Objective—To investigate the prescription of analgesic
drugs to hospitalized critically ill dogs and cats
and determine compliance of nursing staff in administering
the prescribed analgesics.
Animals—272 dogs and 79 cats hospitalized in an
intensive care unit during a 2-month period.
Procedure—Patient treatment orders were examined
daily for details regarding prescribed and administered
Results—A mean of 39% of cats and dogs in the
intensive care unit were prescribed analgesic drugs
each day, the most common of which were opioids.
Local anesthetic drugs, nonsteroidal anti-inflammatory
drugs, and ketamine were prescribed less frequently.
Cats were less likely than dogs to receive
analgesics after traumatic injury, but the difference
was not significant. There was no difference between
species in frequency of prescription of analgesic
drugs after surgery. Most patients were prescribed a
single class of analgesic drug; only 13% had orders
for multiple analgesics. Of the patients for which analgesics
were prescribed, 64% received them exactly
as prescribed, 23% had at least 1 reduction in dosing,
and 13% had at least 1 increase in dosing. When a
decrease in dosing occurred, the drugs were opioids
in each instance, whereas when drug dosing was
increased, the drugs were of various types.
Conclusions and Clinical Relevance—Discrepancies
sometimes existed between the dose of analgesic prescribed
and that administered. This appeared to occur
primarily because of concerns about adverse effects of
opioid drugs. Strategies to reduce these effects may
improve pain management in critically ill dogs and cats.
(J Am Vet Med Assoc 2005;227:425–429)