Duration of action of a topical anaesthetic formulation for pain management of mulesing in sheep

Antinociceptive and wound healing effects of a commercial formulation of lidocaine, bupivacaine, adrenaline and cetrimide applied topically to superficial skin wounds in horses

BACKGROUND

Post-traumatic distal limb wounds cause discomfort and heal gradually by second intention. The topical application of Tri-Solfen (lidocaine hydrochloride, bupivacaine hydrochloride, adrenaline acid tartrate and cetrimide [LBAC]) produces effective postsurgical cutaneous analgesia in lambs, calves and piglets; however, its effect on wounds in horses is unknown.

METHODS

The antinociceptive effect, measured by mechanical threshold (MT), and the wound healing impacts of LBAC compared with saline were investigated on surgically created 20 × 20 mm distal limb wounds in 10 horses. Treatment was applied once daily for 7 days following wounding on day 0. Mechanical thresholds were measured after treatment on days 1, 2 and 3. Healing was observed for 25 days.

RESULTS

The topical application of LBAC immediately following wounding and its reapplication 24 hours later increased the average MT on the first post-traumatic day by 3 Newtons. However, no antinociceptive benefit was observed on days 2 or 3. Treatment with LBAC did not adversely affect wound healing when compared with saline.

LIMITATIONS

Methodological differences preclude absolute MT comparisons between studies. The experimental design did not include a model of contaminated or naturally occurring wounds.

CONCLUSION

LBAC may provide an early antinociceptive benefit when applied to uncontaminated surgically created wounds without compromising healing.

An Exploration of Analgesia Options for Australian Sheep

During their lifetime, sheep undergo many painful husbandry and disease processes. Procedures undertaken on the farm, such as tail docking, castration, and mulesing, all cause considerable pain. In addition, sheep may experience painful diseases and injuries that require treatment by veterinary practitioners, and in biomedical research, sheep may undergo painful experimental procedures or conditions. It is important due to ethics, animal welfare, social licence, and, at times, legal requirements for farmers, veterinary practitioners, and researchers to provide pain relief for animals in their care. While there is a heightened awareness of and a greater interest in animal welfare, there remain few licensed and known analgesia options for sheep within Australia. A literature review was undertaken to identify currently known and potential future options for analgesic agents in sheep in farm and biomedical settings. Non-steroidal anti-inflammatories, opioids, local anaesthetics, α2 adrenoreceptor agonists, and NMDA receptor antagonists are some of the more common classes of analgesic drugs referred to in the literature, but few drugs are registered for use in sheep, with even fewer proven to be effective. Only six analgesic product formulations, namely, lignocaine (e.g., Numocaine®), Tri-Solfen®, ketamine, xylazine, and meloxicam (oral transmucosal and injectable formulations), are currently registered in Australia and known to be efficacious in some types of painful conditions in sheep. The gap in knowledge and availability of analgesia in sheep can pose risks to animal welfare, social licence, and research outcomes. This article presents a summary of analgesic agents that have been used in sheep on farms and in clinical veterinary and biomedical research settings along with details on whether their efficacy was assessed, doses, routes of administration, indication for use, and pain assessment techniques (if any) used. The outcome of this research highlights the challenges, gaps, and opportunities for better analgesia options in sheep.

How Well Does Australian Animal Welfare Policy Reflect Scientific Evidence: A Case Study Approach Based on Lamb Marking

The development and substance of animal welfare policy is subject to a range of social, cultural, economic, and scientific influences that commonly vary within and between countries. Discrepancies in policy can create confusion and mistrust among stakeholders and consumers and limit the ability to create a uniform minimum level of requirements to safeguard animal welfare, as well as create a level 'playing field' for farmers when trading with other jurisdictions. The livestock sector is receiving growing scrutiny globally for real and perceived violations of animal welfare, for example, the practice of mulesing in Australia. This article explores animal welfare legislation within Australia and how it reflects the scientific evidence surrounding routine husbandry practices in sheep, including tail docking, castration, and mulesing. While there is some variation between state and territory legislation, the most notable concern is the lack of enforceable recommendations surrounding the evidence-based use of analgesia and anaesthesia for painful husbandry procedures. The age at which these procedures are recommended to be performed is relatively consistent across Australian jurisdictions, but there is a marked difference compared to international legislation. The global context of animal welfare legislation, public perception, and producer perception of these procedures are also discussed, highlighting the difficulty of creating robust animal welfare legislation that promotes a good standard of welfare that is respected worldwide whilst being practical in an Australian setting given our unique geography and climatic conditions.

Role of Topical Anaesthesia in Pain Management of Farm Animals, a Changing Paradigm

Field evidence indicates that livestock producers are motivated by access to products that readily deliver pain management during husbandry interventions and, more recently, viral epidermal infectious diseases, including FMD. There has been impressive adoption in Australia of a farmer-applied spray-on topical anaesthetic wound formulation (TAF; Tri-Solfen®, Medical Ethics, Australia), initially for managing pain of the breech modification ‘mulesing’ procedure that reduces susceptibility of sheep to flystrike. Over 120 million lambs have now received pain relief and cattle producers have commenced using the TAF for a range of husbandry procedures. This product has demonstrated efficacy for surgical castration and tail docking of lambs, surgical castration and dehorning of calves, surgical castration of piglets, debridement of lesions of the hoof for lame cattle and, importantly, treatment of clinical FMD lesions, including decubitus ulcerations occurring from prolonged recumbency. Multimodal use of an NSAID for improved pain management is advocated, particularly meloxicam, available by prescription from veterinarians for injection and as an oral formulation (Ilium Buccalgesic®, Troy Laboratories, Australia), with current work assessing the potential for prolonged delivery in molasses blocks. Increased use of TAF with NSAIDs significantly reduces pain and suffering in livestock, with enhanced healing of FMD lesions, reduced viral loads from Orf infections in lambs and diminished necessity of ‘antibiotic cover’, assisting antimicrobial-resistance (AMR) stewardship.

