members of the organization have gone on
to complete a rigorous certification process and become Certified Veterinary Pain Practitioners (CVPP). To accomplish this,
they have to have shown a multi-disciplinary competence in the
treatment of both acute and chronic pain. It takes several years
to get this certification, so you can be assured that by choosing
one of these pain practioners, your dog will receive some of the
best pain care available in the veterinary world. To find a practitioner near you, go to www.ivapm.org, click on the "About
IVAPM" tab and then choose "Find a CVPP."

So, what do you do if you have a dog with a chronic pain
condition? First of all, you need to determine what your dog's
painful issues are. For example, if your dog has cancer, an oncologist would be a logical (and easy to make) choice. However, the decision becomes more difficult as you look at many
pain issues, which often cross the boundary from one specialty
to another. It is not uncommon for older dogs to have a combination of orthopedic, neurologic, and muscular problems. On

Another organization is the American College of Veterinary
Sports Medicine and Rehabilitation. This is an organization of
specialists who are the close equivalent of human physiatrists
(medical doctors with special training in physical therapy).
Not only are these veterinarians experts in the treatment of
chronic painful conditions from a rehabilitation point of view,
they have a strong understanding of the use of pharmaceuticals
to complement their "hands-on" treatments. (I know because

Clean Run | March 14

http://www.ivapm.org

Clean Run - March 2014

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