Pain Management for Veterinary Technicians and Nurses E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 1235

Veröffentlichungsjahr: 2024

Beschreibung

A practical guide for veterinary technicians and nurses on essential concepts of animal pain management

Pain management is an essential aspect of medical care, but in the field of veterinary medicine it poses unique challenges. Learning to recognize animal pain, to advocate for patient care, and to build and implement pain management protocols allows veterinary nursing teams to be more effective and vastly improves patient outcomes. Mastering this aspect of veterinary medicine means developing an understanding of pain physiology and pharmacology of pain management drugs, the necessity of various analgesics in different care environments, and how to tackle obstacles to animal pain care.

Pain Management for Veterinary Technicians and Nurses, 2^nd edition provides a robust update to the only textbook on this subject directed at veterinary technicians in the US. Already a standard text for its coverage of small companion animals, this book now also covers analgesic techniques in horses, lab animals, and zoo species, making it a valuable resource for technicians in a range of professional and clinical situations. Updated to incorporate the latest evidence-based medicine, it promises to continue as the essential introduction to this oft-overlooked but critical dimension of veterinary medicine.

Pain Management for Veterinary Technicians and Nurses readers will also find:

• Multiple expanded chapters as well as a new chapter covering pain management for c-sections and neonatal care
• A new emphasis on critical thinking and a holistic approach to patient care
• Coverage of complementary and alternative therapies
• Expanded illustrations of regional analgesia techniques

Pain Management for Veterinary Technicians and Nurses is a valuable guide for veterinary technicians in both general and specialized anesthetic practice, as well as veterinary students and general veterinary practitioners.

Leseprobe

Pain Management for Veterinary Technicians and Nurses

Second Edition

Edited by

Stephen Niño Cital, RVT, SRA, RLAT, CVPP, VTS (Research Anesthesia)

HHMI at Stanford University,

Remedy Veterinary Specialists & Veterinary Anesthesia Nerds, LLC., CA, USA

Tasha McNerney, CVT, CVPP, VTS (Anesthesia & Analgesia)

Veterinary Anesthesia Nerds, LLC. and Mt. Laurel Animal Hospital, NJ, USA Philadelphia, PA, USA

Darci Palmer, LVT, VTS (Anesthesia & Analgesia)

Veterinary Anesthesia Nerds, LLC. and

Tuskegee University College of Veterinary Medicine, AL, USA

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Library of Congress Cataloging‐in‐Publication DataNames: Cital, Stephen Nin˜o, editor. | McNerney, Tasha, editor. | Palmer, Darci, editor.Title: Pain management for veterinary technicians and nurses / edited by Stephen Nin˜o Cital, Tasha McNerney, Darci Palmer.Description: Second edition. | Hoboken, New Jersey : Wiley‐Blackwell, [2025] | Preceded by Pain management for veterinary technicians and nurses / editor, Mary Ellen Goldberg ; consulting editor, Nancy Shaffran. 2015. | Includes bibliographical references and index.Identifiers: LCCN 2024023166 (print) | LCCN 2024023167 (ebook) | ISBN 9781119892380 (paperback) | ISBN 9781119892403 (adobe pdf) | ISBN 9781119892397 (epub)Subjects: MESH: Pain Management–veterinary | Pain–veterinary | Analgesia–veterinary | Animal TechniciansClassification: LCC SF910.P34 (print) | LCC SF910.P34 (ebook) | NLM SF 910.P34 | DDC 636.089/60472–dc23/eng/20240625LC record available at https://lccn.loc.gov/2024023166LC ebook record available at https://lccn.loc.gov/2024023167

Cover Design: WileyCover Image(s): © Darci Palmer, © Stephen Niño Cital, © Tasha McNerney

List of Contributors

Jaime Brassard, RVT, CVPP, VTS(Anesthesia & Analgesia)Founding Member and Technical DirectorCanadian Association of VeterinaryCannabinoid Medicine (CAVCM)Whitehorse, Yukon Territory, CA