The Neuroimmune Interface and Chronic Pain Through the Lens of Production Animals

Communication between the central nervous system (CNS) and the immune system has gained much attention for its fundamental role in the development of chronic and pathological pain in humans and rodent models. Following peripheral nerve injury, neuroimmune signaling within the CNS plays an important role in the pathophysiological changes in pain sensitivity that lead to chronic pain. In production animals, routine husbandry procedures such as tail docking and castration, often involve some degree of inflammation and peripheral nerve injury and consequently may lead to chronic pain. Our understanding of chronic pain in animals is limited by the difficulty in measuring this pathological pain state. In light of this, we have reviewed the current understanding of chronic pain in production animals. We discuss our ability to measure pain and the implications this has on animal welfare and production outcomes. Further research into the neuroimmune interface in production animals will improve our fundamental understanding of chronic pain and better inform human clinical pain management and animal husbandry practices and interventions.

Efficacy of Intra-Operative Topical Wound Anaesthesia to Mitigate Piglet Castration Pain-A Large, Multi-Centred Field Trial

Simple Summary

Piglet castration causes pain and stress to the animal. Although desperately needed, there are complexities developing safe and effective methods of pain alleviation applicable for on-farm use. Topical anaesthesia, instilled to the wound during surgery, is a newly evolving on-farm method to mitigate castration pain. In the current study, we investigated the use of Tri-Solfen^® (Animal Ethics Pty Ltd, Melbourne, Australia), a topical local anaesthetic and antiseptic formulation, instilled to the wound during the procedure, to alleviate subsequent castration-related pain experienced in piglets. We performed a large, blind, multi-centred trial comparing pain in piglets castrated with or without Tri-Solfen^®. Piglets treated with wound instillation of Tri-Solfen^®, 30 s prior to subsequent castration, showed significantly lower pain-induced motor and vocal responses during the procedure. Acute post-operative pain-related behaviours, evident in piglets in the first 30 min following castration, were also significantly reduced in treated piglets compared with untreated piglets. Using this method, Tri-Solfen^® provides an effective on-farm method to mitigate acute castration-related pain in young piglets.

Abstract

Piglet castration results in acute pain and stress to the animal. There is a critical need for effective on-farm methods of pain mitigation. Local anaesthesia using Tri-Solfen^® (Animal Ethics Pty Ltd., Melbourne, Australia), a topical local anaesthetic and antiseptic formulation instilled to the wound during surgery, is a newly evolving on-farm method to mitigate castration pain. To investigate the efficacy of Tri-Solfen^®, instilled to the wound during the procedure, to alleviate subsequent castration-related pain in neonatal piglets, we performed a large, negatively controlled, randomised field trial in two commercial pig farms in Europe. Piglets (173) were enrolled and randomised to undergo castration with or without Tri-Solfen^®, instilled to the wound immediately following skin incision. A 30 s wait period was then observed prior to completing castration. Efficacy was investigated by measuring pain-induced motor and vocal responses during the subsequent procedure and post-operative pain-related behaviour in treated versus untreated piglets. There was a significant reduction in nociceptive motor and vocal response during castration and in the post-operative pain-related behaviour response in Tri-Solfen^®-treated compared to untreated piglets, in the first 30 min following castration. Although not addressing pain of skin incision, Tri-Solfen^® is effective to mitigate subsequent acute castration-related pain in piglets under commercial production conditions.

Progress With Livestock Welfare in Extensive Production Systems: Lessons From Australia

The extensive livestock production industries are vital to the national economy of Australia. Continuing improvements to extensively-raised livestock welfare is desirable, necessary and in some situations mandatory, if the social license for animal sourced food and fiber production is to continue sustainably. However, meeting increasingly high welfare standards is challenging. The changing climate in this millennium, has seen the occurrence of two of the most severe drought periods on record in Australia, resulting in complex welfare issues arising from unforeseen disease, trade and environmental catastrophes. The onset of the first drought coincided with an uncontrolled epidemic of ovine paratuberculosis. It ended just prior to a temporary ban on live export of tropical cattle to Indonesia that induced a major market failure and led to severe morbidity and mortality on some beef properties. The second drought period progressed in severity and culminated in the most extreme bushfires recorded, causing unprecedented levels of mortality, morbidity and suffering in farmed animals and wildlife. Temperature extremes have also caused periodic heat-associated or cold-induced hyopthermia losses, requiring increased vigilance and careful management to reduce both temperature-induced stress during transport and the high ovine peri-parturient losses traditionally observed in extensive sheep farming. Several issues remain controversial, including surgical mulesing of wool sheep to manage flystrike, and the continuing live export trade of sheep and cattle. However, in reviewing the increasingly complex welfare challenges for the extensive livestock population industries that are export trade dependent and remain vulnerable to welfare activism, it appears progress has been made. These include development of prescribed livestock welfare Standards and Guidelines and the introduction of the Exporter Supply Chain Assurance System (ESCAS) to address export concerns. Further, the sheep mulesing crisis led to improved producer welfare attitudes and practices, including pain management during aversive husbandry procedures that is now occurring globally. Finally, innovations in animal welfare surveillance and assessment, are additional encouraging signs that suggest improving change management of extensive farm animal welfare is occurring that provides lessons well-beyond Australian shores.

