Pain management in cats--past, present and future. Part 1. The cat is unique

Cats are popular pets but until recently their perioperative and traumatic pain was seriously underestimated and under treated. There are several causes of this under treatment. First, it may be difficult to detect pain in cats, because they do not demonstrate overt pain-associated behaviour. Secondly, there are relatively few analgesic drugs with market authorization for cats. Thirdly, cats have an unfortunate reputation for toxicity from analgesic drugs, particularly opioid-induced mania and classical non steroidal anti inflammatory drug toxicity. Fourthly, cats are deficient in some metabolic pathways used to metabolise analgesic drugs in other species; this may lead to genuine toxicity or to lack of effect. Recently, understanding of feline behaviour and physiology has improved, leading to better clinical management of this enigmatic species. Behavioural methods are proving to be the best means of assessing pain, and knowledge of unique feline physiology has enabled rational treatment protocols to be developed specifically for cats.