Use of Meloxicam or Ketoprofen for Piglet Pain Control Following Surgical Castration

A comprehensive painkillers screening by assessing zebrafish behaviors after caudal fin amputation

Recently, the usage of zebrafish for pain studies has increased in the past years, especially due to its robust pain-stimulated behaviors. Fin amputation has been demonstrated to induce a noxious response in zebrafish. However, based on the prior study, although lidocaine, the most used painkiller in zebrafish, has been shown to ameliorate amputated zebrafish behaviors, it still causes some prolonged effects. Therefore, alternative painkillers are always needed to improve the treatment quality of fin-amputated zebrafish. Here, the effects of several analgesics in recovering zebrafish behaviors post-fin amputation were evaluated. From the results, five painkillers were found to have potentially beneficial effects on amputated fish behaviors. Overall, these results aligned with their binding energy level to target proteins of COX-1 and COX-2. Later, based on their sub-chronic effects on zebrafish survivability, indomethacin, and diclofenac were further studied. This combination showed a prominent effect in recovering zebrafish behaviors when administered orally or through waterborne exposure, even with lower concentrations. Next, based on the ELISA in zebrafish brain tissue, although some changes were found in the treated group, no statistical differences were observed in most of the tested biomarkers. However, since heatmap clustering showed a similar pattern between biochemical and behavior endpoints, the minor changes in each biomarker may be sufficient in changing the fish behaviors.

Effects of assessment method (real-time versus video-recorded) on a validated pain-altered behavior scale used in castrated piglets

We aimed to compare two assessment methodologies (real-time vs. video-recorded) using the Unesp-Botucatu Pig Composite Acute Pain Scale (UPAPS) in piglets before and after castration. Twenty-nine male piglets were castrated. Four observers scored the UPAPS over three perioperative timepoints of castration following two assessment methodologies. In real-time assessments, the observers were in-person observing the piglets in front of the pen. After two weeks, the observers did video-recorded assessments randomizing piglets and timepoints. Modeling was conducted to compare the UPAPS and each pain-altered behavior between methodologies. Intraclass correlation coefficient (ICC), Bland-Altman, and Lin's concordance correlation coefficient (CCC) were conducted to investigate agreement between methodologies. UPAPS was statistically equivalent between methodologies (P = 0.4371). The ICC for each method was very good (0.85 to 0.91). The agreement of the UPAPS assessed between methodologies had minimal bias (- 0.04), no proportion bias, and 53% of the assessments presented a perfect agreement. However, CCC of the UPAPS was moderate (0.65), and only one pain-altered behavior ("presents difficulty in overcoming obstacles or other animals") occurred more in real-time assessments (P = 0.0444). In conclusion, piglet pain assessment by UPAPS can be conducted in real-time based on a suitable agreement between the real-time and video-recorded assessment methods.

An investigation of the use of ethyl chloride and meloxicam to decrease the pain associated with a single or double incision method of castration in piglets

Castration is a stressful and painful procedure that can impact swine welfare negatively. The objectives of this study were to (1) evaluate the effect of one incision compared to two incisions and the use of a topical vapocoolant (VAPO; ethyl chloride; a topical anesthetic) applied before castration and (2) evaluate the most effective combination in reducing pain in objective 1 and the use of Metacam®; meloxicam before castration on measures of performance, behavior, and physiology. Study 1 consisted of six treatment groups (N = 27 pigs per treatment) and included: nothing (NO); sham castrated (SH); one incision castration (C1); one incision castration plus VAPO (C1V); two incision castration (C2); two incision castration plus VAPO (C2V). Body weights and blood samples were taken at baseline and other time points after castration. Behavior measures were collected for 24 h after castration. Wound scores were collected daily for 10 days. The C1 pigs and C1V pigs were significantly heavier than the other castrated treatment groups but not different from NO and SH pigs. Vocalizations were louder for C1 and C1V pigs (P = 0.0015). Study 2 (N = 40 pigs per treatment) included: nothing (NO); one incision castration (C1); and one incision castration plus meloxicam administered 15 min before castration (C1M). The same measures (performance, behavior, and physiology) were collected as in Study 1. Performance measures and behavior did not differ among treatment groups. Physiological measures were only different for red blood cells (RBC; P = 0.0304). Pigs in C1 and C1M treatment groups had cortisol concentrations that were greater than the NO treatment group at 15 min post-castration (P < 0.05). The data collected give insight into the benefits of one-incision castration compared to 2-incision castration. However, the data only support a lower-level relief from acute pain associated with castration, as it is evident that pigs still experience stress at 15 min post-castration with or without the use of meloxicam. Further research could potentially identify the correct timing, route and dose for the administration of meloxicam.