Local Anesthetic Delivered with a Dual Action Ring and Injection Applicator Reduces the Acute Pain Response of Lambs during Tail Docking

Simple Summary

Tail docking is a procedure practiced on millions of lambs all over the world. The objective is to prevent fecal soiling on the lower part of the tail, reduce soiling of the breech, and thereby lessen the risk of blowfly strike. Docking can be done with a knife or a clamp, but applying a latex ring round the tail, cutting off the blood supply so that the tail drops off a few weeks later, is the most popular method. All methods cause acute pain which diminishes substantially after the first hour. The present trial determined whether local anesthetic delivered by a prototype Numnuts^® device, a novel, dual-function applicator, would reduce this pain in two to four-week-old lambs. Comparison of lambs that were sham handled, lambs that underwent ring tail docking and a third group of lambs that underwent ring tail docking and that were injected with lignocaine using the dual function device was conducted. All lambs were returned to their pen with their mothers and videoed for three hours for behavioral signs of pain. Every five minutes for the first hour and then every ten minutes, each lamb’s posture, movement and feeding behavior was classified and quantified, and the data subjected to statistical analysis. It was concluded that applying lignocaine using the novel device greatly reduced the degree of pain observed.

Abstract

Docking the tail of lambs is a standard husbandry procedure and is achieved through several techniques including clamps, hot or cold knives and latex rings, the last of which is the most popular. All tail docking methods cause acute pain which can be reduced by application of local anesthetic, however precise anatomical injection for optimal efficacy requires considerable skill. This pen trial evaluated the ability of local anesthetic (LA) delivered with a dual function ring applicator/injector to alleviate acute tail docking pain. Thirty ewe lambs were assigned to one of three treatment groups (n = 10 per group): ring plus local anesthetic (Ring LA), ring only (Ring) and sham handled control (Sham). Lambs were videoed and their behavior categorized every five minutes for the first hour and every 10 min for the subsequent two hours after treatment. There was a significant effect (p < 0.001) of treatment on total active pain related behaviors in the first hour, with Ring lambs showing higher counts compared to Ring LA or Sham. Ring lambs also displayed a significantly higher count of combined abnormal postures (p < 0.001) than Ring LA or Sham lambs. Delivery of 1.5 mL of 2% lignocaine via the dual action device abolished abnormal behaviors and signs of pain in Ring LA lambs. However, lambs in the Ring LA group spent less time attempting to suckle compared to Ring and Sham lambs, suggesting that some residual discomfort remained.

Effect of a Topical Formulation on Infective Viral Load in Lambs Naturally Infected with Orf Virus

INTRODUCTION

Orf is a highly contagious eruptive viral disease of the skin and mucosa of sheep and goats. Although vaccination with live or attenuated orf virus is the preferred option for disease control, the vaccine is unavailable in many countries. Treatment of orf lesions involves standard hygiene and in numerous cases, management of presumptive secondary infections with antibiotics, increasing risks of antimicrobial resistance (AMR). The wound dressing formulation Tri-Solfen® containing two local anaesthetics (lignocaine and bupivacaine), adrenaline and an antiseptic (cetrimide) in a gel formulation was developed for pain relief in sheep undergoing surgical husbandry procedures in Australia. Recently, TS therapy was found to reduce suffering and enhance recovery in cattle and buffalo with oral and skin lesions due to foot-and-mouth disease (FMD) virus infection. It was noted that TS has a low pH and is potentially viricidal, potentially aiding disease control.

METHODS

One-month-old lambs (n=14), naturally infected with orf, were recruited from a farm during a natural outbreak of the disease. The animals were selected at the early stages of the infection and randomly divided into two cohorts: Group A (n=11) treated with the topical wound gel formulation (TS); and Group B (n=3) an untreated control group. Swabs were obtained before treatment (T0) and on days one (T1), 3 (T2) and 5 (T3) post-treatment, then submitted to direct DNA extraction with real-time PCR quantification, plus incubation with primary tissue cultures from ovine skin fibroblasts (OSF) and T-immortalized goat embryonic fibroblasts (TIGEF).

RESULTS

Although no significant differences were found in the clinical progression of the lesions and PCR quantification (p=0.722) between these small cohorts, there was a significant difference (p<0.05) in reduction in infective viral load between the groups when assessed in OSF cell cultures between T0 and T3.

CONCLUSION

These preliminary findings suggest that treatment of early stage lesions with this TS may reduce the infective viral load present in orf lesions.

Pain Management in Farm Animals: Focus on Cattle, Sheep and Pigs

Pain causes behavioral, autonomic, and neuroendocrine changes and is a common cause of animal welfare compromise in farm animals. Current societal and ethical concerns demand better agricultural practices and improved welfare for food animals. These guidelines focus on cattle, sheep, and pigs, and present the implications of pain in terms of animal welfare and ethical perspectives, and its challenges and misconceptions. We provide an overview of pain management including assessment and treatment applied to the most common husbandry procedures, and recommendations to improve animal welfare in these species. A cost-benefit analysis of pain mitigation is discussed for food animals as well as the use of pain scoring systems for pain assessment in these species. Several recommendations are provided related to husbandry practices that could mitigate pain and improve farm animal welfare. This includes pain assessment as one of the indicators of animal welfare, the use of artificial intelligence for automated methods and research, and the need for better/appropriate legislation, regulations, and recommendations for pain relief during routine and husbandry procedures.

