Pain Management For Piglets During Castration and Tail D ocking

1. Pain Management For Piglets During Castration and Tail Docking Monique Pairis-Garcia BS, DVM, PhD, mdpairis@iastate.edu Anna Johnson BSc, MSc, PhD, johnsona@iastate.edu Department of Animal Science, Iowa State University Ames, IA

2. Objectives • Defining pain • How to measure pain? • Regulatory concerns for using pain relieving drugs in the United States • Case Study: Drug efficacy for pain management during castration

3. Defining Pain Pain: “Unpleasant sensory and emotional experience associated with actual or potential tissue damage”1 • Pain and suffering are clinically important conditions adversely affecting an animal’s quality of life (short-term or long-term) • Prevention and alleviation of animal pain and suffering (i.e., management) are important goals 1IASP, 2004

4. Lameness • Mastitis • Farrowing difficulties • Respiratory disease • GI disease • Lameness • Shoulder ulcers • Heal erosions • Fractures • Tail/vulva bites • Injuries • Castration • Tail docking • Teeth clipping • Reproductive surgery • Repairs

5. Castration Tail Docking • Lameness • Mastitis • Farrowing difficulties • Respiratory disease • GI disease • Lameness • Shoulder ulcers • Heal erosions • Fractures • Tail/vulva bites • Injuries • Castration • Tail docking • Teeth clipping • Reproductive surgery • Repairs

6. Castration • Removal of testicles or destruction of testicular formation2 • Prevention of unwanted breeding • Reduced fighting and aggression • Meat quality improvement • Pain associated with scrotal incision, extraction of the testes and severing of the spermatic cords 2Petherick , 2010 Mcglone, 2014

7. Tail Docking • Portion of tail removed • Prevent/Decrease tail biting • Decrease economic loss associated with reduction in growth performance and increased incidence of infection • Pain associated with physical removal3 LiatRommeThomsen, 2013 3Sutherland et al, 2011

8. How to measure pain • Physiological measures • Hormones, Catecholamines, Immune response • Behavioral measures • Locomotion, postures, maintenance behaviors • Performance measures

9. Physiological Measures • Hormones • ACTH (Adrenocorticotropic hormone)4 • Cortisol • Catecholamines • Norepinephrine/Epinephrine5 effects on: • Heart rate • Glucose levels • Lactate levels **Physiological measures can also increase due to general arousal and handling** 4Prunier et al, 2005; 5Hay et al 2003

10. Physiological Measures • Immune function6 • Acute phase proteins • Pro-inflammatory cytokines • Antibody response **May result in greater welfare concerns if animal’s health is compromised** 6Moya et al, 2008 Wikipedia, 2014

11. Behavioral Measures • Behavioral changes • Locomotion and Posture7 • Head turning toward hindquarters • Hind leg lifting • Slow twitching tail • Maintenance behaviors8 • Reduced feeding • Reduced drinking • Reduced activity 7Wemelsfeder and van Putten, 1985; 8McGlone and Hellman, 1988

12. Vocalization • Behavioral indicator of pain9 • Immediate vocal response • High frequency calling • Increased calling rate 9Xin et al, 1989

13. Performance Measures • Average daily gain • Feed intake • Market weight • Carcass quality • Mortality Iowa State University, 2011

15. Regulatory Concerns in the U.S. • Animal drugs intended for use in the U.S are regulated by Food and Drug Administration (FDA) Center for Veterinary Medicine (CVM)10 • There are no pain relieving drugs specifically approved by FDA for use in livestock in the U.S.11 • Extra-label drug use (ELDU) is regulated under the Animal Medicinal Drug Use Clarification Act of 1994 (AMDUCA) 10Smith and Modric, 2013 11Coetzee, 2011

16. AMDUCA requirements • Valid Veterinary-Client-Patient Relationship (VCPR) • Extra-label use limited to circumstances when a threat is posed to the health of an animal, or when failure to treat results in suffering or death • FDA approved animal and human drugs • There is no approved product to address the issue • Product administered under the direction of a licensed veterinarian and assigned an extended withdrawal time to avoid residues.

18. Pharmacological • Local Anesthetics • Lidocaine • General Anesthetics • CO2Gas • Isoflurane • Analgesics • NSAIDs

19. Local anesthetics Local • Most commonly used pain relieving drug in food animal medicine12 • Produces loss of sensation without loss of consciousness by preventing and blocking nerve impulses • Lidocaine/Prilocaine **Short Acting** 12Muir et al, 1995

20. Lidocaine • Lidocaine is commonly suggested as a drug for pain relief during castration and tail docking. • Lidocaine is NOT APPROVED for veterinary use • Only Lidocaine approved for humans can legally be prescribed under AMDUCA and used in an extra-label manner

21. General Anesthetics • Loss of feeling or sensation • State of unconsciousness with absence of pain sensation • Suppresses cerebral activity • Co2 • Isoflurane • Sevoflurane **Short Acting**

22. Analgesics Non-steroidal anti-inflammatory drugs (NSAIDs) Flunixin meglumine Meloxicam Ketoprofen **Longer acting but take time to have an effect**

23. Case Study: Pain relief for castration

24. Materials and Methods • 141 litters • Four male piglets/ litter • Four treatments • Castration alone (C) • Castration + Meloxicam (M) • Castration + Lidocaine (L) • Castration + Lidocaine + Meloxicam (LM)

28. Production Measures • Mean weight on castration day was not different. • No difference in weight gain • 11% morbidity with no treatment effect • 5% mortality with no treatment effect

29. Case Summary • Lidocaine reduced pain during castration • Meloxicam reduced pain after castration • No treatment effects on: • Skin temperature, weight gain, morbidity or mortality • Herdsmen effectively administered local anesthesia

30. Take home points • Pain associated with castration and tail docking is a current welfare issue on farm • Pain relief may be conducted using either anesthetics, analgesics or a combination of both • Use of these drugs in an extra label manner is approved under AMDUCA • Multi-modal drug approach is most effectivefor pain relief

31. THANK YOU VERY MUCH FOR YOUR ATTENTION QUESTIONS?