Measurement properties of pain scoring instruments in farm animals: A systematic review using the COSMIN checklist

This systematic review aimed to investigate the measurement properties of pain scoring instruments in farm animals. According to the PRISMA guidelines, a registered report protocol was previously published in this journal. Studies reporting the development and validation of acute and chronic pain scoring instruments based on behavioral and/or facial expressions of farm animals were searched. Data extraction and assessment were performed individually by two investigators using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. Nine categories were assessed: two for scale development (general design requirements and development, and content validity and comprehensibility) and seven for measurement properties (internal consistency, reliability, measurement error, criterion and construct validity, responsiveness and cross-cultural validity). The overall strength of evidence (high, moderate, low, or very low) of each instrument was scored based on methodological quality, number of studies and studies' findings. Twenty instruments for three species (bovine, ovine and swine) were included. There was considerable variability concerning their development and measurement properties. Three behavior-based instruments scored high for strength of evidence: UCAPS (Unesp-Botucatu Unidimensional Composite Pain Scale for assessing postoperative pain in cattle), USAPS (Unesp-Botucatu Sheep Acute Composite Pain Scale) and UPAPS (Unesp-Botucatu Pig Composite Acute Pain Scale). Four instruments scored moderate for strength of evidence: MPSS (Multidimensional Pain Scoring System for bovine), SPFES (Sheep Pain Facial Expression Scale), LGS (Lamb Grimace Scale) and PGS-B (Piglet Grimace Scale-B). Most instruments (n = 13) scored low or very low for final overall evidence. Construct validity was the most reported measurement property followed by criterion validity and reliability. Instruments with reported validation are urgently required for pain assessment of buffalos, goats, camelids and avian species.

Validation of the Unesp-Botucatu pig composite acute pain scale (UPAPS) in piglets undergoing castration

To accurately assess pain and support broadly-based analgesic protocols to mitigate swine pain, it is imperative to develop and validate a species-specific pain scale. The objective of this study was to investigate the clinical validity and reliability of an acute pain scale (UPAPS) adapted for newborn piglets undergoing castration. Thirty-nine male piglets (five days of age, 1.62 ± 0.23 kg BW) served as their own control, were enrolled in the study and underwent castration in conjunction with an injectable analgesic administered one-hour post-castration (flunixin meglumine 2.2 mg/kg IM). An additional 10, non-painful female piglets were included to account for the effect of natural behavioral variation by day on pain scale results. Behavior of each piglet was video recorded continuously at four recording periods (24 h pre-castration, 15 min post-castration, 3 and 24 h post-castration). Pre- and post-operative pain was assessed by using a 4-point scale (score 0-3) including the following six behavioral items: posture, interaction and interest in surroundings, activity, attention to the affected area, nursing, and miscellaneous behavior. Behavior was assessed by two trained blinded observers and statistical analysis was performed using R software. Inter-observer agreement was very good (ICC = 0.81). The scale was unidimensional based on the principal component analysis, all items except for nursing were representative (rs ≥ 0.74) and had excellent internal consistency (Cronbach's alpha ≥ 0.85). The sum of scores were higher in castrated piglets post-procedure compared to pre-procedure, and higher than in non-painful female piglets confirming responsiveness and construct validity, respectively. Scale sensitivity was good when piglets were awake (92.9%) and specificity was moderate (78.6%). The scale had excellent discriminatory ability (area under the curve > 0.92) and the optimal cut-off sum for analgesia was 4 out of 15. The UPAPS scale is a valid and reliable clinical tool to assess acute pain in castrated pre-weaned piglets.