Analgesia for Sheep in Commercial Production: Where to Next?

Simple Summary

Increasing societal and customer pressure to provide animals with ‘a life worth living’ continues to apply pressure on industry to alleviate pain associated with husbandry practices, injury and illness. Although a number of analgesic solutions are now available for sheep, providing some amelioration of the acute pain responses, this review has highlighted a number of potential areas for further research.

Abstract

Increasing societal and customer pressure to provide animals with ‘a life worth living’ continues to apply pressure on livestock production industries to alleviate pain associated with husbandry practices, injury and illness. Over the past 15–20 years, there has been considerable research effort to understand and develop mitigation strategies for painful husbandry procedures in sheep, leading to the successful launch of analgesic approaches specific to sheep in a number of countries. However, even with multi-modal approaches to analgesia, using both local anaesthetic and non-steroidal anti-inflammatory drugs (NSAID), pain is not obliterated, and the challenge of pain mitigation and phasing out of painful husbandry practices remains. It is timely to review and reflect on progress to date in order to strategically focus on the most important challenges, and the avenues which offer the greatest potential to be incorporated into industry practice in a process of continuous improvement. A structured, systematic literature search was carried out, incorporating peer-reviewed scientific literature in the period 2000–2019. An enormous volume of research is underway, testament to the fact that we have not solved the pain and analgesia challenge for any species, including our own. This review has highlighted a number of potential areas for further research.

Optimal Methods of Documenting Analgesic Efficacy in Neonatal Piglets Undergoing Castration

Analgesic products for piglet castration are critically needed. This requires extensive animal experimentation such as to meet regulatory-required proof of efficacy. At present, there are no validated methods of assessing pain in neonatal piglets. This poses challenges for investigators to optimize trial design and to meet ethical obligations to minimize the number of animals needed. Pain in neonatal piglets may be subtle, transient, and/or variably expressed and, in the absence of validated methods, investigators must rely on using a range of biochemical, physiological and behavioural variables, many of which appear to have very low (or unknown) sensitivity or specificity for documenting pain, or pain-relieving effects. A previous systematic review of this subject was hampered by the high degree of variability in the literature base both in terms of methods used to assess pain and pain mitigation, as well as in outcomes reported. In this setting we provide a narrative review to assist in determining the optimal methods currently available to detect piglet pain during castration and methods to mitigate castration-induced pain. In overview, the optimal outcome variables identified are nociceptive motor and vocal response scores during castration and quantitative sensory-threshold response testing and pain-associated behaviour scores following castration.

Impact of a Topical Anaesthesia Wound Management Formulation on Pain, Inflammation and Reduction of Secondary Infections after Tail Docking in Lambs

Simple Summary

Tail docking is routinely conducted in sheep husbandry around the world, often without anaesthesia or analgesia despite recognition that it is a painful process. Several methods are used, although the Council of Europe states that surgical methods with anaesthesia should be used to dock the tail, with these recommendations copied into national legislation by most European countries. However, no studies have been documented comparing the use of general anaesthesia and stitching. This study compared different surgical approaches with and without general anaesthesia, and with and without surgical stitching, plus examined the efficacy of applying a commercially available wound gel spray containing topical anaesthetics and an antiseptic, immediately on tail amputation. Results demonstrated that lambs display more pain when the surgery included stitching and these wounds became more readily infected, potentially requiring antibiotic therapy. As the generation of potential antimicrobial resistance and drug residues issues in food-producing animals from over-use of antibiotics is an emerging one health consideration, the availability of a topical anaesthetic formulation that provides pain relief and contains an antiseptic that reduces secondary infections and hasten wound healing, is of potential importance for improving husbandry procedures such as tail docking.

Abstract

We examined several procedures for surgical tail docking; with and without general anaesthesia (GA), including the use of a topical wound gel formulation to provide pain relief (PR) and improve healing after surgery, containing local anaesthetics lignocaine and bupivacaine, with cetrimide and adrenalin. Forty-four lambs were recruited into four equal cohorts: Groups A and C, the tail was excised with a scalpel without anaesthesia or stitches; Groups B and D, the tail was surgically excised and stitched under GA; Groups C and D wounds were immediately sprayed with PR. Behavioural observations identified that Groups A and C displayed significantly less pain-related behaviours than Groups B and D shortly after the procedure, especially if treated with PR. Similarly, the mean of days when animals showed no signs of wound infection was longer in the groups not undergoing stitching. Finally, treatment with PR appeared to reduce the cortisol response and avoided the elevation of serum amyloid A in lambs where the tail was excised without general anaesthesia. In conclusion, surgical tail-docking without GA but where wounds are immediately sprayed with PR, appears as an affordable and more welfare-appropriate method for conducting tail docking in lambs.