Lis Conarton, MSW, LVT, CCRP, CVPP, VTS (Physical Rehabilitation)Director of Organizational Culture andEngagement & CARE Pet Therapy Managerand Veterinary Rehabilitation ProviderVeterinary Medical Center of CNYEast Syracuse, NY, USA

Molly Cripe Birt, RVT, VTS(Equine Veterinary Nursing)Senior Large Animal Surgery TechnologistPurdue University College of VeterinaryMedicineWest Lafayette, IN, USA

Wendy Davies, CVT, CCRVT, VTS(Physical Rehabilitation)Veterinary Rehabilitation Technician, Collegeof Veterinary Medicine University of FloridaGainesville, FL, USA

Danielle DeCormier, LVT, VTS (Oncology)Director of Clinical Services EducationMedVetWhitmore Lake, MI, USA

Amy Dowling, CVT, VTS(Anesthesia & Analgesia)Assistant Anesthesia SupervisorUniversity of Pennsylvania VeterinaryHospitalPhiladelphia, PA, USA

Jeanette M. Eliason, CVT, RDH, VTS(Dentistry)Veterinary Nurse Supervisor and Staff DentalHygienist in the Dentistry & Oral SurgeryService, Department of Clinical Sciences andAdvanced Medicine, School of VeterinaryMedicine, University of PennsylvaniaPhiladelphia, PA, USA

Mary Ellen Goldberg, LVT, CVT, SRA,CCRVT, CVPP, VTS (Lab Animal Medicine‐Retired), VTS (Physical Rehabilitation‐Retired), VTS (Anesthesia &Analgesia‐Honorary)IACUC Member, Mannheimer FoundationInc. & Independent ContractorBoynton Beach, FL, USA

Kristen Hagler, RVT, CCRP, CVPP, VTS(Physical Rehabilitation)Head of Canine Physical RehabilitationServices, Circle Oak Ranch Equine andCanine RehabilitationPetaluma, CA, USA

Rachael Hall, LVTVeterinary Student, Class of 2027, formerlyECC & Anesthesia Veterinary TechnicianWashington State University College ofVeterinary MedicinePullman, WA, USA

MegAnn Harrington, CVT, VTS(Production Animal Internal Medicine)Veterinary Technician SpecialistNashville Animal Hospital LivestockConsulting ServicesNashville, AR, USA

Janel Holden, LVT, VTS (Anesthesia & Analgesia)Veterinary Technician Specialist, WashingtonState University College of Veterinary MedicinePullman, WA, USA

Rebecca Johnston, RVT, VTS(Equine Veterinary Nursing)Veterinary Technician SpecialistMoore Equine Veterinary CentreRocky View, Alberta, CA

Ian Kanda, RVT, VTS(CP‐ Exotic Companion Animal)Exotic Veterinary Technician SpecialistPet Hospital of PenasquitosSan Diego, CA, USA

Jessica Birdwell, MSMHR, LVMT, VTS(Anesthesia & Analgesia)Veterinary Nursing DirectorThe College of Veterinary MedicineUniversity of TennesseeKnoxville, TN, USA

Katrina Lafferty, CVT, RLAT, VTS(Anesthesia & Analgesia)Senior Anesthesia Veterinary TechnicianSpecialist, Anesthesia and Pain ManagementDepartment, Veterinary Medical TeachingHospital, University of Wisconsin–MadisonMadison, WI, USA

Imeldo Laurel, LVT, VTS (Dentistry)Anesthesia and Dentistry VeterinaryTechnician, Friendship Hospital for AnimalsWashington, DC, USA

Tasha McNerney, CVT, CVPP, VTS(Anesthesia & Analgesia)Founder, The Veterinary Anesthesia NerdsLLC. & Training DirectorMt. Laurel Animal HospitalMt. Laurel, NJ, USA

