Randomized single-blinded prospective comparison between ozone therapy and electroacupuncture for canine thoracolumbar disk disease.

Ozone therapy has been used to control pain in animals. Moreover, electroacupuncture (EA) has been effective in neurological recovery and pain control in dogs with thoracolumbar discopathy. EA was compared with Ozone applied at acupuncture points in dogs with signs of thoracolumbar disk disease. Chondrodystrophic mongrel dogs, with lesion scores between 1 and 4, were randomly divided into groups: EA (n = 13) - electroacupuncture at BL20, BL23, ST36, KID3 and BL60 and dry needle in lumbar Bai Hui, and OZO (n = 15) - paravertebral application of 3 mL ozone (20 µg / mL) at BL20, BL23, lumbar Bai Hui, ST36, and KID3/BL60, both groups with weekly applications. No significant differences were observed between groups in weekly blind pain assessments using a dynamic interactive visual analog scale, and neurological assessments using a numerical-functional scale. Both groups showed a progressive improvement in pain control and neurological condition, which was observed when comparing the group's EA and OZO in dogs with all lesion scores. The time of return to locomotion (days) of dogs scored 3 and 4, between groups EA (10.6 ± 5.4) and OZO (14.5 ± 15.7), had no significant differences. Ozone therapy was effective to control pain and motor rehabilitation and sensory functions of dogs with thoracolumbar discopathy signs, just as electroacupuncture. Ozone application was a quick and easy-to-handle treatment. Paravertebral and subcutaneous routes did not require anesthesia or other advanced imaging technology, besides being safe and effective.

Acupuncture in Zoological Companion Animals.

Over the past years, the concept of pain management in veterinary medicine has evolved and led to the establishment of a new concept of multimodal approach to pain management, as the current standard of care. The use of multimodal analgesia combining pharmacologic and nonpharmacologic techniques not only helps optimize the quality and efficacy of analgesia but also may prevent the development of chronic or persistent pain. During the past decade, acupuncture has become more popular and evolved into one of the most used forms of integrative medicine interventions and nonpharmacologic therapeutic options for pain management in humans and animals in North America and Europe. There is ample evidence from basic and clinical research for acupuncture is effective in the treatment of acute and chronic pain by influencing neural networks of the nervous system. While in the modern days' veterinary acupuncture has been predominantly used in horses and dogs, its popularity in zoologic companion animals (ZCA) has increased in recent years as an adjunct therapy for treating musculoskeletal, neurologic, and gastrointestinal disorders due to its minimal invasiveness and low risk of adverse events. The integrative use of acupuncture has become even more important with the increasingly limited use of opiates in veterinary medicine due to the opiate crisis. The purpose of this article aims to provide guidance for using acupuncture for pain management in ZCA in clinical practice, based on available information and recommendations from experienced veterinary acupuncturists.

Preventative Care: Managing the Geriatric Horse with Integrative Therapies.

Horses 15 years of age and older now account for a significant portion of the equine population. Integrative therapies can provide important diagnostic and treatment tools for managing and maintaining the health of geriatric horses. Aged horses are often afflicted with chronic disease processes that are difficult to effectively manage with conventional medicinal approaches, such as laminitis and osteoarthritis. Diagnostic and therapeutic approaches using integrative therapies, such as acupuncture and spinal manipulation, are presented in this article for managing aged horses with metabolic disorders and musculoskeletal pain, stiffness, or muscle hypertonicity.

The scientific basis of acupuncture for veterinary pain management: A review based on relevant literature from the last two decades.

The practice of acupuncture is becoming increasingly popular in veterinary medicine, especially as a method of providing pain relief. Originally based on principles derived from centuries of observation, conventional scientific mechanisms of action for acupuncture as a pain-relieving modality have recently been elucidated. Acupuncture points allow access to multiple regions of the body via the peripheral nervous system and its connection with the central nervous system. Local, segmental (spinal), and suprasegmental (brain) effects of acupuncture involve enhanced release of pain-relieving endogenous substances (e.g., opioids) and mitigated release of pain-inducing substances (e.g., inflammatory cytokines). In addition, there is evidence that acupuncture can induce positive neurochemical and cytoarchitectural change in the central nervous system via the phenomenon of neuroplasticity. Electroacupuncture is considered the most effective type of acupuncture delivery, allowing for more potent and long-lasting pain relief than is achieved via other methods (e.g., dry needling). The purpose of this review article is to summarize the relevant scientific literature from the last two decades relating to the physiological mechanisms of action of acupuncture as a pain-relieving modality.

