Pain Management For Piglets During Castration and Tail Docking Monique Pairis-Garcia BS, DVM, PhD, mdpairis@iastate.edu Anna Johnson BSc, MSc, PhD, johnsona@iastate.edu Department of Animal Science, Iowa State University 1 Ames, IA Objectives • Defining pain • How to measure pain? • Regulatory concerns for using pain relieving drugs in the United States • Case Study: Drug efficacy for pain management during castration 2 Defining Pain Pain: “Unpleasant sensory and emotional experience associated with actual or potential tissue damage”1 Pain and suffering are clinically important conditions adversely affecting an animal’s quality of life (short-term or long-term) Prevention and alleviation of animal pain and suffering (i.e., management) are important goals 1IASP, 2004 3 Procedures Painful Events Procedures • Castration • Tail docking • Teeth clipping • Reproductive surgery • Repairs Management • Lameness • Shoulder ulcers • Heal erosions • Fractures • Tail/vulva bites • Injuries Disease • Lameness • Mastitis • Farrowing difficulties • Respiratory disease • GI disease 4 Procedures Painful Events Castration Procedures • Castration • Tail docking • Teeth clipping • Reproductive surgery • Repairs Management • Lameness • Shoulder ulcers • Heal erosions • Fractures • Tail/vulva bites • Injuries Disease • Lameness • Mastitis • Farrowing difficulties • Respiratory disease • GI disease Tail Docking 5 Castration • Removal of testicles or destruction of testicular formation2 – Prevention of unwanted breeding – Reduced fighting and aggression – Meat quality improvement • Pain associated with scrotal incision, extraction of the testes and severing of the spermatic cords 2Petherick , 2010 6 Mcglone, 2014 Tail Docking • Portion of tail removed – Prevent/Decrease tail biting – Decrease economic loss associated with reduction in growth performance and increased Liat Romme Thomsen, 2013 incidence of infection • Pain associated with physical removal3 3Sutherland et al, 2011 7 How to measure pain • Physiological measures – Hormones, Catecholamines, Immune response • Behavioral measures – Locomotion, postures, maintenance behaviors • Performance measures 8 Physiological Measures • Hormones – ACTH (Adrenocorticotropic hormone)4 – Cortisol • Catecholamines – Norepinephrine/Epinephrine5 effects on: • Heart rate • Glucose levels • Lactate levels **Physiological measures can also increase due to general arousal and handling** 4Prunier et al, 2005; 5Hay et al 2003 9 Physiological Measures • Immune function6 – Acute phase proteins – Pro-inflammatory cytokines – Antibody response **May result in greater welfare concerns if animal’s health is compromised** 6Moya et al, 2008 10 Wikipedia, 2014 Behavioral Measures • Behavioral changes – Locomotion and Posture7 • Head turning toward hindquarters • Hind leg lifting • Slow twitching tail – Maintenance behaviors8 • Reduced feeding • Reduced drinking • Reduced activity 7Wemelsfeder and van Putten, 1985; 8McGlone and Hellman, 1988 11 Vocalization • Behavioral indicator of pain9 – Immediate vocal response – High frequency calling – Increased calling rate 9Xin et al, 1989 12 Performance Measures • • • • • Average daily gain Feed intake Market weight Carcass quality Mortality 13 Iowa State University, 2011 Manage Pain On Farm Husbandry Techniques Pharmacological Techniques 14 Regulatory Concerns in the U.S. • Animal drugs intended for use in the U.S are regulated by Food and Drug Administration (FDA) Center for Veterinary Medicine (CVM)10 • There are no pain relieving drugs specifically approved by FDA for use in livestock in the U.S.11 • Extra-label drug use (ELDU) is regulated under the Animal Medicinal Drug Use Clarification Act of 1994 (AMDUCA) 10Smith and Modric, 2013 11Coetzee, 2011 15 AMDUCA requirements • Valid Veterinary-Client-Patient Relationship (VCPR) • Extra-label use limited to circumstances when a threat is posed to the health of an animal, or when failure to treat results in suffering or death • FDA approved animal and human drugs • There is no approved product to address the issue • Product administered under the direction of a licensed veterinarian and assigned an extended withdrawal time to avoid residues. 16 17 Pharmacological • Local Anesthetics – Lidocaine • General Anesthetics –CO2 Gas –Isoflurane • Analgesics –NSAIDs 18 Local anesthetics Local • Most commonly used pain relieving drug in food animal medicine12 • Produces loss of sensation without loss of consciousness by preventing and blocking nerve impulses – Lidocaine/Prilocaine **Short Acting** 12Muir et al, 1995 19 Lidocaine • Lidocaine is commonly suggested as a drug for pain relief during castration and tail docking. • Lidocaine is NOT APPROVED for veterinary use • Only Lidocaine approved for humans can legally be prescribed under AMDUCA and used in an extra-label manner 20 General Anesthetics • Loss of feeling or sensation • State of unconsciousness with absence of pain sensation • Suppresses cerebral activity – Co2 – Isoflurane – Sevoflurane **Short Acting** 21 Analgesics Non-steroidal antiinflammatory drugs (NSAIDs) Flunixin meglumine Meloxicam Ketoprofen **Longer acting but take time to have an effect** 22 Case Study: Pain relief for castration 23 Materials and Methods • 141 litters • Four male piglets/ litter • Four treatments – Castration alone (C) – Castration + Meloxicam (M) – Castration + Lidocaine (L) – Castration + Lidocaine + Meloxicam (LM) 24 25 26 27 Production Measures • Mean weight on castration day was not different. • No difference in weight gain • 11% morbidity with no treatment effect • 5% mortality with no treatment effect 28 Case Summary • Lidocaine reduced pain during castration • Meloxicam reduced pain after castration • No treatment effects on: – Skin temperature, weight gain, morbidity or mortality • Herdsmen effectively administered local anesthesia 29 Take home points • Pain associated with castration and tail docking is a current welfare issue on farm • Pain relief may be conducted using either anesthetics, analgesics or a combination of both • Use of these drugs in an extra label manner is approved under AMDUCA • Multi-modal drug approach is most effective for pain relief 30 THANK YOU VERY MUCH FOR YOUR ATTENTION QUESTIONS? 31