Animal Health / November 21, 2022

Update of the “WSAVA Global Pain Management Guidelines 2022”

Marina Rodriguez Alonso | Veterinarian, master in equine physiotherapy | Global Brand Manager INDIBA Animal Health


In 1995, Dr. James Campbell, former president of the American Pain Society, was the first to refer to pain as the “fifth vital sign” (P5VS)1. Pain is a signal from the nervous system that something may be wrong2. Hence the importance of giving it the attention it deserves.

Last October, an update of the “WSAVA 2022 Global Pain Management Guidelines” was published. An extensive document, 80 pages in total, which covers all the important aspects of pain management. It is a document that aims to emphasize that pain should be recognized, studied, and treated.

One of the most interesting aspects of this document is that it focuses on the importance of using multimodal therapies to treat and manage pain. That is, using pharmacological and non-pharmacological therapies to address pain in different ways. Here is a glimpse of what this document covers in this regard.


Avoiding suffering from pain. A moral and ethical responsibility.

In several countries around the world, such as Spain, animals are legally protected against mistreatment and are considered sentient beings3. As veterinarians and animal health professionals, it is our moral and ethical responsibility, as expressed in the WSAVA document, to prevent animal suffering caused by pain, using all our available skills and tools.

To further support this, the document cites the mission of the Global Pain Council (GPC) to “raise global awareness and call for action based on the understanding that all animals are sentient and therefore can feel and suffer pain”.


What aspects are covered by the guidelines?

As we well know, animals do not express pain verbally as we humans do, which generates a disadvantage in the recognition of pain. Fortunately, many institutions and experts have studied and developed tools to recognize when an animal is suffering pain, to what degree, and what origin it may have, and thus guide it to a more effective treatment.

The guidelines, which are more than guidelines for the professional and not a rule, include the tools available to recognize pain, as well as to define the types of pain, its origin, and the treatment based on these aspects. Also, as mentioned at the beginning, they place great emphasis on the use of multimodal protocols in treatment.

The first section describes pain – and defines it as complex and involving physical and sensory components. Therefore, it is defined not as something that is “felt”, but as something that is “made to be felt”. Furthermore, according to the IASP (International Association for the Study of Pain), the inability to communicate pain does not mean that it does not exist.

It is also important to understand the differences between acute and chronic pain, also referred to in this paper as adaptive and maladaptive. This section also outlines the tools for pain recognition in dogs and cats, and the therapeutic options for pain management in different cases and according to their origin.

The second section of the guidelines discusses general treatment approaches. One aspect that can be highlighted is the emphasis placed on the use of multimodal analgesia protocols; that is, the combination of pharmacological and non-pharmacological therapies. On the one hand, these therapies can create synergies between them by acting on different nociceptive pathways that help to produce an optimal analgesic effect. This can also help decrease the doses of drugs used, thus minimizing adverse effects.

Finally, the third section of the paper describes various specific protocols for each case in which pain is a sign. It is important to note that in any of the cases, the protocols should be reviewed and tailored to each patient by a veterinary professional.


Where does INDIBA come into all this?

Our technology has a lot to do with everything we have mentioned. It has been scientifically proven that the use of our radiofrequency at the specific frequency of 448 kHz produces a significant reduction in pain, both acute and chronic. It is also a tool that can be used concomitantly with any analgesic therapy, be it a drug or another modality, making synergy with it to optimize the results.

Not only scientific evidence proves it, but our users also see in their daily clinical practice how the use of INDIBA is beneficial for the treatment of pain in animals.


“The use of INDIBA has allowed me to reduce the use of analgesics, both in dosage and duration of treatment.”

Leticia Estudillo

Veterinary specialist in rehabilitation (Spain).



“The most significant case of back pain I have seen (…) After INDIBA treatment, the horse began to relax, yawn and release. The release was far more significant than I have ever seen with manual therapies or even other physical agents.”

Callie Charles

Veterinarian Equine Rehabilitation Specialist (UK)



  1. Sacher, C et al. 2017. Moving Beyond Pain as the Fifth Vital Sign and Patient Satisfaction Scores to Improve Pain Care in the 21st Century. Published online 2017 Dec 15. doi: 10.1016/j.pmn.2017.10.010 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5878703/
  2. Pain. Medline Plus. Available online: https://medlineplus.gov/pain.html
  3. Cerrillo, A. Periódico La Vanguardia. 2022. Las mascotas ya son, por ley, seres sintientes. https://www.lavanguardia.com/vida/20220106/7971147/mascotas-son-ley-seres-sintientes-reforma-codigo-civil.html
  4. Monteiro, B et al. 2022 WSAVA guidelines for the recognition, assessment and treatment of pain. https://doi.org/10.1111/jsap.13566


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