Comparison of Two Mesotherapy Protocols in the Management of Back Pain in Police Working Dogs: A Retrospective Study.

This study aimed to compare 2 protocols for the management of back pain in police working dogs. Twenty animals were signaled based on history, trainer complaints, physical and radiographic examination consistent with back pain. In a retrospective study, 2 groups were considered: GM, treated with a solution comprising a combination of lidocaine, dexamethasone, and tiocolchicoseide; and GT, treated with the same solution, with the addition of Traumeel LT. Response to treatment, measured by the Canine Brief Pain Inventory (CBPI, divided into pain interference score - PIS, and pain severity score - PSS) and Hudson Visual Analogue Scale (HVAS), was evaluated before treatment (T0), after 15 (+15d) days and 1 (+30d), 2 (+60d), 3 (+90d), 4 (+120d), 5 (+150d) and 6 (+180d) months. Results were compared using an independent samples t-test or a Paired Samples t-test. Comparing results for each moment with T0 within each group, differences where observed only in GM at +15d (P < .01 for PIS and P < .01 for PSS), +30d (P = .04 for PIS and P < .01 for PSS), +60d (P = .03 for PIS and P = .02 for PSS) and +90d (P = .02 for PSS). Treatment was successful in reducing PSS (reduction of ≥1) in 8/10 animals of GM at +15d (80%), 8/10 at +30d (80%), 5/10 at +60d (50%), 4/10 at +90d (40%), 3/9 at +120d (33.3%) and 2/9 at +150d -+ 180d (22.2%). In GT, treatment was successful in 1/10 at +15d -+30d (10%), 2/10 at +60d (20%) and 1/10 at +90d (10%). No differences were observed with HVAS any time point for either intervention or when comparing groups in each moment. The protocol used in GM produced significant improvements, while the addition of Traumeel did not, rather reducing the effect of treatment in working dogs with back pain. Further studies are required.

Standing Sedation and Iocoregional Analgesia in Equine Dental Surgery.

Procedural sedation has become popular for describing a semiconscious state that allows patients to be comfortable during certain surgical or diagnostic procedures. Sedation may be enhanced by locoregional anesthetic techniques to produce sufficient analgesia and muscle relaxation for surgery to occur. Sedation and local anesthesia for standing diagnostic and surgical procedures on the horse's head circumvents the potential complications of general anesthesia (particularly, complications related to recovery). However, the implementation of a locoregional anesthetic technique requires a thorough understanding of the anatomy to maximize success and minimize possible complications.

Conditioned place aversion of caustic paste and hot-iron disbudding in dairy calves.

Cauterization by hot iron and application of caustic paste are 2 common methods of disbudding calves. In this study, we compared the affective experience of these 2 procedures on young dairy calves using conditioned place aversion. Male dairy calves (n = 14; 7 ± 2 d old) were disbudded by both thermal and chemical methods (1 horn bud at a time, 48 h apart). Calves received treatments in pens made visually distinct with either red squares or blue triangles on the walls. Calves were restricted to these treatment pens for 6 h following disbudding. For all treatments, calves received a sedative (xylazine, 0.2 mg/kg), local anesthetic (lidocaine, 5 mL), and analgesic (meloxicam, 0.5 mg/kg). Calves were then tested for conditioned place aversion at 48, 72, and 96 h after their last treatment. During tests, calves were placed in a neutral pen connected to both treatment pens where they had previously been disbudded. Time spent in each treatment pen was recorded until calves chose to lie down for 1 min (latency to lie down: 31.0 ± 8.6 min). During the first test (48 h after last disbudding), calves spent more time in the pen associated with hot-iron disbudding compared with what would be expected by chance (intercept: 73.5%, 95% CI: 56.5, 90.5) and fewer calves lay down in the caustic paste pen than in the hot-iron pen (3 vs. 10 lying events). No evidence of preference for the hot-iron pen was found in the following test sessions (72 and 96 h since last disbudding). These results suggest that calves initially remember caustic paste disbudding as a more negative experience than hot-iron disbudding, even with the use of sedation, local anesthesia, and analgesia.

Geriatric Care of Rabbits, Guinea Pigs, and Chinchillas.

