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Pain and Inflammation

What is it?

Inflammation is the body’s response to injury. It is a dynamic process spanning the time of injury to time of healing, and is, in fact, the first stage of healing. The first stage of inflammation is somewhat destructive, as many of the cells involved release destructive enzymes aimed at killing any invading bacteria.

Other more “constructive” cells help clean up the “mess” of damaged cells and tissues. Lastly, “building cells” set up fibrous bridges and new blood vessels in the reconstruction phase. Inflammation is managed by a cascade of events and chemicals which are called in to detect and repair tissue damage.

Signs of inflammation:

  • Redness
  • Heat
  • Swelling
  • Pain
  • Loss of function

Pain is caused by stimulation of pain receptors which are found in most tissues of the body. It is recognised as being physiological (“healthy pain”, e.g. labour pains) or pathological (resulting from disease or damage). Pain occurs when impulses from pain receptors travel via nerve tracts to the spine and on to the brain.

Impact

Is inflammation a bad thing?

The answer to this is “yes and no”. To the extent inflammation controls or dampens an injurious process in the body to permit healing to progress, it is a good thing. However, sometimes inflammation can lead to fibrous scarring and the inflammatory response itself can be a major cause of tissue damage.

So there is good pain and bad pain. Good pain may stop you using your broken arm but pain which does not assist healing is “undesirable”. In bovine mastitis for example, even when bacteria causing the infection have been killed, tissue damage is still present as a result of the inflammation. This damage continues to affect the milk, the udder and the cow for several days afterwards1.

How to Treat Pain and Inflammation

Treatment with non-steroidal anti-inflammatory drugs (NSAIDs) is the most common means used to overcome the unwanted effects of inflammation. These drugs are powerful in mitigating the physiological pathways which cause pain and inflammation.

The treatment of mastitis in farm animals has historically been focussed at killing the bacteria. Little or no consideration has been given to the impact of pain or the management of inflammation for rapid restoration of udder function. Previous research has yielded some fascinating conclusions. It would appear that pain from mastitis is significant, and even in moderate cases can continue for up to 20 days following the clinical diagnosis of the disease2. This sensitivity correlates with the length of time required for the somatic cell (inflammatory) response to decline and the presence of inflammatory proteins in the bloodstream to return to normal. There appears to be a long term significant pain component to mastitis.

Freedom from pain for farm animals is now an emerging priority in Europe and the subject of further research. There should be both welfare and production benefits associated with treatment of painful, inflammatory conditions.

A recent, large-scale, landmark clinical study evaluated the use of Metacam® in combination with an antimicrobial, for the treatment of mild and moderate mastitis. The study demonstrated a significant reduction in SCC and a valuable reduction in the culling rate of cows beyond that which could be obtained by the use of an antibiotic alone3. This study is now changing everyday practice.

Prevention

Prevention of pain and inflammation will always be an integral part of the management of livestock, as embodied in the RSPCA’s Five Freedoms. However, trauma and infectious conditions are challenges that are faced on a daily basis in livestock production, and use of analgesics such as NSAIDs should be part of that management.

References:

1. Andrew Biggs. Mastitis in Cattle, The Crowood Press Ltd, 2009, ISBN 978 1 84797 071 8
2. Fitzpatrick et al. Proceedings of the British Mastitis Conference 1998, p36-44.
3. McDougall et al (2009) J Dairy Sci 92:4421-4431

An educational service from Boehringer Ingelheim Limited, Vetmedica Division, the makers of Metacam®, Bovikalc®, Ubrolexin®, Ubro Yellow®, Ubro Red® and Mamyzin®.

Advice on the use of Metacam, Bovikalc or other therapies should be sought from your veterinary surgeon. Metacam contains meloxicam, UK: POM-V IE: POM. Bovikalc contains calcium chloride and calcium sulphate and is not a veterinary medicine which is subject to authorisation by the Irish Medicines Board. Further information available from Boehringer Ingelheim Limited, Vetmedica Division, Bracknell, Berkshire, RG12 8YS, UK. Email: vetmedica.uk@boehringer-ingelheim.com | Web: www.boehringer-ingelheim.co.uk

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Date of preparation: Jul 2013. AHD 7729. Use Medicines Responsibly (www.noah.co.uk/responsible)