New study highlights gaps in analgesia for spay surgery
- zeropainphilosophy
- Jun 7
- 5 min read
This pain update reviews a study published recently in Veterinary Medicine and Science. The title of the article is "A survey study on the current veterinary practice and attitudes to anaesthesia and analgesia for spay surgery in the United Kingdom" and the lead author is Dr Martino-Boulton.
The objectives of this study were to investigate the current veterinary practice and attitude towards anaesthesia and analgesia for spay surgery in the United Kingdom. An electronic questionnaire composed of 57 questions organised in six sections was designed using the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) guidelines and was distributed online. Participants were recruited through both personalised email invitation and the publication of a hyperlink on social media. Data were analysed with descriptive statistics, analysis of means and analysis of proportions using commercially available software.
Entries from 150 participants were used for data analysis.The proportion of participants who were confident in treating pain differed by their decade of graduation, with a lower proportion of confident colleagues graduated before and from 2001, compared to those graduating in the decades 2001 to 2010 and 2011 to 2020. Colleagues reported implementing multimodal analgesia for spay procedures of dogs and cats in 43% and 44% of cases respectively. The proportions of participants who reported using local regional blocks, mainly with lidocaine in dogs, were 82%. Those were higher than cats, which is 43%. Post-spay surgery pain was perceived by participants as more intense in dogs than in cats.
The conclusion of the study was that despite an overall good level of attentiveness of British veterinary professionals to feline and canine anaesthesia during and following spay surgery, the study identified areas for improvements, particularly perception and assessment of feline pain and implementation of local regional and anaesthetic techniques, particularly in cats.
In a previous pain update, we reviewed the topic of intraperitoneal and incisional analgesia based on a publication from the WSAVA Global Pain Council. This publication was one of the capsule reviews that WSAVA produce and provides us with details on how we can simply implement local regional techniques in dogs and cats undergoing spay surgery and abdominal surgery .If you follow this link here, you will see a table detailing the doses both in mg/kg and examples in millilitres of how much local anaesthetic to use for an incisional local regional technique combined with intraperitoneal. It's a really easy way to manage and prevent visceral pain and there are studies that show a benefit to the combination of a line block and intraperitoneal anaesthesia.
So if you're looking for one really easy way to improve comfort in your spay surgeries and your castrates, incisional local anaesthetic is one of those. And for abdominal procedures, incorporating an intraperitoneal technique as well. You can read more about that here.
On the topic of feline pain, these authors recognise that further education is required around feline pain assessment. Over recent years, we have seen the development of a number of tools which enable us to effectively assess acute pain in cats. Two of the most notable are the short form of the Glasgow Composite Pain Scale for cats and the Feline Grimace Scale. If you're looking to find all of those pain scales in one easy place, then click here to access our pain update on the Vet Pain app.
The Vet Pain app is an easy way to find all pain scales in one place, bar the Feline Grimace Scale. The Feline Grimace Scale can be downloaded in an app form and is incredibly easy to use.If you'd like to listen to some information on the Feline Grimace Scale, we have this podcast available for you to listen to via the link here.
If you would like comprehensive information on analgesia for spay and neuter procedures, you can watch our webinar on this topic and you'll find the link to the webinar here.
In the paper described herein, the authors questioned which opioids respondents were using for feline and canine spay surgeries. The vast majority of people were using methadone as a premed for feline spay, and that fits with the data we have from the big pain survey. Where I would reflect on this is that methadone and buprenorphine have similar analgesic efficacy in cats and either of those are a suitable option. In the study, however, there were some respondents saying they used butorphanol, which is not an effective analgesic. The answer to this question, which opioid to use for a cat, should either be methadone or buprenorphine, there isn't really another answer as far as analgesia goes. This was a UK based survey so if you're working in a location where methadone isn't available, then morphine is a suitable alternative.
Regarding canine spay protocols, a much higher proportion of people use methadone for canine spay. There is information in the literature that documents that methadone is a more effective analgesic than buprenorphine for spay. That's probably where those numbers come from, with 84% of people using methadone as their premed. Let's bear in mind that this was a UK-based survey. The data around the perioperative use of non-steroidals in this piece of work was a little bit variable, with 83% of respondents saying they use non-steroidals perioperatively in cats, but only 51% saying they use non-steroidals perioperatively in dogs. There was a high proportion of did not answer that question. And we didn't have an explanation of that. There were, however, a higher number of people in the respondents saying they don't use perioperative non-steroidals in cats. Now that's an interesting answer and I'm not aware of any literature that supports us not using non-steroidals for management of acute pain in the perioperative period. So I would always incorporate a non-steroidal in my spay protocol for both cats and dogs.
Based on the information here, the author states that feline pain may still be partially neglected and addressed less attentively than in dogs. And we have some really easy options, both from a pain scoring and from a local regional point of view that we can incorporate into both our canine and our feline neutering. So please take a look at those links.
References
Martino-Boulton, J., Antonopoulou, I., Pinnock, H., & Adami, C. (2025). A Survey Study on the Current Veterinary Practice and Attitudes to Anaesthesia and Analgesia for Spay Surgery in the United Kingdom. Veterinary Medicine and Science, 11(1), e70151. https://doi.org/10.1002/vms3.70151
This post was written by Matt Gurney.
Matt & Carl established Zero Pain Philosophy to provide educational resources & telemedicine to veterinary professionals globally, enabling optimal management of pain.
Matt sees referrals in the pain clinic at Eastcott Referrals. You can also receive telemedicine advice from us here if you have a pain case where you need a helping hand.
Matt Gurney is an RCVS & European Specialist in Veterinary Anaesthesia & Analgesia and works at Anderson Moores Veterinary Specialists. Matt is Past President of the European College of Veterinary Anaesthesia & Analgesia and works at Eastcott Referrals in the UK.
Carl Bradbrook is an RCVS & European Specialist in Veterinary Anaesthesia & Analgesia and is Past President of the Association of Veterinary Anaesthetists. Carl works at Anderson Moores Veterinary Specialists in the UK.
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