POST-OPERATIVE RECOVERY AND SUPPORT

When selecting a surgical approach, it is important that the surgeon consider the anatomy and normal body posture of the animal. This is especially important in ruminants. In this way, the least painful approach or the one promoting a speedy recovery can be chosen. The surgeon should also be familiar with the behaviour of the animal species being used, so that the appropriate closure technique can be used.

During surgery, it is important that the physiological condition of the animal be monitored and kept stable. The degree of monitoring will depend on the equipment available. Basic monitoring of the cardiovascular system, respiratory system and core temperature requires very little equipment. These observations should be recorded in the animal's surgery record. It is essential that the animal be clinically examined at least twice per day in the immediate post-operative period.

Attention should be paid to the fluid requirements of the animal. Careful attention should be paid to hemostasis during surgery, to avoid hypovolemic shock, especially in small animals. Prolonged surgical procedures or those in which there will be significant blood loss require intravenous electrolyte

replacement and/or blood transfusion.

The animal should be positioned on the table so as to avoid compromising cardiovascular or respiratory function and pressure point tissue necrosis. It should be protected from hypothermia and firmly, but carefully restrained in the operative position.

The use of a single animal in multiple survival surgeries is strongly discouraged. Multiple major surgery protocols must be approved by the institution's Animal Care Committee (ACC), and allowed only if for scientific reasons. Multiple major surgeries on a single animal are not to be performed in order to save money. A second major surgery may be performed if it is non-survival.

Minor procedures such as biopsies may be performed more than once. However, it is important that animals recover completely between procedures.

The subject of anesthesia is covered elsewhere in this Guide; however, the following points should be noted by experimental surgeons:

a) all surgical procedures are to be carried out under anesthesia;

b) those doing surgery have an obligation to be aware of the efficiency of the anesthetic technique being used;

c) it is the responsibility of the surgeon and anesthetist to ensure that this animal is spared discomfort during the entire peri-operative period. This includes the period during the induction of anesthesia, for the entire surgical period and for the post-surgical recovery period.

d) in no case is it acceptable to use muscle paralytics without appropriate anesthetics. No ACC should approve the use of a "paralysed-awake animal" (see also Ethics of Animal

Investigation) in a surgical or other procedure which might involve pain or distress.

E. POST-OPERATIVE RECOVERY AND SUPPORT

Recovery from anesthesia can be hazardous and requires frequent, perhaps continuous monitoring.

Depending on the anesthetic regime, recovery may take from a few minutes to several hours. Qualified staff must be available to monitor the animal throughout the entire recovery period. In the case of recovering neonatal rodents, care must be taken to prevent maternal cannibalism. Under no circumstances should any animal be allowed to recover unattended.

A number of nursing activities will be required during the immediate post-operative period, e.g., removal of endotracheal tube if used, maintenance or removal of intravenous lines, frequent turning of the animal to avoid bruising and vascular and respiratory problems, and recording of physiological parameters. All these should take place in a designated area suitable for intensive care.

When normal eating and drinking behaviour has resumed, and physiological parameters have been stabilized or are within expected limits, the animal may be removed from intensive care to more standardized husbandry. However, the animal must continue to be monitored carefully; the wound will need attention, sutures need to be removed, catheters flushed, etc. Depending on the model created, long-term post-operative care may involve special diets, daily medication, physiotherapy or some other form of specialized treatment. All animals must be monitored for signs of post-surgical infection or other complications.

The goal of the surgery team must be to minimize any pain or distress. The degree of post-operative pain will vary; however, in all cases, every attempt must be made to relieve pain with appropriate use of analgesics and good nursing care. Investigators must consult with a veterinarian to set up an analgesic regime for ALL species of animals used. The type of analgesic, the dose and duration of treatment will depend on the species and temperament of the animal and the type of surgery it has undergone. Most analgesics in use are relatively short acting and require administration every few hours.

It is the responsibility of the investigator to make sure that the necessary staff are available to administer analgesics as prescribed. The laboratory animal veterinarian will have the necessary expertise to advise on the newer analgesics and methods of administration.

All personnel in the project should be familiar with the animal's behaviour and posture when normal and when in pain.

a) Responsibility for Surgical Standards

i) The responsibility for the animal in each surgical case lies with the person doing the surgery who, in turn, should be accountable to the institutional ACC for his/her adherence to these standards and for demonstrating an acceptable level of expertise.

ii) The responsibility for supervision of the experimental animal surgical facility should be clearly defined.

iii) Where supportive treatment is required (analgesics, tranquillizers, antibiotics, etc.), the surgical investigator must institute suitable treatment in consultation with a veterinarian.

iv) If the animal, as a result of the experimental manipulation, is in distress that cannot be relieved, authorized personnel, e.g., the laboratory animal veterinarian, should be contacted immediately and procedures instituted for euthanasia.

F. REFERENCES

ACADEMY OF SURGICAL RESEARCH. Guidelines for training in surgical research in animals. J. Investig.

Surg. 1989; 2: 263-268.

BENNETT, B.T., BROWN, M.J. and SCHOFIELD, J.C. Essentials for animal research: a primer for research personnel. Beltsville, MD: National Agricultural Library 1990.

CANADIAN COUNCIL ON ANIMAL CARE. Guide to the care and use of experimental animals. Vol. 2.

Ottawa, Ont.: CCAC, 1984.

FLECKNELL, P.A. Laboratory animal anesthesia. London: Academic Press, 1987.

GAY, W.I., ed. Methods of animal experimentation. Research surgery and care of the research animal--Part A: patient care, vascular access, and telemetry. New York, NY: Academic Press, 1986a; VII.