Efficacy of transdermal flunixin in mitigating castration pain in piglets

Castration is a painful procedure performed in swine and to date, there are no approved products available in the US to alleviate this pain. Previous work evaluating the efficacy of flunixin meglumine has shown promise in mitigating pain in swine, but no work to date has evaluated transdermal flunixin efficacy in mitigating castration pain in piglets. Therefore, the objective of this study was to evaluate the efficacy of transdermal flunixin (TDF) in mitigating castration pain utilizing a previously validated behavioral pain scale. A total of 98 Large White x Duroc cross male piglets from 98 litters were enrolled in this study. Piglets were randomly assigned to the following treatments: (1) TDF plus castration (3.33 mg/kg; CF; n = 24), (2) TDF plus sham castration (3.33 mg/kg; SF; n = 26), (3) topical physiological saline plus sham castration (S; n = 24), or (4) topical physiological saline plus castration (C; n = 24). All treatments were administered 24 h prior to castration. Four-min continuous videos clips were collected 24 h before castration (−24 h), immediately post-castration (0 h), and 24 h post-castration (+24 h). Video clips were then observed and scored by one trained observer using a 4-point pain scale (score 0–3) encompassing the five behavioral domains of the pig acute pain scale (UPAPS). Total pain score averages were analyzed as repeated measures by analysis of variance applying a multilevel model. The UPAPS effectively distinguished varying levels of painful and non-painful states in castrated piglets as observed via deviations in total pain scores across timepoints (P &lt; 0.0001), treatment (P &lt; 0.001) and treatment*timepoint (P &lt; 0.0001). Immediately post-castration (0 h), piglets in the C and CF group demonstrated greater total average pain scores than piglets in the S (P &lt; 0.03) and SF (P &lt; 0.01) groups and castrated piglets treated with TDF demonstrated lower total pain scores (P &lt; 0.05) and required less analgesic intervention immediately post-castration compared to castrated piglets receiving no treatment (P &lt; 0.0001). For C group 54% required rescue analgesia compared to 29%, 8% and 0% for CF, SF and S piglets respectively. Future work should evaluate implementation of this pain management protocol on a wide scale commercial farm setting.

[Comparison of the efficiency of inhalation and injection anaesthesia for the castration of male suckling piglets in different organic farms]

OBJECTIVE

In Germany, injection and inhalation anesthesia with the addition of an analgesic drug are an interim solution to surgical castration under general anesthesia due to the ban on non-anesthetic castration of male suckling piglets under 8 days of age. However, the efficiency of both anesthetic procedures is submit to controversial discussion. Most of the studies addressing this question only examined one of the procedures in comparison to piglets castrated without anesthesia or uncastrated controls. Comparisons between the anesthesia methods, especially under conditions of organically working farms, are almost completely lacking. The aim of the present study was therefore to compare the efficacy of injection and inhalation anesthesia under practical conditions in 7 organic farms as well as to examine the effect of metamizole administered in addition to meloxicam.

MATERIAL AND METHODS

For this purpose, 514 male suckling piglets were examined with regard to anesthesia efficiency (reflex test, defence behaviour), body temperature, post-operative bleeding and wound healing, post-operative behavior and pain behavior as well as the course of the recovery phase.

RESULTS

The results show a basic superiority of inhalation anesthesia over injection anesthesia, especially in the areas of anesthetic efficacy, thermoregulation and duration of the recovery phase. In 7.7 to 15 % of piglets, the perianal and interclaw reflexes studied were still present at the time of castration. Following injection and inhalation anesthesia, in total 83.6 (25.2 %) of the piglets showed at least one of the following criteria: positive reflex response, clear defensive movements or vocalisations. Body temperature dropped by 0.41 °C under inhalation anesthesia and by 1.82 °C under injection anesthesia. Post-castration bleeding and wound healing were hardly influenced by the type of anesthesia. Almost all piglets showed signs of pain and pain-associated behavior for 5 and 72 hours after castration, regardless of the type of anesthesia. The post-castration recovery phases lasted significantly longer after injection anesthesia (107 minutes) than following inhalation anesthesia (33.3 minutes) until the piglets were returned to the sow.

CONCLUSION

Neither injection nor inhalation anesthesia in spite of additional administration of meloxicam, nor the supplementary use of metamizole, fulfil the EU requirements for painless castration.

CLINICAL RELEVANCE

The necessary analgesia during and after castration of male suckling piglets is not achieved under either isoflurane or ketamine/azaperone anesthesia, despite the use of meloxicam and metamizole.