Anne Marie McPartlin, CVT, LVT, RVTSenior Program CoordinatorRural Area Veterinary ServicesHumane Society of the United StatesWatertown, NY, USA

Margot Monti, CVT, VTS (Zoological Medicine)Veterinary Technician SpecialistOregon ZooPortland, OR, USA

Alison Mott, RVTHospital Manager and Senior VeterinaryTechnician, Sacramento ZooSacramento, CA, USA

Stephen Niño Cital, RVT, SRA, RLAT, CVPP,VTS‐LAM (Research Anesthesia)Lab Manager, Howard Hughes MedicalInstitute at Stanford University,Pain and Cannabinoid Service DirectorRemedy Veterinary Specialists& Partner, Veterinary Anesthesia Nerds, LLC.San Francisco Bay Area, CA, USA

Darci Palmer, LVT, VTS(Anesthesia & Analgesia)Lecturer and Clinical Skills TrainerTuskegee University College of VeterinaryMedicine & PartnerVeterinary Anesthesia Nerds, LLCAuburn, AL, USA

Natalie Pedraja, LVTPractice Manager, UrgentVet – CarytownRichmond, VA, USA

Taly Reyes, LVMT, VTS (Anesthesia & Analgesia)Veterinary Nurse SupervisorThe College of Veterinary MedicineUniversity of TennesseeKnoxville, TN, USA

Karen Maloa Roach, RVT, VTS (ECC)ICU and Training MentorMt. Laurel Animal HospitalMt. Laurel, NJ, USA

Brooke Quesnell, CVT, VTS (Oncology)Clinical Education Specialist & OncologyVeterinary Technician Specialist, WestVetBoise, ID, USA

Mark Romanoski, CVT, RVTExotics Department Veterinary TechnicianCenter for Avian and Exotic MedicineManhattan, NY, USA

Robin Saar, RVT, VTS (Nutrition)Sr. Scientific Communication TechnicianRoyal Canin Canada, andPrivate Nutrition Education ConsultantLethbridge, Alberta, CA

Heather Ann Scott, RVT, LVT, VTS (ECC)Technician Learning and DevelopmentSpecialist, Ethos Veterinary Emergency andReferral Center HawaiiHonolulu, HI, USA

Erin Spencer, MEd, CVT, VTS (ECC)Director of Veterinary Nursing DevelopmentVeterinary Emergency Group and FieldVeterinary TechnicianRural Area Veterinary ServicesHumane Society of the United StatesDerry, NH, USA

Rachel Stauffer, RVT, LVT, CVT, VTS (ECC)Travel Nursing Manager and RECOVERCoordinator, Veterinary Emergency GroupPowhatan, VA, USA

Melissa (Missy) Streicher, CVT, VTS(Dermatology)Dermatology Technician, Auburn UniversityCollege of Veterinary MedicineAuburn, AL, USA

Elizabeth (Liz) Vetrano, CVT, VTS(CP‐Exotic Companion)Supervisor, Mt. Laurel Animal HospitalMt. Laurel, NJ, USA

Lindsay Wesselmann, LVT, VTS (Zoological Medicine)Veterinary TechnicianAlaska Wildlife Conservation CenterGirdwood, AK, USA

Foreword

One of the truly great things about getting old is having a long history and, with a little luck, remembering most of it. I began my journey into the world of animal pain management in 1991, long before there was a discipline in veterinary medicine, even before there was much organized thought on the topic. Not a surprise, really, when you consider that there was little understanding of the process or significance of painfulness, not just in animals but also in human medicine where it concerned non‐ or preverbal patients. It seemed our ability to recognize, much less treat, pain even as recently as the end of the twentieth century was limited to the patient's ability to express it in a language common to caretakers. OUCH! Of course, even when expressed, there were few options and a high incentive to disbelieve the bearer of the pain.