GAY, W.I., ed. Methods of animal experimentation. Research surgery and care of the research animal--Part B: surgical approaches to the organ systems. New York, NY: Academic Press, 1986b; VII.

GAY, W.I., ed. Methods of animal experimentation. Research surgery and care of the research animal--Part C: surgical approaches to the organ systems. New York, NY: Academic Press, 1989; VII.

SWINDLE, M.M. and ADAMS, R.J., eds. Experimental surgery and physiology: induced animal models of human disease. Baltimore, MD: Williams and Wilkins, 1988.

Additional Reading

BINNINGTON, A.G. and COCKSHUTT, J.R. Decision-making in small animal soft tissue surgery. Toronto, Ont.: B.C. Decker Inc. 1988.

BOJRAB, M.J., ed. Current techniques in small animal surgery. 3rd Ed. Philadelphia, PA: Lea and Febiger, 1990.

CUNLIFFE-BEAMER, T.L. Surgical techniques. In: Guttman, H.N., ed. Guidelines for the well-being of rodents in research. Bethesda, MD: SCAW (Scientists Center for Animal Welfare), 1990.

DOUGHERTY, R.W. Experimental surgery in farm animals. 1st Ed. Ames, IA: Iowa State University Press, 1981.

FLECKNELL, P.A. The relief of pain in laboratory animals. Lab. Anim. 1984; 18: 147-160.

GOURLEY, I.M. and VASSEUR, P.B., eds. General small animal surgery. Philadelphia, PA: J.B. Lippincott Company, 1985.

KNECHT, C.D., ALLEN, A.R., WILLIAMS, D.J. and JOHNSON, J.H. Fundamental techniques in veterinary surgery. 3rd Ed. Philadelphia, PA: W.B. Saunders Company, 1987.

LANE, D.R., ed. Jones's animal nursing. 4th Ed. New York, NY: Pergamon Press, 1985.

MORTON, D.B. and GRIFFITHS, P.H.M. Guidelines on the recognition of pain, distress and discomfort in experimental animals and an hypothesis for assessment. Vet. Rec. 1985; 116: 431-436.

OEHME, F.W., ed. Textbook of large animal surgery. 2nd Ed. Baltimore, MD: Williams and Wilkins, 1988.

PIERMATTEI, D.L. An atlas of surgical approaches to the bones of the dog and cat. 2nd Ed. Philadelphia, PA: Saunders, 1979.

PRATT, P.W., ed. Medical nursing for animal health technicians. 1st Ed. Goleta, CA: American Veterinary Publications, Inc. 1985.

PRICE, C., ed. Practical veterinary nursing. Cheltenham, Eng.: BSAVA Publications, 1985.

ROMATOWSKI, J. Prevention and control of surgical wound infection. J. Am. Vet. Med. Assoc., 1989; 194:

107-114.

SLATTER, D.H., ed. Textbook of small animal surgery. Philadelphia, PA: W.B. Saunders Company, 1985.

SWINDLE, M.M. Basic surgical exercises using swine. New York, NY: Praeger Publishers, 1983.

TRACY, D.L., ed. Small animal surgical nursing. St. Louis, MO: C.V. Mosby Company, 1983.

TUFFERY, A.A., ed. Laboratory animals: An introduction for new experimenters. Chichester, Eng.: J. Wiley

& Sons Ltd., 1987.

WAYNFORTH, H.B. Experimental and surgical technique in the rat. London: Academic Press, 1980.

X. CONTROL OF ANIMAL PAIN IN RESEARCH, TEACHING AND TESTING

A. INTRODUCTION

"Many of the advances made in our knowledge of the basic mechanisms of pain and advances in pain therapy would have been impossible without experiments in animals, which have yielded enormous benefits for both humans and animals. The knowledge gained has resulted in more effective methods of pain control in both humans and animals, has brought about a decrease in suffering, and has thus improved the quality of peoples' lives" (Bonica, 1992).

The assessment and management of pain and suffering is a challenge that must be faced if animals are to be treated ethically and humanely (Fosse, 1991). A landmark publication on animal pain was Dawkins's (1980) Animal Suffering: The Science of Animal Welfare. Recent valuable additions include Animal Pain:

Ethical and Scientific Perspectives (Kuchel, Rose and Burrell, 1990), Animal Pain (Short and Van Poznak, 1992), and a handbook, Recognition and Alleviation of Pain and Distress in Laboratory Animals, prepared by the Committee on Pain and Distress in Laboratory Animals of the Institute of Laboratory Animal Resources (ILAR), which discusses stressors in the laboratory and the animal behaviours they cause, the physiology of pain and distress, drug dosages and euthanasia (ILAR, 1992).

The first symposium on animal pain was presented in 1982 by the Federation of American Societies for Experimental Biology (FASEB) (Kitchell, Erickson, Carstens et al. 1983). It was quickly followed by other publications, symposia, and guidelines related to pain relief in animals (Zimmerman, 1983; RSPCA, 1983;

Wall and Melzack, 1984; Flecknell, 1984; Gibson and Paterson, 1985; Morton and Griffiths, 1985;

AVTRW, 1986; Frenk, Cannon, Lewis et al. 1986; AVMA, 1987; Beynen, Baumans, Bertens et al. 1987;

Rowan, 1988; Anon., 1990; Balls, 1989, 1990; Arena and Richardson, 1990; Dawkins, 1990; Goyd, 1990; LASA, 1990; Bateson, 1991; Moberg, 1992).

Sackman (1991) has prepared a review article on control of pain in cats and dogs.