Preliminary Findings on a Novel Behavioural Approach for the Assessment of Pain and Analgesia in Lambs Subject to Routine Husbandry Procedures

Simple Summary

The identification and assessment of pain in sheep are important but, due to their stoic nature, are difficult. In the present study, we evaluated the use of qualitative behavioural assessment to assess pain in lambs caused by routine husbandry procedures performed at lamb marking (ear tagging, castration, mulesing, and tail docking). To do this, video footage of control lambs and of lambs subject to these procedures that were either administered analgesics (Tri-Solfen and meloxicam) or a placebo, was captured 1.5 h post-procedure and assessed by 19 observers. Results showed that the observers agreed in their assessment of the lambs and, as expected, the pain caused by the husbandry procedures altered the behavioural patterns and demeanour of the lambs in a way that was captured by observers using this approach. At the time of assessment, it also appears that the analgesics administered did not reduce the pain experienced by those lambs that received them. These results suggest that qualitative behavioural assessment may be useful in identifying pain in lambs; however further work is needed to test this methodology with lambs given effective analgesic pain relief.

Abstract

The identification and assessment of pain in sheep under field conditions are important, but, due to their stoic nature, are fraught with many challenges. In Australia, various husbandry procedures that are documented to cause pain are routinely performed at lamb marking, including ear tagging, castration, mulesing, and tail docking. This study evaluated the validity of a novel methodology to assess pain in lambs: qualitative behavioural assessment (QBA) was used to compare the behavioural expression of control lambs (CONTROL) with that of lambs subject to these procedures that received either a saline placebo 15 min before procedures (PLACEBO), or were administered meloxicam 15 min before procedures in addition to the standard analgesic Tri-Solfen at the time of procedures, as per the manufacturer’s recommendations (ANALGESIC TREATMENT; AT). In terms of behavioural expression, it was expected that: CONTROL ≠ PLACEBO, AT = CONTROL, and PLACEBO ≠ AT. Video footage of the 6−8-week-old lambs (n = 10 for each treatment) was captured approximately 1.5 h postprocedure and was presented, in a random order, to 19 observers for assessment using the Free-Choice Profiling (FCP) approach to QBA. There was significant consensus (p < 0.001) among the observers in their assessment of the lambs, with two main dimensions of behavioural expression explaining 69.2% of the variation. As expected, observers perceived differences in the demeanour of lambs in the first dimension, scoring all lambs subject to the routine husbandry procedures as significantly more ‘dull’ and ‘uneasy’ compared to the control lambs (p < 0.05). Contrary to expectations, the results also suggested that analgesic treatment did not provide relief at the time of observation. Further investigations to validate the relationship between behavioural expression scores and pain are necessary, but these results suggest that painful husbandry procedures alter the behavioural expression of lambs and these differences can be captured using QBA methodology.

Behavioural measures reflect pain-mitigating effects of meloxicam in combination with Tri-Solfen® in mulesed Merino lambs

Flystrike costs the Australian industry $173 to 280 M per annum and 70% to 80% of Merino lambs are currently mulesed to reduce the risk of flystrike. To alleviate welfare concerns there has been widespread adoption of analgesics to mitigate the pain associated with mulesing. The objective of this experiment was to determine the effectiveness of Tri-Solfen® and meloxicam (Metacam® 20) at reducing pain-related behavioural responses to mulesing in Merino lambs. One hundred and forty Merino lambs were allocated to one of seven treatment groups: (1) non-mulesed (Control); (2) mulesed with no pain relief; (3) subcutaneous (s.c.) meloxicam administered 15 min before mulesing; (4) Tri-Solfen® administered at time of mulesing; (5) Tri-Solfen® and saline injection (s.c.) 15 min before mulesing; (6) Tri-Solfen® and meloxicam (s.c.) 15 min before mulesing; and (7) meloxicam (s.c.) at time the of mulesing. Behavioural responses such as standing, walking and lying were measured every 15 min for 6 h on the day of marking and for up to 2 h for 4 days thereafter. Standing (hunched v. normal) and walking (stiff v. normal) behaviours were then categorised into pain- and normal-related behaviours while lying remained in its own category. Mulesed lambs with no pain relief displayed significantly more pain-related behaviours than Control lambs during the 6 h post-mulesing (1.22 v. 0.22 out of a total score of 3; RSD=1.15). Lambs that received a combination of pain relief displayed significantly less pain-related behaviour than mulesed lambs with no pain relief on the day of mulesing (0.85 v. 1.22 out of a total score of 3; RSD=1.15). Administration of meloxicam or Tri-Solfen® on their own had minimal if any significant effect on pain-related behaviours on the day of mulesing. The results of this experiment support the use of pain-related behaviours to measure the efficacy of analgesics and the use of multimodal analgesia during mulesing of lambs.

Innovative pain management solutions in animals may provide improved wound pain reduction during debridement in humans: An opinion informed by veterinary literature

Painful animal husbandry procedures are routinely performed in a range of livestock species without analgesia. Recently, innovative strategies have been developed to address wound pain in these animals. In particular, a farmer-applied "spray and stay" approach that is administered directly to open wounds was developed (Tri-Solfen® Medical Ethics Pty Ltd., Melbourne, Victoria, Australia). This strategy anaesthetises the wounds immediately upon their formation, with long-lasting effect. This development, described as a "pain management revolution," has become firmly established in the Australian livestock industries and has global potential. The positive outcomes of this approach provide insights and highlight potential benefits that may be accrued from its use in human wound care, providing rapid-onset wound analgesia and/or anaesthetising wounds prior to cleansing and debridement procedures. If these benefits are realised from a clinician and patient perspective for wound debridement as an initial indication, it could provide new horizons in pain management for a spectrum of wound-related procedures. Evidence from use in animal husbandry does support the concept that multimodal anaesthesia holds great potential in the field of wound management across many procedures.

