BioTraceIT™ is Presenting at the NIH Pain in Animals Workshop

Nov 14, 2017 | Innovation, Veterinary

BioTraceIT™ is Presenting at the NIH Pain in Animals Workshop

Nov 14, 2017 | Innovation, Veterinary |

The following is an interview with BioTrace IT President Deb Dullen in regards to an upcoming presentation at the NIH Pain and Animals Workshop.

Cresta:
Hello Deb, Can you tell us about the upcoming event you, and your colleagues, are presenting at?

Dullen:
The event is the NIH Pain and Animals Workshop. Quoting the website: Despite recent advances, chronic pain is one of the most poorly understood, underdiagnosed, and undertreated medical problems facing veterinary medicine today. One of the most frustrating parts of pain therapeutic development in veterinary medicine is the lack of validated methods to measure pain in different species and diseases. We propose to bring the strengths of all these partners together to discuss the current state of pain measurement in animals and to formulate a roadmap of research and development priorities for the future. The Organizers span multiple perspectives including veterinarians, surgeons, pain management specialists, and clinical researchers both from academic institutions and NINDS program at NIH. There are veterinary surgeons as well as neuroscientists that we have spoken to and worked with in the past. The goal of this workshop is to look at how we measure pain in animals and looking at some of the individuals that are on the organizing committee, there are people that are the senior research advisors for translational and comparative medical research. That’s an important topic when you are researching pain in animals, “How does our understanding of pain in animals affect people?”

The following is an interview with BioTrace IT President Deb Dullen in regards to an upcoming presentation at the NIH Pain and Animals Workshop.

Cresta:
Hello Deb, Can you tell us about the upcoming event you, and your colleagues, are presenting at?

Dullen:
The event is the NIH Pain and Animals Workshop. Quoting the website: Despite recent advances, chronic pain is one of the most poorly understood, underdiagnosed, and undertreated medical problems facing veterinary medicine today. One of the most frustrating parts of pain therapeutic development in veterinary medicine is the lack of validated methods to measure pain in different species and diseases. We propose to bring the strengths of all these partners together to discuss the current state of pain measurement in animals and to formulate a roadmap of research and development priorities for the future. The Organizers span multiple perspectives including veterinarians, surgeons, pain management specialists, and clinical researchers both from academic institutions and NINDS program at NIH. There are veterinary surgeons as well as neuroscientists that we have spoken to and worked with in the past. The goal of this workshop is to look at how we measure pain in animals and looking at some of the individuals that are on the organizing committee, there are people that are the senior research advisors for translational and comparative medical research. That’s an important topic when you are researching pain in animals, “How does our understanding of pain in animals affect people?”

We are also in the process of creating a presentation regarding work that we have completed in dog rehabilitation patients experiencing pain. During patient exams, we measured a direct pain biosignal with the PainTrace® device and compared our findings to veterinary diagnosis. Exams thoroughly evaluated patient anatomy from the cervical spine through the hind limbs. We measured the degree of pain corresponding to the veterinary diagnosis and differentiating between pain, discomfort, spasms, or triggers. The size of our pain biosignal peaks directly correlates with the amount of pain experienced. The correlations were reported with a p-value of less than 0.001 which means that we had near perfect correlation.

Cresta:
So were the results in this dog study similar to the pain monitoring in the video with the PainTrace® of Dr. Charlie Short.

Dullen:
Yes, we quantify pain in both animals and humans. In humans, our PainTrace® values correspond with self-reported pain. Being able to measure pain in many species supports research and improves our understanding of pain in so many ways.

Cresta:
Why is it so important that NIH is shifting their focus to animals?

Dullen:
If we have a better understanding of pain in animals, we can not only improve veterinary care but also improve translational research and the capacity to create treatments for companion animals, people, and large animals. Animals tend to mask their pain instinctually so better understanding how they exhibit pain and experience pain is a specific challenge.

Cresta:
What does the future hold for NIH’s involvement in animal health?

Dullen:
NIH is a very renowned research center. I’ve worked with them in the past on proteomics and genomics. This is the first workshop they are holding related to Pain in Animals, and I cannot comment on exactly where this will go I foresee that it will be quite far-reaching as there is an increasing focus on animal health. Mammals, in general, have physiologically similar pain responses. However, instinctually, we have differences based upon whether we might be a prey animal or a predator. Interestingly, we’ve learned that horses will mask their pain because they are a prey animal; or herd animal. An antelope or bison are also examples of herd animals which if injured tend to mask, or hide, pain so that a predator does not notice the injury. A predator in the wild would obviously seek out the injured, or sick, animal and prey on it since it would not be able to run as fast as the rest of the herd.

Masking pain becomes a barrier when creating treatments in veterinary medicine for animals since masked pain may not be evident and therefore evaluation of reaction to treatments has increased challenges. It’s paramount that we understand pain in animals – and for that matter people too.