In 1991, I was already 10 years into a 13‐year stretch working at the University of Pennsylvania Veterinary Hospital. As head of the ICU, I saw endless “painful” patients and commensurately stressed‐out veterinary support staff. We were certain our patients were suffering but felt up against a wall of resistance to treatment. Perhaps some of you still experience this today. I came to believe that the resistance we met came from a lack of understanding of the importance of treating pain as a disease and the shortage of options at that time. In addition to those barriers, we were never trained to recognize the signs of pain in animal species, especially in those who were evolutionarily determined to hide weakness from would‐be predators (including veterinary staff armed with medical supplies of all sorts). It was also commonplace to hear mythical comments like “I won't be able to assess the patient if I drug him,” “I don't think it's pain, it's just her personality,” and perhaps most insidious, “Pain is good because it keeps them from moving around after surgery” (a myth brilliantly debunked by one of my heroes, Dr. Bernie Hanson, DVM, DACVECC, DACVIM, and his team at the University of North Carolina in 1993).

As my frustration grew, so did my search for answers. I spent many long hours at the medical library focusing on pain management (or the lack thereof) in neonates and young children, hoping to find answers but finding instead a surprising lack of treatment in those populations as well. Interestingly, whatever information did exist was largely the work of nurses working with parents lobbying for attention to painfulness in their kids. Of course, we do not have the benefit of parents; pet owners are typically not with their pets in the hospital, and at home they do not readily recognize the signs of animal pain.

Big “Aha!” moment: This is a nursing issue! I became convinced that this was our fight and began to mobilize. To begin, I conducted a rather simple survey in 1992, sending it to the faculty veterinarians, interns, residents, and students at 10 veterinary schools. I received over 800 responses to the single question on the survey, “How do you know if your patient is in pain?” The results were overwhelmingly similar, although as we would later learn, often erroneous: “vocalization, not moving around, not eating” were among the top responses. The single most consistent response, however, was the one that would determine the course of the rest of my career in veterinary medicine. “How do you know if your patient is in pain?” “Because my technician tells me.”

I wrote and delivered my first pain management lecture at the International Veterinary Emergency and Critical Care Symposium (IVECCS) in 1994 using an overhead projector and a wax crayon. It was titled “Do Animals Feel Pain?” I was not sure how the topic would be received. Imagine my excitement when the room was packed to standing room only with veterinarians and technicians, all of whom were more than eager to discuss the question. I felt energized by the overwhelming response, and my pain management odyssey was underway.

I will fast forward through the next 25 years because you already know the outcome of the story: more formal studies, organizations tasked with looking into the issue, science unraveling the mysteries of pain processing and pharmaceutical companies developing analgesics specifically for animals. For me personally, it meant thousands of worldwide lectures, dozens of publications, many committee seats and board positions. All of the work was geared toward relentlessly delivering the message to practice the highest standard of animal pain management whether in a premier veterinary academic institution or in the most remote locations in developing countries. Today, animal pain management is a standard of care, and thousands of veterinary professionals are devoted to ensuring their patients are as pain free as possible. The illustrious authors and editors of this work are among them. You are among them. After all, you bought the book!

I am now joyfully retired, secure in the knowledge that this vital work continues every day. I have complete faith in the authors and editors of this incredibly comprehensive collection of information. They are among the top experts in the field. The book you are holding will guide you through the recognition and treatment of pain in a huge variety of animal species. It will help you further the mission to provide your patients with the care they deserve.

It is a great honor to have contributed to the advancement of animal pain management. Now it is “over to you”!

Wishing you and your patients all the best,

Nancy Shaffran CVT, VTS(ECC‐ret)

Acknowledgments

To all the veterinary technicians and assistants that provide excellent care and advocate for your patients, especially those who feel unheard while pushing for change. We hear you. Your patients hear you. Keep it up.

–Stephen Niño Cital

I would like to thank my husband, Rob, who is better at U/S guided blocks than I am, for always encouraging me to shoot for the stars and never turning down my last‐minute travel ideas.