A randomised field study evaluating the effectiveness of buccal meloxicam and topical local anaesthetic formulations administered singly or in combination at improving welfare of female Merino lambs undergoing surgical mulesing and hot knife tail docking

This study was a field-based behavioural assessment of the pain responses to surgical mulesing modulated by a buccal formulation of meloxicam (Buccalgesic) and a topical local anaesthetic wound dressing (Tri-Solfen). 20 lambs were randomly allocated to each of: 1) Placebo and sham handled (Sham); 2) Placebo and mulesing (Mules); 3) Buccalgesic and mulesing (Mules+B); 4) Tri-Solfen and mulesing (Mules+T); 5) Placebo, Tri-Solfen and mulesing (Mules+T+P); 6) Buccalgesic, Tri-Solfen and mulesing (Mules+T+B). Lamb behaviour was observed by scan sampling every 15 min for 6 h post mulesing then for 1.5 h daily over the subsequent 10 days. Wound score, wound sensitivity and body weight were recorded on day 4, 7 and 10. On the day of mulesing, abnormal behaviours were reduced for all groups that received the analgesic drugs compared to the Mules group (P < 0.05). Tri-Solfen reduced expression of abnormal behaviours in the first 4 h; Buccalgesic reduced expression of abnormal behaviours between 2 and 6 h; and combination treatment reduced expression of abnormal behaviours over the entire observation period. On the subsequent two days, the drug combination resulted in fewer abnormal postures than Tri-Solfen alone. The drug combination tended to result in lower pain sensitivity (965.3 g tolerated) than either Mules+T+P (828.8 g), or Mules+B (791.2 g) on day 7 (P < 0.05). Use of Tri-Solfen and Buccalgesic singly or in combination improved the welfare of lambs undergoing surgical mulesing. The residual effect of pain and discomfort caused by mulesing, were evident despite provision of analgesic drugs.

A pen study evaluation of buccal meloxicam and topical anaesthetic at improving welfare of lambs undergoing surgical mulesing and hot knife tail docking

Mulesing is a painful husbandry procedure commonly used to reduce the risk of breech strike in sheep. This study assessed the behavioural (over 6 h), cortisol, haptoglobin and haematology responses to surgical mulesing plus tail hot knife docking (mulesing); modulated by a buccal meloxicam formulation (Buccalgesic), a topical local anaesthetic wound dressing (Tri-Solfen) or both agents. 24 lambs were allocated to each of: 1) Placebo and sham handled (Sham); 2) Placebo and mulesing (Mules); 3) Buccalgesic and mulesing (Mules + B); 4) Tri-Solfen and mulesing (Mules + T); 5) Placebo, Tri-Solfen and mulesing (Mules + T + P); 6) Buccalgesic, Tri-Solfen and mulesing (Mules + T + B). Compared with Mules, Mules + T had a lower cortisol response (72.5 ± 8.7 nmol/L v 122.9 ± 8.7 nmol/L) at 30 min, reduced statue standing at 2 h (3.9% v 11.4%) and increased lying (20.9-25.0% v 7.3-12.5%). Mules + B had reduced cortisol response at 6 h (48.1 ± 8.5 nmol/L), reduced Neutrophil:Lymphocyte ratio at 6 h (Mules + B: 1.25; Mules: 2.44), reduced statue standing at 2 h and 4-6 h (4.1-8.3%), and increased lying at 5 h (27.4%). Mules + B + T had lower cortisol concentrations at 30 mins (86.51 ± 8.71 nmol/L), TWCC not significantly different from Sham at 6 h (9.07 vs 8.09) and 24 h (9.05 vs 8.38). Mules + T + B had significantly lower TWCC than Mules at 12 h (9.56 vs 11.05) and 24 h (9.05 vs 10.42). Mules + T + B did not.

Effects of Topical Anaesthetic and Buccal Meloxicam Treatments on Concurrent Castration and Dehorning of Beef Calves

The use of pain relief during castration and dehorning of calves on commercial beef operations can be limited by constraints associated with the delivery of analgesic agents. As topical anaesthetic (TA) and buccal meloxicam (MEL) are now available in Australia, offering practical analgesic treatments for concurrent castration and dehorning of beef calves, a study was conducted to determine their efficacy in providing pain relief when applied separately or in combination. Weaner calves were randomly allocated to; (1) no castration and dehorning/positive control (CONP); (2) castration and dehorning/negative control (CONN); (3) castration and dehorning with buccal meloxicam (BM); (4) castration and dehorning with topical anaesthetic (TA); and (5) castration and dehorning with buccal meloxicam and topical anaesthetic (BMTA). Weight gain, paddock utilisation, lying activity and individual behaviours following treatment were measured. CONP and BMTA calves had significantly greater weight gain than CONN calves (p < 0.001). CONN calves spent less time lying compared to BMTA calves on all days (p < 0.001). All dehorned and castrated calves spent more time walking (p = 0.024) and less time eating (p < 0.001) compared to CONP calves. There was a trend for CONP calves to spend the most time standing and CONN calves to spend the least time standing (p = 0.059). There were also trends for the frequency of head turns to be lowest in CONP and BMTA calves (p = 0.098) and tail flicks to be highest in CONN and BM calves (p = 0.061). The findings of this study suggest that TA and MEL can potentially improve welfare and production of calves following surgical castration and amputation dehorning.