Specialized veterinary care needed for geriatric rabbits, guinea pigs, and chinchillas is described along with medical conditions common in this age group. Clinical signs of pain, safe analgesics, therapeutics, and alternative modalities are outlined along with guidelines for end-of-life care and decision-making. A handout containing advice for small mammal herbivore clients with geriatric pets is included.

Behavioral changes in calves 11 days after cautery disbudding: Effect of local anesthesia.

Hot-iron disbudding results in painful burn wounds that take weeks to heal. Spontaneous behaviors indicative of pain are apparent in the immediate hours after disbudding, but whether they occur later in the healing process is unknown. To evaluate whether ongoing pain was present around the time the necrotic tissue loosens from the scalp, we tested the effect of administration of local anesthetic 11 d after the procedure. Disbudded female Holstein and Jersey calves (n = 24) were randomly assigned to receive an injection of local anesthetic (lidocaine) or saline at the cornual nerve on both sides of the head. We recorded the frequency of 8 behaviors for 75 min: head shakes, head rubs, head scratches, ear flicks, tail flicks, bucks/jumps/kicks, grooming, and transitions between standing and lying. Calves treated with lidocaine shook their heads less and tended to flick their ears less than calves administered saline, consistent with the effects of pain relief previously reported in the immediate hours after disbudding. These calves also rubbed their head against the sides of the pen more often, suggesting lidocaine suppressed wound protective behavior. Head shaking and head scratching became more common in the last 25 min compared with the first 50 min in calves treated with lidocaine, consistent with the return of sensation to the disbudding wounds. No treatment differences in the other behaviors were observed. These results suggest that calves experience ongoing pain 11 d after hot-iron disbudding, adding to a growing body of evidence that pain persists for weeks after the procedure.

Local and regional anaesthesia in dogs and cats: Overview of concepts and drugs (Part 1).

Pain management in veterinary patients is a crucial component of appropriate patient care. Multimodal analgesia that includes both systemically and locally/regionally administered drugs is generally the most effective approach to providing pain relief. Local anaesthetic drugs used in local and regional blockade are unique in that they can completely block the transmission of pain (in conscious patients) or nociceptive (in anaesthetized patients) signals, thereby providing profound analgesia. In addition, local and regional administration of drugs, when compared with systemic bolus administration, generally results in a lower incidence of dose-related adverse effects. Due to the potential to provide profound analgesia and the high safety margin (when used correctly) of this drug class, local anaesthetics are recommended as part of the analgesic protocol in the majority of patients undergoing surgical procedures or suffering traumatic injuries. This manuscript, Part 1 of a two-part instalment, emphasizes the importance of using local and regional anaesthesia as a component of multimodal analgesia, provides a review of the basic pharmacokinetics/pharmacodynamics of local anaesthetic drugs in general, lists information on commonly used local anaesthetic drugs for local and regional blockade in dogs and cats, and briefly introduces the novel liposome-encapsulated bupivacaine (NOCITA®). Part 2 is a review of local and regional anaesthetic techniques used in dogs and cats (Grubb & Lobprise, 2020).

Acupuncture for the Treatment of Animal Pain.

Acupuncture is recognized to induce multifactorial changes in the neuroregulatory aspects of pain physiology. Many aspects overlap with known receptor interactions of commonly used analgesic drugs, and acupuncture can increase the efficacy or replace the use of these pharmacologic pain treatments. This article discusses the currently recognized components of the pain pathways that are modified by acupuncture. It introduces the role of fibroblasts and fascia in mechanotransduction and discusses the ways in which this provides a link between the acupuncture needle and the nervous system and is a conduit for extracellular fluid movement, lymphatics, and the immune system.

Locoregional Anesthesia of the Thoracic Limbs and Thorax in Small Animals.

The incorporation of nerve stimulation and ultrasound guidance to veterinary regional anesthesia allows accurate performance of techniques to block the thoracic limb and the thorax. When performed correctly, regional anesthesia can either constitute an alternative to the use of opioids and other systemic analgesics, or have a significant opioid-sparing effect. This article provides an overview of some techniques described using objective methods of nerve location, which can be used to provide perioperative locoregional anesthesia and analgesia to the thoracic limb and thorax. The approaches described may be used to decrease the perioperative use of opioids in small animals.

Locoregional Anesthesia of the Head.

Locoregional (local and regional) anesthesia is used routinely during surgical procedures of the head. The goal of this article is to provide a practical guide for the clinician to safely perform different techniques in dogs and cats and to minimize the risk of complications associated with locoregional anesthesia.