To my son Oliver, because your default emotion is kindness, and I am so, so proud of the human you are turning into. To Darci and Stephen. What can I say? The best travel companions, the best friends…Dulce Leche! To Nancy Shaffran, MaryEllen Goldberg, and Vickie Byard…you are the inspirations in every way. Thank you for making veterinary medicine better. Thank you for making me better.

–Tasha McNerney

To the past, present, and future veterinary students that I encounter on a daily basis – Thank you for inspiring me to never stop looking for better ways to promote best practices in veterinary anesthesia and analgesia. To my mentors and fellow veterinary colleagues – Thank you for the encouragement and motivation to strive to learn something new each and every day. To my husband Lee and our boys, Cody, and Zach – Thank you for your support, love, and understanding for when I take on all these crazy projects.

–Darci Palmer

And to all the Veterinary Anesthesia Nerds,

This book is ultimately dedicated to you. Your insatiable curiosity and thirst for knowledge have propelled the industry forward, inspiring countless veterinary professionals to continually seek improvement and innovation in the field. Your tireless efforts have not only alleviated the suffering of countless animals but have also advanced the quality of care provided by veterinary professionals worldwide. Thank you for your passion, your endless curiosity, and your relentless dedication to patient care.

–Tasha, Darci, and Stephen

About the Companion Website

This book is accompanied by a companion website:

www.wiley.com/go/mcnerney/2e 

This website includes:

Videos

1Advancing Veterinary Pain Management into a New Era

Mary Ellen Goldberg

Independent Contractor & Mannheimer Foundation Inc., Boynton Beach, FL, USA

“The greatest evil is physical pain.”

Saint Augustine of Hippo (386)

1.1 Introduction

A living being, from the moment of birth, seeks pleasure as the ultimate good while rejecting pain as the ultimate adversity and does their best to avoid it. Pain is based on an anatomical and physiological foundation. It is the intent of this chapter to historically look at human pain, proceed forth into veterinary pain, and conclude with a veterinary technician's pivotal role moving forward in pain management today.

1.2 Brief History of Human Pain Management

Western cultural identity has, in part, been influenced by ancient Greek texts such as The Iliad and The Odyssey by Homer because of the emphasis these stories placed on pain. Sophocles continues to describe pain almost as an independent being that seizes possession of the subject, invades it, and takes over. Thus, words like consuming or devouring are used to describe the ill being (Rey 1993). Galen of Pergamon was a Greek physician, surgeon, and philosopher in the Roman Empire. Galen is known today for classifying the different forms of pain which have been handed down to modern times: Pulsific or throbbing, gravative or weighty, tensive or stretching, and pungitive or lancinating (Rey 1993).

In contrast to Western medicine, which can be traced back to Hippocrates, Chinese acupuncture was fully developed by the end of the second century BCE (before the common era). Among many ancient civilizations, such as kingdoms in Africa, Sumer, China, Mesoamerica, and the Indus‐Ganges, China is the only civilization where acupuncture was well documented 2000 years ago that still survives (Chiu 2014).

Before the advent of modern anesthesia, humans used diverse means to diminish pain, including pressure or ice to numb extremities. Many indigenous cultures had their own understanding of pain and often took a more holistic approach to managing discomfort, something that we see a reawakening of today. They administered herbal medicines including mandragora, hemp‐marijuana, and opium. Some used fermented drinks that contained alcohol used not only for pain but also for ceremonies and recreation. The Incas, as an example, knew of the topical effects of coca/cocaine leaves, but they had no way to administer it other than placing coca‐laced saliva into wounds. Hua Tuo (in the second century CE) was a Chinese physician and surgeon who is best known for his surgical operations and the use of mafeisan, an herbal anesthetic formulation made from hemp. Using a preparation of hemp and wine, he was able to make his patients insensitive to pain (Tubbs et al. 2011). Other Mesoamerican Indigenous and Aboriginal Australian people not only used herbal and mechanical means for pain relief but also incorporated ceremony, showing a deep understanding of the interconnection between physical, emotional, and spiritual health in all creatures. Unfortunately, many of these ancient herbal remedies and other culturally significant practices were banned or lost during colonization, only to be “rediscovered” in modern times by the same but very distant relatives of the original colonizers. The loss or suppression of indigenous peoples' healing practices leaves us with a “Western” or “Eurocentric” perspective in textbooks on the evolution of pain management (Eger et al. 2014; Geck et al. 2020; Quiñonez‐Bastidas and Navarrete 2021; Carmona Rosales 2021; Wren et al. 2011).

