Pain management in ruminants.

Based on the available literature, the most important tool available in modern veterinary medicine is preemptive analgesia. Veterinarians must capture "opportunities" to prevent the onset of pain, prevent noxious stimuli or their perception, and limit the pain-stress-distress cascade that results in altered behavior and deviation from physiologic norms. Rational treatment of pain requires an appreciation of its consequences, a fundamental understanding of the mechanisms that are responsible for its production,and a practical appreciation of the analgesic drugs that are available. The goal of pain treatment should be to restore normal (physiologic) pain responses and to eliminate pathologic pain processes. In this context, pain therapy should be directed at the multiple mechanisms (multimodal therapy)responsible for its production, and analgesic therapies should be instituted before (preemptive therapy) pain is initiated (eg, surgery) whenever possible.