Recognizing Post-Castration Pain in Piglets: A Survey of Swine Industry Stakeholders and the General Public

We need validated, practical methods for pain assessment in piglets. Pain assessment can help researchers, veterinarians and industry professionals identify the need for analgesia or other pain management approaches when applying painful procedures, such as surgical castration. A pain assessment tool, the Piglet Grimace Scale (PGS), was previously validated in this context, but it is not widely applied. It is important that the PGS can be applied by a range of people, not just pain assessment experts. Our objective was to study the validity and reliability of PGS ratings applied by swine industry professionals and the general public, to assess its potential utility in non-research applications. To do so, we conducted an online Qualtrics survey in which, after completing a brief online training module and a practice test, 119 respondents were asked to rate 9 piglet images showing facial expressions immediately after surgical castration or sham-handling. Respondents were provided information on the castration treatment for each image and had continuous access to the scale throughout the survey. The survey also contained demographic questions. Industry respondents were recruited through networking, and participants from the general public were recruited through Amazon Mechanical Turk. Four trained experts scored each image, and these scores were averaged to produce gold standard scores. Intraclass correlations indicated strong internal consistency among experts, industry and public. ANOVA demonstrated scoring to be moderately comparable between groups. Campbell and Fiske’s Multi-Trait Multi-Method framework provided qualified support for the internal validity and reliability of the PGS scale, even applied by non-experts (industry and public). Both response groups were able to recognize pain in castrated piglets. However, public respondents attributed higher levels of pain to sham-handled piglets than industry respondents (2.83 vs. 2.35; p=0.047), and both response groups systematically overestimated pain experience compared to the experts, suggesting more training may be necessary before using the scale in a diagnostic capacity. Nevertheless, overall findings support wide applicability of PGS, even with minimal training, to improve awareness, recognition and monitoring of swine pain among veterinarians, industry professionals and even members of the public.

Pharmacokinetic/pharmacodynamic modeling of ketoprofen and flunixin at piglet castration and tail-docking

This study performed population‐pharmacokinetic/pharmacodynamic (pop‐PK/PD) modeling of ketoprofen and flunixin in piglets undergoing routine castration and tail‐docking, utilizing previously published data. Six‐day‐old male piglets (8/group) received either ketoprofen (3.0 mg/kg) or flunixin (2.2 mg/kg) intramuscularly. Two hours post‐dose, piglets were castrated and tail docked. Inhibitory indirect response models were developed utilizing plasma cortisol or interstitial fluid prostaglandin E2 (PGE2) concentration data. Plasma IC50 for ketoprofen utilizing PGE2 as a biomarker was 1.2 μg/ml, and ED50 for was 5.83 mg/kg. The ED50 calculated using cortisol was 4.36 mg/kg; however, the IC50 was high, at 2.56 μg/ml. A large degree of inter‐individual variability (124.08%) was also associated with the cortisol IC50 following ketoprofen administration. IC50 for flunixin utilizing cortisol as a biomarker was 0.06 μg/ml, and ED50 was 0.51 mg/kg. The results show that the currently marketed doses of ketoprofen (3.0 mg/kg) and flunixin (2.2 mg/kg) correspond to drug responses of 33.97% (ketoprofen‐PGE2), 40.75% (ketoprofen‐cortisol), and 81.05% (flunixin‐cortisol) of the maximal possible responses. Given this information, flunixin may be the best NSAID to use in mitigating castration and tail‐docking pain at the current label dose.

Pharmacokinetics of combined administration of iron dextran with meloxicam or flunixin meglumine in piglets

OBJECTIVE

The objective was to evaluate the pharmacokinetics of compounding non-steroidal anti-inflammatory drugs (NSAIDs) meloxicam or flunixin meglumine with iron dextran (ID) in piglets.

ANIMAL

Forty piglets (8 d of age) were randomly allocated into 5 groups (8 piglets/group) and received 1 intramuscular injection in the neck of the following treatments: flunixin meglumine (2.2 mg/kg) administered alone (F) or mixed with ID (F+ID); or meloxicam (0.4 mg/kg) administered alone (M) or mixed with ID (M+ID); or ID alone.

PROCEDURE

Blood samples were collected via indwelling jugular catheters at pre-dose, and 10, 20, 30, 45, and 60 min, and 2, 4, 8, 12, 24, 36, 48, and 72 h post-treatment to determine plasma NSAIDs concentrations using liquid chromatography-tandem mass spectrometry. Pharmacokinetic parameters for plasma meloxicam and flunixin meglumine concentration-time profiles were determined for each piglet using noncompartmental analysis approaches. Statistical analyses were performed using SAS software with significance set at P < 0.05.