Topical anaesthesia reduces sensitivity of castration wounds in neonatal piglets

The aim of this study was to do determine the efficacy of the topical anaesthetic Tri-Solfen® in the amelioration of the pain of castration in piglets. The trial was conducted over a three day period, and blocked across six litters with 12 piglets treated on days one and two, and 16 on day three. The piglets were randomly allocated by weight and litter to 1 of 4 treatment groups: (i) sham castration (SHAM; n = 10); (ii) surgical castration with no anaesthetic intervention (CAST; n = 10); (iii) surgical castration with post-operative topical anaesthesia (TRI; n = 10); (iv) surgical castration with a pre-operative intra-testicular lignocaine hydrochloride injection (LIG; n = 10). Wound sensitivity testing involved von Frey monofilaments of weights 4g and 300g, and an 18 gauge needle, used to stimulate the wound and surrounding skin respectively, at various pre-determined sites. Neonatal piglets receiving topical anaesthesia (Tri-Solfen®) spray into castration wounds had significantly lower wound sensitivity responses for up to 4h, compared to those castrated following intra-testicular lignocaine injection or those with no treatment. The use of topical anaesthetic is suggested as a practical and affordable method of improving piglet welfare during castration.

Effect of Topically Applied Anaesthetic Formulation on the Sensitivity of Scoop Dehorning Wounds in Calves

The post-operative effects of three formulations of topical anaesthetic and a cornual nerve block on the sensitivity of scoop dehorning wounds in calves were compared in two trials. In Trial 1, 21 female Holstein dairy calves aged 8 to 24 weeks were randomly allocated to two groups: (1) scoop dehorning with a post-operative application of a novel topical anaesthetic powder (DTAP, n = 10); and (2) scoop dehorning with a post-operative application of a novel topical anaesthetic ethanol liquid (DTAE, n = 11). In Trial 2, 18 castrated male and 18 female Hereford beef calves aged 16 to 20 weeks were randomly allocated to four groups: (1) scoop dehorning with a pre-operative cornual nerve block of lignocaine (DCB, n = 9); (2) scoop dehorning with a post-operative application of the novel topical anaesthetic ethanol liquid from Trial 1 (DTAE, n = 9); (3) scoop dehorning with a post-operative application of a topical anaesthetic gel (DTAG, n = 9); and (4) sham dehorning (CON, n = 9). Sensitivity was assessed by scoring the behavioural response of calves to stimulation of the wound or skin at time points before and after treatment. In Trial 1, DTAP calves had a greater probability of displaying more severe responses than DTAE calves at 90 and 180 min (P < 0.001). In Trial 2, at 1 h, DTAG calves had a greater probability of displaying more severe responses than CON calves. At 2 h onwards, all dehorned calves had a greater probability of displaying more severe responses than CON calves (P < 0.001). There were no differences between the responses of DCB, DTAG and DTAE calves at any time point. Topical anaesthetic formulations result in almost immediate but temporary anaesthesia of the wound following scoop dehorning in calves and may provide a practical option for pain relief on-farm.

Evaluating the efficacy of a topical anaesthetic formulation and ketoprofen, alone and in combination, on the pain sensitivity of dehorning wounds in Holstein-Friesian calves

The aim of this study was to investigate the effect of a topically applied local anaesthetic and the non-steroidal anti-inflammatory drug ketoprofen, alone and in combination, on the pain sensitivity response of calves to dehorning (mean age 2.2 months). Calves were randomly allocated and blocked by age to one of four groups. Groups were: scoop dehorning (D, n = 8), scoop dehorning + i.m. administration of 3 mg/kg ketoprofen (DK, n = 8), scoop dehorning + application of topical anaesthetic (DTA, n = 7) and scoop dehorning + application of topical anaesthetic and i.m. administration of ketoprofen (DKTA, n = 7). A pressure algometer was used to determine the mechanical nociceptive threshold (MNT), being the pressure (kg/f) at which calves withdrew from the stimulus. Measurements were taken before dehorning and at 1 min, 1, 2, 5 and 24 h post-dehorning at both the cut skin edge of the wound and the peri-wound area. The effect of treatment changed over time (P < 0.001). MNT was highest before treatment (MNT = 5.03 kg/f) and tended to decrease over time (MNT = 1.16 kg/f 24 h post-treatment). Overall, D calves exhibited the lowest MNT with an average of 1.77 kg/f. DTA calves had the highest MNT (3.89 kg/f), followed closely by DKTA calves (3.24 kg/f). DK calves exhibited an intermediate MNT of 2.61 kg/f. MNT of the cut skin edge was generally lower than that of the peri-wound area (2.01 vs 3.81 kg/f, respectively, P = 0.02).The topical anaesthetic formulation significantly reduced the pain sensitivity of dehorning wounds. There was no observed enhanced analgesic effect with addition of ketoprofen. The cut skin edge was more sensitive to pressure than the peri-wound area.

