Pre-emptive Pain Management

All surgery patients experience pain, 100% of them. 

The question is, how can we most effectively block that pain?


The science behind pain, how it is perceived, and how it is blocked, is deep and complicated.

It is a lot more complex that most people have ever imagined. Click the link for an in-depth discussion of pain management.  As complicated as pain management is, there are three basic principles:

            1. There is a big difference between unconsciousness (anesthesia) and pain control (analgesia).

                Just because you  are asleep when the painful stimulus happens does not mean the pain will be under

                control once you wake up.

            2. You need to start blocking pain before the pain ever starts or you are just playing catch-up.

            3. Several pain medications acting together are much better than just one. (Multi-modal pain management)

With Pre-emptive, Multi-modal Pain Management, we start to control pain well before the surgery even begins.
  • For Dogs, we start by giving an injection of a potent opioid pain medication, similar to morphine or Demerol.
  • Combined with this are doses of a medication that acts on a spinal level to further block pain
  • Another medication that stabilizes cells and further increases pain blocking.
  • During the actual surgery we use local anesthetics at the incision site, kind of like the dentist, to further block pain.
  • In addition, the patient’s IV fluid bag is medicated with some of the same medications that were used before anesthesia was induced.
  • After surgery we give a second injection of  heavy-duty opioid pain medication
  • Then the patient gets a dose of a long-acting oral opioid-like medication for overnight.
  • And finally, the patients are started the evening of surgery on the ibuprofen-like take-home medication.
  • Cats are similar, but the program is modified to suit their unique metabolism.


This may sound like a lot of medication, but it is really very safe.

Because we use several different medications, we are able to use lower doses of each so that we get all the beneficial effects while minimizing the adverse effects. Pre-emptive, Multi-modal Pain Management is much, much better than just the pills often used for post-op pain relief. This is the kind of pain management you would get if you went in for surgery.

All this only adds about $28 to the cost of the procedure.

We recommend it because of the increased pain control, comfort, and stress relief it provides.

Click here to return to the Consumer Guide to Spay and Neuter Surgery

Click here to go on to IV Fluid Support

Click here to go to a page on the benefits of Laser Surgery

Click here to go to a page about how to tell if your pet is in pain.