how do I objectively assess chronic pain in senior dogs and cats in a clinical setting?

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Validated Clinical Metrology Instruments (CMIs) are the cornerstone of objective chronic pain assessment in senior dogs and cats, supplemented by physical examination, owner-completed questionnaires, and client-captured video of the animal in its home environment.12 For dogs, the Canine Brief Pain Inventory (Canine BPI) and the Liverpool Osteoarthritis in Dogs (LOAD) questionnaire are recommended for in-clinic use based on current evidence.4 Additional validated tools include the Glasgow Composite Short Form Pain Scale, the Helsinki Chronic Pain Index (HCPI), the UNESP-Botucatu Multidimensional Composite Pain Scale, and the Colorado State Pain Scale.3 Physical examination and clinic observation require moderate training and serve screening and monitoring purposes, but neither is formally validated as a stand-alone pain assessment.1 Physiological variables — heart rate, respiration, and blood pressure — are simple to obtain but are not specific indicators of pain.1 For cats, the Feline Musculoskeletal Pain Index (FMPI) and the Client-Specific Outcome Measure (CSOM) are recommended for monitoring pain signs and treatment response, while the feline MiPSC (Montreal Instrument for Cat Arthritis Testing screening component) is recommended for screening at-risk patients.4 Additional validated feline CMIs include the Montreal Instrument for Cat Arthritis Testing (MI-CAT) and the Feline Physical Function Formula (FPFF).4 All of these instruments are completed by the caregiver and are designed to measure the impact of degenerative joint disease pain and to monitor treatment efficacy; they also assist with initial diagnosis when administered at the outset.4 Veterinary technicians and nurses are valuable for introducing pain scales to caregivers and guiding their use, whether at the appointment or via telemedicine.4 Client-captured video of the pet ambulating, jumping, or interacting in its home environment is a practical adjunct that can detect early neuropathic or musculoskel