René Descartes, a French scientist and philosopher, was the first recorded person to claim that pain comes from the brain. His study focused on phantom limb pain and since there was no limb to feel pain, he concluded that pain must come from the brain. Descartes opened the door to the understanding that the brain was a key component of pain, though it would be centuries before the complete connection between the brain, nervous system, and pain was made (Rey 1993).

Albrecht von Haller was interested in the reactions of fibers and how to distinguish between the irritability of muscle fiber – which he called contractibility – and the excitability of nerve fibers – which he called sensitivity (Olson 2013a).

Pierre Jean George Cabanis' work incorporated a psychophysiological approach to pain, which included the emotional component. His work led to new techniques such as using electrical stimulation for the treatment of pain.

Xavier Bichat represented a passage from organic sensitivity to animal sensitivity and the threshold concept. Bichat's contribution to pain medicine was his discovery of the importance of the sympathetic nervous system (Olson 2013a).

The early part of the nineteenth century saw the development of health clinics, which increased interest in the study of pain. Pain research at this time remained within the framework of specificity theory advanced by Johannes Müller and later Maximilian von Frey, which saw pain as an independent sensation with its own sensory apparatus. Müller proposed a theory for pain, which considered findings from physiology, historical observations, pathology, and integrated psychological dimensions of pain. He believed that pain was not imaginary – that it could occur without an external stimulus. Von Frey was trying to identify points on the skin that responded specifically to one of the four cutaneous sensations: touch, heat, cold, and pain. To accomplish this task, he invented what he called an esthesiometer, where the stimulus consisted of hair (Olson 2013b).

In 1965, Ron Melzack and Patrick Wall proposed a theory suggesting that neural mechanisms in the dorsal horn of the spinal cord could act as a “gate,” increasing or decreasing the flow of nerve impulses from peripheral fibers to the spinal cord cells projecting to the brain. In other words, the spinal cord “gate” either blocks pain signals or lets them pass onto the brain (Melzack and Wall 1965). Today, the gate control theory continues to thrive and evolve despite considerable controversy. The technology of spinal cord stimulation is also based on the gate control theory where products approved by the FDA are already on the market.

In 1973, John Bonica, the founding father of the modern‐day field of pain medicine and the driving force in establishing the International Association for the Study of Pain (IASP), proposed that relief of pain is a basic human right (Jackson and Norman 2014).

1.3 Veterinary Pain Management Through the Centuries

The surviving records on the advancement of veterinary medicine occurred during the Greek, Roman, and Byzantine eras. During this period, many species were investigated, with primary attention paid to the horse.

The development of nailed‐on horseshoes was a major technological step that enhanced the performance of draft and cavalry horses in the Dark Ages. The Celts were first to use red hot iron to fit under the strong rim of the horse's hoof. The Islamic world chose lighter shoes that could be shaped cold (Dunlop and Williams 1996).

During the Middle Ages, mandragora (or the root of the mandrake plant) was made into an anesthetic potion administered to the patient (human or animal) before surgery or cautery (Eger et al. 2014). It induced a deep sleep likely due to the plants natural production of deliriant hallucinogenic tropane alkaloids (atropine, scopolamine, and hyoscyamine) (Roberts and Wink 1998).