Effects of a topically applied anaesthetic on the behaviour, pain sensitivity and weight gain of dairy calves following thermocautery disbudding with a local anaesthetic.

Aims: To compare the effect of a topically applied anaesthetic to no pain relief or meloxicam on the behavioural responses, pain sensitivity and weight gain of calves following disbudding with or without sedation. Methods: A total of 364, 2-6 week-old calves from three commercial farms were systematically allocated to one of six treatment groups. All calves received a cornual nerve block prior to disbudding, with half restrained in a crate and half sedated with xylazine. Within these groups one third received no further treatment (control), one third were treated with meloxicam >10 minutes prior to disbudding and one third received a topical anaesthetic applied to the horn bud wounds following disbudding. The frequency of ear flicks, head shakes, head scratches and pain sensitivity of the wound were recorded on up to eight occasions over 24 hours after disbudding. Calves were weighed before, and 7 and 28 days after, disbudding to determine average daily weight gain (ADG). Results: Compared to calves in the crate-control group, all other groups had reduced ear flicks at all times following disbudding (p < 0.01). Treatment with meloxicam and topical anaesthesia in addition to sedation reduced head scratches compared to calves in the crate-control group (p ≤ 0.013). At 22 hours after disbudding head shakes were reduced in sedated calves treated with topical anaesthetic compared to calves in the crate-control group (p < 0.001). Pain sensitivity was lower in all sedated calves than unsedated calves (p < 0.001). The ADG between Days 0-7 was 0.14 (95% CI = 0.015-0.274) kg/day greater in sedated calves treated with meloxicam than calves in the crate-control group (p = 0.03), and the ADG between Days 0-28 tended to be 0.06 (95% CI=-0.01-0.13) kg/day greater in sedated calves treated with topical anaesthetic than calves in the crate-control group (p = 0.09). Conclusion and clinical relevance: Sedation of calves for disbudding reduced the pain experienced in the following 24 hours. There was a benefit to providing calves with topical anaesthetic following disbudding on behavioural responses and pain sensitivity, which was similar to that of treating calves with meloxicam.

Therapeutic developments in equine pain management.

Many drugs and non-drug modalities are used to manage pain in horses, but evidence regarding efficacy and safety remains limited. This manuscript will first briefly review tried and tested techniques, e.g. the use of non-steroidal anti-inflammatory drugs, in the management of pain. Newer approaches to administering medications such as oral use of detomidine, which was previously only administered by injection, will also be discussed. Finally, introductory information on newer therapies, for example acupuncture and chiropractic manipulation, that the veterinarian may consider for the management of equine pain will be presented.

Management of preweaned bull calves on dairy operations in the United States.

Many calves born on dairy farms are male, but little research to date has focused on the management of these calves. The objective of this study was to survey management practices of preweaned dairy bull calves and compare these practices with those used for heifer calves on the same operations. This study was conducted as part of the USDA National Animal Health Monitoring System Dairy 2014 study and included a sample of 42 operations from 10 states. On average, 2.4% of bull calves died before leaving the operation, with most operations selling bull calves before weaning (97.6%). Bull calves left the operation at an average age of 7.6 d (median = 4 d). Producers reported that 96.3% of bull calves received colostrum. Of bulls that were fed colostrum, the vast majority (95.4%) were hand-fed; the remaining calves received colostrum via a combination of hand-feeding and suckling (3.1%) or by suckling only (1.5%). In contrast, all heifer calves on those operations were only hand-fed colostrum. On average, bull calves received 3.1 L of colostrum at their first feeding at 4.3 h after birth compared with 2.9 L at 2.9 h after birth for heifer calves. In the first 24 h, bull and heifer calves received 4.8 and 5.5 L of colostrum, respectively. Only 21.4% of operations dehorned bull calves; in comparison, heifer calves were dehorned on 90.5% of operations. Few operations used analgesics or anesthetics when dehorning bull calves, whereas 28.9% of operations used anesthetics or analgesics when dehorning heifer calves. Overall, 27.8% of operations castrated bull calves. Of the operations that did castrate bulls, 70.0% used a band at an average age of 6.3 wk; the remaining 30% of operations used a knife at 14.7 wk of age on average. Few operations used analgesics or anesthetics when castrating. These results illustrate differences in the care of bull and heifer calves and suggest the need to improve education regarding recommended colostrum feeding and pain management practices in all calves regardless of sex.