RESULTS

The AUC_0-tlast, AUC_0-∞, C_max, and relative bioavailability values in the M+ID and F+ID groups were lower than corresponding M and F groups. The M+ID group elimination half-life was lower, whereas λ_z and t_max values were greater than the corresponding M group.

CONCLUSION

Relative bioavailability of meloxicam and flunixin meglumine were reduced when compounded with ID in the same bottle and administered to piglets.

CLINICAL RELEVANCE

Further research is warranted to evaluate if decreased NSAID exposure when compounded with ID alters analgesic efficacy or drug residue depletion.

Impact of Routine Management Procedures on the Welfare of Suckling Piglets

Piglets often undergo several painful treatments during the initial days of their lives. In this review, we investigate the acute (i.e., immediate), short-, and long-term implications of piglet processing on behavioral, physiological, clinical, and performance parameters, and how welfare impairments depend on performance instead of sham procedure, alternative techniques, or the age of the piglets. Welfare indicators that have been used to determine the least distressing procedures and knowledge gaps with regard to the procedures are identified and discussed. Tail docking and especially piglet castration have been the most researched topics, whereas marking for identification has been rarely addressed. Few or no studies have investigated the effects of teeth resection and tail docking on piglets of different age groups. Additionally, results are often found to be inconsistent, highlighting the need for additional research to determine the optimal age for processing. Studies comparing different processing techniques have produced contradictory results, but ear notching, teeth clipping, hot cautery tail docking, and tearing during castration have been determined to result in increased pain. Generally, a shorter procedure duration can reduce stress, with operator training having a distinct impact on piglet welfare during processing. As such, these topics should be further investigated.

Proposed multidimensional pain outcome methodology to demonstrate analgesic drug efficacy and facilitate future drug approval for piglet castration

Castration of male piglets in the United States is conducted without analgesics because no Food and Drug Administration (FDA) approved products are labeled for pain control in swine. The absence of approved products is primarily due to a wide variation in how pain is measured in suckling piglets and the lack of validated pain-specific outcomes individually indistinct from other biological responses, such as general stress or inflammation responses with cortisol. Simply put, to measure pain mitigation, measurement of pain must be specific, quantifiable, and defined. Therefore, given the need for mitigating castration pain, a consortium of researchers, veterinarians, industry, and regulatory agencies was formed to identify potential animal-based outcomes and develop a methodology, based on the known scientific research, to measure pain and the efficacy of mitigation strategies. The outcome-based measures included physiological, neuroendocrine, behavioral, and production parameters. Ultimately, this consortium aims to provide a validated multimodal methodology to demonstrate analgesic drug efficacy for piglet castration.Measurable outcomes were selected based on published studies suggesting their validity, reliability, and sensitivity for the direct or indirect measurement of pain associated with surgical castration in piglets. Outcomes to be considered are observation of pain behaviors (i.e. ethogram defined behaviors and piglet grimace scale), gait parameters measured with a pressure mat, infrared thermography of skin temperature of the cranium and periphery of the eye, and blood biomarkers. Other measures include body weight and mortality rate.This standardized measurement of the outcome variable's primary goal is to facilitate consistency and rigor by developing a research methodology utilizing endpoints that are well-defined and reliably measure pain in piglets. The resulting methodology will facilitate and guide the evaluation of the effectiveness of comprehensive analgesic interventions for 3- to 5-day-old piglets following surgical castration.

Comparative effects of nonsteroidal anti-inflammatory drugs at castration and tail-docking in neonatal piglets

