The pain management is inadequate in this puppy, as these are signs of pain. Behavioral changes are the most reliable signs of pain in animals.
Tolerance levels and socialization skills certainly vary in all species; however, anticipate, repeatedly evaluate, and treat signs of pain in all cases.
A thoracotomy is one of the most painful procedures performed in animals and humans.
Intense pain management is required, including:
1) an opioid in combination with a tranquilizer or sedative
2) a non-steroidal anti-inflammatory agent
3) intercostal and intrapleural nerve blocks with a long acting local anesthetic – e.g., bupivacaine
Continuous infusion of lidocaine, ketamine, and/or an opioid such as fentanyl or morphine provides excellent analgesia and some sedation. This can replace # 1 above.
Shallow respiration is common in patients with chest pain; hypoventilation and hypoxemia can result.
Opioids can depress respiratory function, but adequate pain management improves ventilation when it doesn’t hurt so much to breathe.
Although Labrador puppies are generally most gregarious and responsive to people, they still exhibit signs of pain when present. Sometimes we need to look very closely; don’t believe that wagging tail!
Here’s a thorough review of physiology and clinical use of analgesia – Pain Management Guidelines for Dogs & Cats from the AAHA and the AAFP Canine Acute Pain Scale from Colorado State Veterinary Medical Center.