A new method of administering local anesthesia for calf disbudding: Findings from a comparative on-farm study in New Zealand.

Anesthesia of the horn bud for calf disbudding commonly is attained by injection of local anesthetic over branches of the cornual nerve, with anesthesia achieved in 3 to 20 min. With experienced and trained staff, this method is effective in 88 to 100% of calves. Variability in response and time of onset can compromise calf welfare if calves are disbudded before anesthesia is attained. Proposed legislative reliance on effective local anesthetic as the minimal method of pain relief for calves at disbudding means that administration of local anesthetic must achieve a repeatable level and rapid onset of analgesia. We describe an alternative method of local anesthesia administration that uses local site infiltration of anesthetic over the horn bud. However, this method has not yet been scientifically validated. This study assessed differences between disbudding using the cornual nerve block and disbudding with local anesthesia administered by local site infiltration. Efficacy of local anesthesia was assessed at 30-s intervals after administration by absence of reaction to 3 consecutive needle pricks over the horn buds. Behavior indicating pain was assessed during disbudding and scored from 0 to 3. Calf behavior was also recorded for 3 h after disbudding. Accelerometer data loggers were fitted to each calf for 24 h before and after disbudding to assess lying and standing times. Median time to cutaneous desensitization for local infiltration was 60 s compared with 225 s for cornual nerve block, and the variance in time to desensitization was less with local infiltration. Calves disbudded under cornual block had a larger behavioral response (indicated by a graded aversive body reaction) than calves disbudded under local infiltration. A multivariable model predicted that the mean body reaction score would be 0.6 for calves disbudded under local infiltration and 1.2 for calves disbudded under cornual block. There was no difference in any behaviors between the treatment groups in the 3 h after disbudding. Method of analgesia had no effect on lying time over the 24 h after disbudding. In this study, local infiltration was at least as effective in providing analgesia for disbudding as the cornual nerve block. Our results suggest that a more consistent, effective level of analgesia during disbudding was achieved using local infiltration and that there was no difference in postoperative expressions of pain.

Canadian National Dairy Study: Heifer calf management.

In the past decade, substantial changes have occurred in the way dairy heifer calves are managed. The objectives of this study, part of phase I of the 2015 Canadian National Dairy Study, were to examine heifer calf health and adoption of rearing practices, and to explore factors associated with different rearing strategies on Canadian dairy farms. The questionnaire was open to all licensed dairy producers in Canada and had a 12% response rate (n = 1,373). Fifty-one percent of respondents reported never allowing heifer calves to nurse their dam, and 17% always removed calves within 30 min of birth. Sixty-seven percent reported always feeding heifer calves 4 L of colostrum within 12 h of birth; 17% always fed colostrum between 2100 and 0400 h; 5% pasteurized all colostrum fed on farm. Seventy-seven percent of respondents reported calving and stillbirth information for 2014; the mean reported stillbirth rate was 4.9% (SD = 3.3). Forty percent housed calves in individual pens, 34% in group pens, 21% in individual hutches, 2% reported tethering calves, and 1% used group hutches. Of those who housed calves in groups, 59% reported a maximum group size of 3 to 10 calves, 31% reported a pair (2) of calves per pen or hutch, and 10% reported a group >10 calves. The maximum amount of milk offered to calves per day during the preweaned period was a mean of 8 L (SD = 3). Fifty percent of respondents reported mortality data for 2014; mean preweaning mortality was 6.4% (SD = 8.3), and postweaning mortality was 2.4% (SD = 4.4). Over 95% of producers reported disbudding practices; 86% used cautery, 11% used surgical amputation, and 9% used caustic paste. Twenty-eight percent reported disbudding at less than 3 wk of age, 60% at 3 to 8 wk, and 22% at 8 to 16 wk; 5% of respondents reported dehorning at more than 16 wk of age. Sixty-six percent of cautery users reported use of local anesthetic, 33% used sedation, and 25% used a nonsteroidal anti-inflammatory drug (NSAID). Multivariable regression models showed that the use of local anesthetic when disbudding calves was associated with social media activity (odds ratio = 2.3) and high-speed internet access (odds ratio = 2.0), whereas sedation was associated with geographic region, and NSAID use was associated with disbudding at more than 3 wk of age. Exploring heifer rearing management practices, including adoption of best practices, may help focus future education and extension efforts. Poor reporting of mortality data may reflect a lack of recordkeeping on farm.