In 1656, Christopher Wren (the architect for St. Paul's cathedral and a founder of the Royal Society) infused wine and ale from a syringe made of a dog's bladder, through a goose quill needle into the vein of a dog. The dog survived the experiment. Wren later gave opium intravenously via a quill to dogs, causing unconsciousness in some animals, but killing others. Wren's experiment was the first known injection to produce anesthesia (Moon 2021).

Gasses and vapors later known as anesthetics had been synthesized or isolated before (ether, nitrous oxide, and carbon dioxide) but would be more regularly synthesized from 1798 through 1846 for research and medical use. In 1798–1800, Humphry Davy used nitrous oxide for recreation and research, noting its capacity to diminish or even abolish pain. He suggested its use for surgery, but no one noticed (Ramsay et al. 2005). In 1823, Hickman used carbon dioxide to cause what he called “suspended animation,” a state that permitted apparently painless surgery in animals, but no one noticed (Eger et al. 2014). In the 1840s, William Clarke, Crawford Long, and Elton Romeo Smilie each administered ether in amounts sufficient to permit surgery to be undertaken without pain. But they thought too little of what they had done, or didn't know what they had done, to request public credit for their accomplishment and no one noticed (Keys 1996).

Veterinary anesthesia/analgesia has paralleled human anesthesia/analgesia for the most part, but also still lags in many ways. The two have been intimately intertwined, each contributing to the advancement of the other. The introduction of veterinary anesthesia was delayed by the misperception that the induction of anesthesia in animals was painful and unnecessary, one needed to only “hobble” the animal, in other words, forcefully restrain. This misperception gave way to the governmental demand for the application of anesthesia to relieve the pain of surgery in animals. The performance of anesthesia and surgery in animals today is remarkably like that in humans, particularly in the United States, Great Britain, and Europe (Steffey 2014).

1.4 Animal Research Contributions

Humans have been using other animal species as models of their anatomy and physiology since the dawn of medicine. Because of the taboos regarding the dissection of humans, physicians in ancient Greece dissected animals for anatomical studies (Franco 2013).

Jeremy Bentham was the first person to grant animals moral standing for the sake of their own sentience. He stated, “The question is not, can they reason? Nor, can they talk? But can they suffer?” (Bentham 1789).

Charles Darwin was known for his affection to animals and abhorrence for any kind of cruelty, but also for his commitment to scientific reasoning and progress (Franco 2013).

Joseph Lister pointed out the importance of animal experiments for the advancement of medical knowledge, stressed that anesthetics should always be used, and denounced the ill‐treatment of animals in sports, cruel training methods, and artificial fattening of animals for human consumption as being crueler than their use in research (Gaw 1999).

While animal experiments have played a vital role in scientific and biomedical progress and are likely to continue to do so in the foreseeable future, it is nonetheless important to keep focusing on the continuous improvement of the well‐being of laboratory animals, as well as further development of replacement alternatives for animal experiments (Franco 2013).

Pain is a major welfare issue in animal experiments and must be treated and minimized for ethical and scientific reasons. Unrelieved pain may have a substantial and difficult‐to‐control effect on many physiological processes and behaviors. Pain has the potential to increase the variability of data. Untreated pain may affect complex behavioral traits such as circadian rhythmicity or decision‐making, attention, and learning via motivational changes, and may change the sensory capacities of animals via allodynia and hyperalgesia or affect many physiological and endocrine systems (Jirkof 2017). Thus, adequate pain relief has an important scientific and methodological dimension.

1.5 History of Animal Nursing Staff

Through the years, individuals have aided veterinarians in the care provided to animals. Spouses, family members, and other laypersons served as assistants, receptionists, and office managers for the veterinary practice.

The first record of a program for training, other than for veterinarians, occurred in 1908 with the formation of the Canine Nurses Institute in the United Kingdom (Turner & Turner 2011).

The term veterinary technician is commonly used in the United States and Canada, whereas veterinary nurse is uniformly used in countries throughout Europe and Asia.