Effect of a cooling gel on pain sensitivity and healing of hot-iron cattle brands

Hot-iron branding is painful for cattle, but little is known about how long this pain lasts or effective alleviation methods. Previous work with pigs indicated that cooling burns with a gel (active ingredient: tea tree oil) improved healing compared to untreated wounds. Steers (210±21 kg) were hot-iron branded and allocated to 1 of 3 treatments: control (n=24), 1 gel application immediately after branding (1X; n=12), or 2 gel applications, 1 immediately after branding and one 1 d later (2X; n=12). Pain sensitivity was assessed by applying a known and increasing force with a von Frey anesthesiometer in 5 locations (in the center, at the top of, and 5 and 10 cm above the brand and on the equivalent location on the nonbranded side of the body) until animals showed a behavioral response. Healing was measured with a 6-point scale (1=fresh brand and 6=no scabbing and fully repigmented). Both measures, along with weight gain and surface temperature of the wound, were recorded before and 1, 2, 3, 7, 14, 21, 28, 35, 56, and 70 d after branding. The gel cooled the brand, with the most obvious differences on the day it was applied (3.7 to 4.2°C cooler than control; day×gel interaction, P=0.004). All wounds were at least partially repigmented by 70 d, but only 46% of brands were fully healed at this time. The healing process was slowed when a gel was applied twice (e.g., at 21 d, healing score of 2.5±0.1 and 2.7±0.1 vs. 2.0±0.2 for control and 1X vs. 2X, respectively; P=0.001). Brands tended to remain painful throughout the 70 d (in the center of the brand; before vs. d 1-35, P≤0.001; d 56, P=0.058; and d 70, P=0.092). Overall, gel had little effect on pain sensitivity. Weight gain was reduced on d 1 after branding compared to all other time points (P<0.001) but was not affected by gel application (P=0.277). In conclusion, applying gel did not improve outcomes after branding. In addition, by 70 d after the procedure, hot-iron brands still tended to be more painful than nonbranded tissue and 54% were not fully healed. These results raise additional animal welfare concerns about hot-iron branding.

Effect of a topical anaesthetic formulation on the cortisol response to surgical castration of unweaned beef calves

Impracticality and cost of existing pain management strategies during surgical castration of beef cattle have limited their widespread implementation on-farm. A farmer-applied topical anaesthetic formulation, originally developed and used commercially to mitigate the pain of mulesing in lambs, was investigated for its potential use for managing pain in surgically castrated calves. This formulation contained lidocaine, bupivacaine, adrenalin and cetrimide. In this study, 24 Angus bull calves were randomly allocated to (1) surgical castration (C, n=8), (2) surgical castration with the post-operative application of topical anaesthetic (CTA, n=8) and (3) sham castration/control (CON, n=8). The experiment was conducted over 2 days, with treatment groups evenly represented across each day. Calves were habituated to handling before the experiment and blood samples were collected for plasma cortisol measurement at defined time periods before, at and post treatment, (at -0.5, 0 h, then +0.5, 1, 1.5, 2, 4 and 6 h). There was a significant effect of time on cortisol concentrations across all treatment groups (P<0.01), with lowest concentrations at -0.5 and 6 h and peak concentration at 0.5 h being significantly higher than the cortisol response at 0 h. The effect of treatment was not significant (P=0.077), however, there was a trend for CON calves to display lower cortisol concentrations than C and CTA calves and CTA calves to display lower cortisol concentrations than C calves. The mean area under the curve (AUC) of CON calves was significantly lower than those of C and CTA calves (P=0.04), however, there was no significant difference between the AUCs of CTA and C calves. Immediate application of topical anaesthetic after surgical castration did not significantly reduce plasma cortisol concentrations. However, the trend for CTA calves to display lower cortisol concentrations than C calves warrants further investigation into the use of TA for pain relief of surgically castrated beef calves.

Topical anesthesia mitigates the pain of castration in beef calves

Castration involves the removal of the testes and is performed to improve product quality and management of male calves. The procedure has been proven to cause significant pain and stress, and despite several attempts to reduce the impact of castration on animal welfare, there has yet to be a practical and affordable option made available for farmer application. To address this issue, we conducted 2 trials (n = 18 and 27) to examine the efficacy of topical anesthetic Tri-Solfen (TA) to alleviate the pain of surgical castration. Angus bull calves (135.8 ± 5.7 kg) aged 3 to 4 mo were randomly allocated to 3 treatment groups, including surgical castration, castration in combination with TA, and uncastrated controls. In Trial 1, pain-related behavior was assessed using a customized numerical rating scale (NRS) over 4 h. In Trial 2, pre- and postoperative skin sensitivity of the wound and periwound areas was assessed using an electronic von Frey anesthesiometer (IITC Life Sciences, Woodland Hills, CA) and von Frey monofilaments (300 g). Sampling was repeated at 1 min and 2, 4, 6, and 24 h after castration. Pain threshold was measured as maximum pressure (g) exerted by the electronic anesthesiometer to invoke animal reflex, and responses to the von Frey monofilaments were scored from 0 to 3 using a NRS on the basis of local and central motor reflexes. Calves treated with TA displayed significantly less pain-related behaviors up to 3.5 h after castration than untreated calves (P < 0.001) and did not differ from uncastrated controls. Topical anesthetic-treated calves also exhibited significantly greater pain threshold of the wound (559.2 ± 14.3 g) and surrounding skin (602.8 ± 16.5 g) than untreated calves (446.0 ± 18.9 and 515.3 ± 20.4 g, respectively; P < 0.001). Control and TA-treated calves had significantly lower mean response scores to von Frey stimulation than untreated calves (0.333, 0.978, and 4.289, respectively; P < 0.001). Results indicate that TA effects rapid and prolonged pain alleviation in calves up to 24 h after castration. Topical anesthesia may present a cost-effective, practical, on-farm approach to pain alleviation and is proposed as a potential tool for reducing the welfare impact on the beef animal in routine husbandry procedures.