This study assessed the efficacy of meloxicam, flunixin, and ketoprofen in piglets undergoing routine castration and tail-docking. Six-day-old male piglets (8/group) received one of five randomized treatments: intramuscular saline (SAL PROC), meloxicam (MEL; 0.4 mg/kg), flunixin (FLU; 2.2 mg/kg), ketoprofen (KETO; 3.0 mg/kg) or sham (SAL SHAM; saline injection, no processing). Two hours post-dose, piglets were castrated and tail-docked. Plasma cortisol, interstitial fluid (ISF) prostaglandin E2 (PGE2) and activity levels via Actical® monitoring were used to estimate pain. SAL SHAM and FLU exhibited lower cortisol concentrations than SAL PROC at the time of processing (p = 0.003 and p = 0.049, respectively), and all NSAIDs exhibited lower PGE2 than SAL PROC at 3.69 hours (MEL p = 0.050; FLU p = 0.043 and KETO p = 0.031). While not statistically significant, PGE2 was higher in SAL PROC piglets vs. other treatment groups at most time points. There was also a high degree of variability between piglets, especially for SAL PROC. Activity levels were significantly decreased at multiple time points in SAL PROC and MEL piglets following processing. However, FLU and KETO piglets had increased activity levels closer to that of the SAL SHAM group, suggesting that these NSAIDs are more effective than MEL in providing analgesia. These results demonstrate that management strategies including administration of intramuscular flunixin or ketoprofen to reduce pain associated with processing will likely improve piglet health and welfare in the United States.

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.

Measurement properties of grimace scales for pain assessment in non-human mammals: a systematic review

ABSTRACT

Facial expressions of pain have been identified in several animal species. The aim of this systematic review was to provide evidence on the measurement properties of grimace scales for pain assessment. The protocol was registered (SyRF#21-Nov-2019) and the study is reported according to the PRISMA guidelines. Studies reporting the development, validation, and the assessment of measurement properties of grimace scales were included. Data extraction and assessment were performed by two investigators, following the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. Six categories of measurement properties were assessed: internal consistency, reliability, measurement error, criterion and construct validity, and responsiveness. Overall strength of evidence (high, moderate, low) of each instrument was based on methodological quality, number of studies and studies' findings. Twelve scales for nine species were included (mice, rats, rabbits, horses, piglets, sheep/lamb, ferrets, cats and donkeys). Considerable variability regarding their development and measurement properties was observed. The Mouse, Rat, Horse and Feline Grimace Scales exhibited high level of evidence. The Rabbit, Lamb, Piglet and Ferret Grimace Scales and Sheep Pain Facial Expression Scale exhibited moderate level of evidence. The Sheep Grimace Scale, EQUUS-FAP and EQUUS-Donkey-FAP exhibited low level of evidence for measurement properties. Construct validity was the most reported measurement property. Reliability and other forms of validity have been understudied. This systematic review identified gaps in knowledge on the measurement properties of grimace scales. Further studies should focus on improving psychometric testing, instrument refinement and the use of grimace scales for pain assessment in non-human mammals.

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

Simple Summary

Pain causes behavioral, autonomic and neuroendocrine changes and is a common cause of animal welfare compromise in farm animals. These recommendations focus on cattle, sheep, and pigs, and present the implications of unmanaged 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.

Abstract

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.

Safety Study on Ketoprofen in Pigs: Evaluating the Effects of Different Dosing and Treatment Scheme on Hematological, Hepatic, and Renal Parameters

A safety study on ketoprofen 10% was carried out on pigs using a different dosing and treatment scheme. Forty healthy crossbreed pigs with similar age, weight, and body condition score were distributed into five treatment groups. The pigs were intramuscularly injected once with different doses of ketoprofen: 3 mg/kg (group 1X), 6 mg/kg (group 2X), 9 mg/kg (group 3X). In addition, the 3 mg/kg dosis was administered on three consecutive days (group 1X ext.). Intramuscular injections of saline solution were used in control group (CTL). The pigs were clinically examined throughout the trial and blood samples were taken for hematological and biochemical evaluation on days −4 (before treatment), +3, +7, and +14 (the end of the trial). Any unusual behaviour or clinical signs were reported as potential toxic effects of ketoprofen. Serum measurements showed that none of the ketoprofen doses produced changes in renal or hepatic biochemical parameters, liver enzymes, or total bilirubin. Likewise, hematological assessment indicated no altered parameters or hematocrit percentage in the study groups. These results demonstrate that ketoprofen has no adverse effects in pigs when the doses and scheme evaluated in this study are applied.