Topical vapocoolant spray reduces nociceptive response to ear notching in neonatal piglets.

OBJECTIVE: To evaluate the efficacy of a vapocoolant spray (VS) to provide local anaesthesia for piglets during ear notching. STUDY DESIGN: Randomized study. ANIMALS: Eleven 10 day old and forty 3-5 day old Large White piglets. METHODS: Temperature validation studies using thermocouples and a temperature data logger were conducted on dead and live tissue to determine optimal spray distance and duration to reduce tissue temperature to below 10 °C. A behavioural trial was conducted to assess efficacy for ear notching. Piglets were randomly assigned to one of four treatment groups: positive control (POS; n = 10), VS (n = 10), lignocaine (LIG; n = 10) and negative control (NEG; n = 10). Spray was administered to the margin of each ear, from a distance of 10 cm, and for a duration of 2 seconds immediately prior to ear notching. Behavioural observation was used to assess movement and vocal response, with responses categorized as no response (0) and response (1). RESULTS: Temperature and tissue validation studies indicated that a 2 second spray from 10 cm reduced tissue temperature to below 10 °C, and reduced response to stimulation of the skin with an 18 gauge needle (p < 0.001). There was a significant effect of treatment on response to ear notching (p < 0.001). The probability of a piglet to respond to ear notching was 98.7% for NEG piglets, compared with those treated with VS (5.3%), LIG (1.1%) and sham-notched piglets (0.9%). CONCLUSIONS AND CLINICAL RELEVANCE: This study contributes new data on the pain of ear notching in piglets. The application of a topical VS prior to ear notching reduced the antinociceptive response of piglets to the procedure, similar to that of a local anaesthetic. Cryoanaesthesia presents a simple and effective option for reducing the pain response to this simple husbandry procedure.

Effects of local anesthetic or systemic analgesia on pain associated with cautery disbudding in calves: A systematic review and meta-analysis.

Disbudding is a common management procedure performed on dairy farms and, when done without pain mitigation, is viewed as a key welfare issue. Use of pain control has increased in recent years, but full adoption of anesthesia and analgesia by veterinarians or dairy producers has not been achieved. This may in part be due to the lack of a consistent recommendations of treatment protocols between studies examining pain control methods for disbudding. The objective of this systematic review was to examine the effects of these pain control practices for the most common method of disbudding, cautery, on outcomes associated with disbudding pain in calves. The outcomes were plasma cortisol concentrations, pressure sensitivity of the horn bud area, and validated pain behaviors (ear flick, head shake, head rub, foot stamp, and vocalization). Intervention studies describing cautery disbudding in calves 12 wk of age or younger were eligible, provided they compared local anesthesia, nonsteroidal anti-inflammatory drug (NSAID), or local anesthesia and NSAID to 1 or more of local anesthesia, NSAID, or no pain control. The search strategy used the Agricola, Medline (via OvidSP), and Web of Science databases, as well as the Searchable Proceedings of Animal Conferences (S-PAC), ProQuest Dissertations and Theses Database, and Open Access Theses and Dissertations. Meta-analysis was performed for all outcomes measured at similar time points with more than 2 studies. Local anesthetic was associated with reduced plasma cortisol until 2 h postdisbudding; however, a rise in cortisol was observed in the meta-analysis of studies reporting at 4 h postdisbudding. Heterogeneity was present in several of the analyses for this comparison. The addition of NSAID to local anesthetic showed reduction in plasma cortisol at 4 h, and a reduction in pressure sensitivity and pain behaviors in some analyses between 3 and 6 h postdisbudding. Heterogeneity was present in some meta-analyses, including several using pain behavior outcomes. This may reflect the variation in measurement time periods for behavioral measures between studies, as well as differences among NSAID treatments. Overall, a protective effect of local anesthetic was seen for the acute pain of cautery disbudding, and the delayed rise in cortisol was mitigated by the addition of an NSAID, which also reduced other signs of pain, including pressure sensitivity and pain behaviors. Based on these findings, we recommend use of local anesthetic and an NSAID as best practices for pain mitigation for cautery disbudding of calves 12 wk of age or less. The magnitude and duration of the effect of NSAID treatment was not possible to deduce from the literature because wide variation existed between studies. We recommend consideration of more standardized outcome measurements, especially for pain behaviors. Adherence to reporting guidelines by authors would help ensure more transparent and complete information is available to end users.