Evaluating the utility of a CO2 surgical laser for piglet castration to reduce pain and improve wound healing: a pilot study

CO₂ surgical lasers are widely used for procedures in veterinary and human medicine. There is evidence to suggest surgery using a CO₂ laser reduces pain and swelling and improves healing time compared with surgery with a scalpel. Millions of piglets in North America are surgically castrated each year using a scalpel. Therefore, piglet welfare may be improved by making refinements to the surgical procedure. The objectives of this preliminary study were to determine the ability of a CO₂ surgical laser to (1) reduce pain and (2) improve wound healing of piglets undergoing surgical castration. Two-day-old male Yorkshire × Landrace piglets were used and randomly assigned to 1 of 3 treatments (n = 10 piglets/treatment group): surgical castration with the CO₂ laser, surgical castration with a scalpel, or sham (uncastrated control). Piglets were video recorded in their pens for 1 hr preprocedure and from 0 to 2, 6 to 8, and at 24 hr postprocedure for behavior scoring. Surgical site images were collected at baseline, 0, 8, 24, 48, 72, 96, 120, 144, and 168 hr postcastration for wound healing assessment. Infrared thermography images of the surgical site were also taken at baseline, 0, 0.5, 8, and 24 hr postprocedure to assess inflammation. Finally, blood was collected from each piglet at baseline and 0.5 hr postcastration to assess cortisol levels, prostaglandin E metabolite and pig-major acute phase protein concentration. Laser-castrated piglets displayed more pain behaviors across the observation period than scalpel-castrated piglets (P = 0.05). Laser-castrated piglets also displayed significantly more agonistic behavior than both scalpel-castrated piglets (P = 0.005) and sham piglets (P = 0.036); yet, laser-castrated piglets had significantly lower temperatures at the site of incision compared with scalpel-castrated piglets (P = 0.0211). There was no significant difference in wound healing or any of the blood parameters assessed between laser-castrated and scalpel-castrated piglets. There was evidence of thermal tissue damage on the scrotum of piglets that were castrated using the CO₂ laser. This may have resulted in the unremarkable healing time and the increased pain behavior observed in this study. The surgical laser technique should be refined before conclusions can be made regarding the utility of a CO₂ laser for piglet castration.

On the Road to End Pig Pain: Knowledge and Attitudes of Brazilian Citizens Regarding Castration

We explored the attitudes of Brazilians towards different methods to deal with boar taint in pork (surgical castration without pain control, SC; surgical castration with pain control, SC+PC; immunocastration, IC; raising entire males, EM). Two surveys (Sv1, n = 441 and Sv2, n = 768) containing closed and open questions were conducted. Nearly 70% of Sv1 and Sv2 participants were unaware that meat of entire males may have boar taint and that SC is widely used in pig production in Brazil. In Sv1, acceptability of SC+PC (63%) and IC (53%) was greater than of SC (15%). In Sv2, acceptability of IC (55%) and EM (52%) was greater than of SC (18%). Open-ended responses indicated that participants objected to inflicting pain to pigs to attain a production goal, and were concerned with organoleptic traits and risks of exogenous residues in pork. Participants' views regarding the potential increases in the cost of meat due to adoption of alternative methods varied; some argued that avoiding pain justifies an increase in the price of pork and others that this would impact especially lower income citizens. Our findings indicate that participants opposed surgical castration without pain control, and supported alternative methods. However, the concern with potential risks of presence of residues in meat, expressed by a few participants, may need to be addressed among consumers.

Grimace Scores: Tools to Support the Identification of Pain in Mammals Used in Research

The 3Rs, Replacement, Reduction and Refinement, is a framework to ensure the ethical and justified use of animals in research. The implementation of refinements is required to alleviate and minimise the pain and suffering of animals in research. Public acceptability of animal use in research is contingent on satisfying ethical and legal obligations to provide pain relief along with humane endpoints. To fulfil this obligation, staff, researchers, veterinarians, and technicians must rapidly, accurately, efficiently and consistently identify, assess and act on signs of pain. This ability is paramount to uphold animal welfare, prevent undue suffering and mitigate possible negative impacts on research. Identification of pain may be based on indicators such as physiological, behavioural, or physical ones. Each has been used to develop different pain scoring systems with potential benefits and limitations in identifying and assessing pain. Grimace scores are a promising adjunctive behavioural technique in some mammalian species to identify and assess pain in research animals. The use of this method can be beneficial to animal welfare and research outcomes by identifying animals that may require alleviation of pain or humane intervention. This paper highlights the benefits, caveats, and potential applications of grimace scales.

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.

Assessing Pain Control Efficacy of Meloxicam and Ketoprofen When Compounded with Iron Dextran in Nursing Piglets Using A Navigation Chute

The efficacy of analgesics such as meloxicam and ketoprofen to control pain in piglets when mixed with iron dextran (ID) before injection is unknown. The purpose of this study was to compare perceived pain in castrated piglets treated 1 h before castration with either of these drugs alone, or when mixed with ID, by observing the time it takes for piglets to navigate a chute. Piglets were divided into seven treatment groups (n = 25 piglets per treatment group) including castration with analgesia (meloxicam or ketoprofen), castration with analgesic plus ID, castration without analgesic or ID, sham handled and given ID, and sham handled alone. Piglets were placed in a short chute and their time to navigate the chute was recorded at four timepoints following castration. Piglets given meloxicam or ketoprofen, with or without ID did not differ from each other in their chute navigation times. Additionally, these piglets did not differ from treatment groups that were not castrated. Piglets castrated without analgesia had significantly longer navigation times. These results indicate that meloxicam or ketoprofen, whether mixed with ID prior to injection or not, provide similar analgesic efficacy.

The development and use of facial grimace scales for pain measurement in animals

The measurement of pain in animals is surprisingly complex, and remains a critical issue in veterinary care and biomedical research. Based on the known utility of pain measurement via facial expression in verbal and especially non-verbal human populations, "grimace scales" were first developed a decade ago for use in rodents and now exist for 10 different mammalian species. This review details the background context, historical development, features (including duration), psychometric properties, modulatory factors, and impact of animal grimace scales for pain.

Is the Piglet Grimace Scale (PGS) a Useful Welfare Indicator to Assess Pain after Cryptorchidectomy in Growing Pigs?

Pig cryptorchidism is a congenital anomaly, which requires surgical intervention. Pain assessment in pig farming has some limitations and consumers are increasingly concerned about suffering linked to on-farm procedures. The PGS seems to be a promising tool for pain assessment in piglets, although it has not been investigated whether this tool is applicable to growing pigs. This study was designed to determine whether the PGS could be useful to assess pain in growing pigs undergoing on-farm cryptorchidectomy. Ten mixed-breed cryptorchid pigs were pre-medicated with azaperone and ketamine. Anesthesia was induced and maintained using IV sodium based. Pigs were filmed pre- and 6 h post-surgery to evaluate their behavior (scan sampling every minute). Besides, 36 pictures of the face expressions (18 pre- and 18 6 h post-surgery) were scored with the PGS by three treatment-blind observers. The pre-surgery pig's activity ratio was 59%, while it was 2% 6 h post-surgery. While the PGS inter-observer reliability was excellent (Interclass Correlation Coefficient value of 0.87), the PGS score increased significantly in pigs 6 h post-surgery (Paired sample t-test, p = 0.02). The PGS proved to be a potentially effective method to assess pain associated with cryptorchidectomy. However, further validation studies are required to validate this tool for other potentially painful procedures.

Comparative Plasma and Interstitial Fluid Pharmacokinetics of Meloxicam, Flunixin, and Ketoprofen in Neonatal Piglets

Piglet castration and tail-docking are routinely performed in the United States without analgesia. Pain medications, predominately non-steroidal anti-inflammatory drugs, are used in the EU/Canada to decrease pain associated with processing and improve piglet welfare, however, past studies have shown the efficacy and required dose remain controversial, particularly for meloxicam. This study assessed the pharmacokinetics of three NSAIDs (meloxicam, flunixin, and ketoprofen) in piglets prior to undergoing routine castration and tail-docking. Five-day-old male piglets (8/group) received one of 3 randomized treatments; meloxicam (0.4 mg/kg), flunixin (2.2 mg/kg), ketoprofen (3.0 mg/kg). Two hours post-dose, piglets underwent processing. Drug concentrations were quantified in plasma and interstitial fluid (ISF) and pharmacokinetic parameters were generated by non-compartmental analysis. Time to peak concentration (T_max) of meloxicam, flunixin, and S(-)-ketoprofen in plasma were 1.21, 0.85, and 0.59 h, compared to 2.81, 3.64, and 2.98 h in the ISF, respectively. The apparent terminal half-life of meloxicam, flunixin and S(-)-ketoprofen were 4.39, 7.69, and 3.50 h, compared to 11.26, 16.34, and 5.54 h, respectively in the ISF. If drug concentrations in the ISF are more closely related to efficacy than the plasma, then the delay between the Tmax in plasma and ISF may be relevant to the timing of castration in order to provide the greatest analgesic effect.