Birds researched with clinical signs of pain, such as limping, were offered food that was treated or not treated with an analgesic. In this study, the birds chose to eat food containing painkilling drugs, like an analgesic, over an untreated food. When they measured the behavior, they saw evidence that the limping, or pain, had diminished. It’s just a very quick and easy study that shows that animals are experiencing pain, and given the option, they will choose an analgesic treated food to improve their well-being.   When they measured the behavior, they saw evidence that the limping, or pain, had diminished. It’s just a very quick and easy study that shows that animals are experiencing pain, and given the option, they will choose an analgesic treated food to improve their well-being.

It is very difficult for us to understand whether animals are in pain, and what amount of pain, because they cannot verbalize it. We are working with a group of veterinarians in equine, and there’s a scale that analyzes facial expression during pain. The researchers found that animals have similar facial expressions compared to humans when they’re in pain. However, since they have been filming the horses it was discovered that as soon as a person approaches the stall the horse completely changes its expression. They no longer use this facial scale to evaluate pain.

Cresta:
So you are saying the current pain scales may not be accurate in equine moving forward, and a medical device like PainTrace® Vet is needed to measure and track pain?

Dullen:
With animals and humans, in my opinion, that is the case. There are a lot of different types of pain scales. The truth is that animals are nonverbal patients, and it’s very difficult to determine how much pain these animals are in.  They have species related behaviors that generally relate to masking, or the opposite aggression when enduring pain. In the case of dogs, they may actually become aggressive rather than hide the pain. We’ve been speaking with a veterinary behaviorist and many dogs who have displayed aggressive behavior have been in pain. In my opinion, they become aggressive because they don’t have a good method to communicate their pain. They are nonverbal much like a child or an elderly person with dementia.

During a conversation with the behaviorist, I shared with her an article from the New York Times about a physician whose father had dementia in an assisted living situation. The patient was generally a very kind, peaceful, good-natured individual. All of a sudden he became aggressive and violent. They could not determine the issue. A couple of months went by where they had him restrained trying to make sure he didn’t hurt himself or others. Finally, somebody questioned if he might be experiencing pain. They treated him with pain medication, and his aggressive behavior stopped.

Cresta:
Wow.

Dullen:
Yes, and that’s very much a similar situation to what a dog might do that has pain. It doesn’t have a manner to communicate.

Cresta:
Sure, so it acts out.

Dullen:
Exactly. I was at an institution and we were working with a dog that was in recovery I could tell that she was just trying to say, “Hey, I’m in pain.” So we looked at her and we said, “It’s okay, we know you’re in pain, and we’re going to be very careful with you.  Initially, they had her muzzled because she was obviously showing signs that she was possibly going to be aggressive. After we soothed her; she calmed down. We were extremely careful with her injury, and while she was cautious her behavior became less aggressive.

Cresta:
That’s very very interesting, I have personal experience with dementia and your research can mean a lot to those suffering with it. What about your research did NIH find attractive and compelling about BioTraceIT™ that gained you an invitation to present?

Dullen:
The process is a submittal abstract and data that explains the research methodology, outcomes, and results. Selection of presenters is a blinded process strictly based on research and data. The committee that reviews the submitted research doesn’t know who we are even though we have actually worked with multiple individuals that are on the NIH Pain in Animals Workshop committee. The committee consists of industry leaders in pain management and research in the veterinary field.

Cresta:
That’s exciting to be invited based just on the numbers! How might this advance BioTraceIT™’s agenda for improving animal health?

Dullen:
The reality is that we can provide an objective and quantitative measure of a pain-related biosignal for nonverbal patients. From the veterinary community perspective, we can contribute in multiple ways.

  • One, diagnosis of pain in a nonverbal patient that might mask pain or where it is difficult to determine pain.
  • Two, we can potentially contribute to appropriate drug dosing during surgeries and pre/post-operatively, additionally determining if new treatments are efficacious.
  • Three, we can aid early diagnosis of disease states, such as osteoarthritis, that often are not observed until years after initial onset in canine patients.
  • Four, and this is a focus of the NIH Pain in Animals Workshop, we can contribute to research as an objective measure.

We can measure outcomes in a quantitative fashion to be able to better understand what works and what doesn’t in a statistically meaningful way. We can decrease the number of patients that are required to have a statistically significant outcome measure and additionally improve the capacity for translational medicine. If work is being done in animals, it could be advantageous for the human medical care community as well. Our device works across species and has consistent measurements from one group to the next.

We are for all species, we’ve worked in rodents, cats, dogs, horses, and people. From the current information we would surmise, though we don’t make claims without future research, that we would be able to measure pain in all mammals. Our goal is to be able to aid both veterinary and human medicine.

Cresta:
And is this what your presentation will entail?

Dullen:
We will be presenting a poster at the NIH Pain in Animals Workshop, answering questions, and presenting our work to the individuals that are attending the poster sessions.

Our topic is the ability to provide an objective and quantitative pain measure obtained in a study of canine patients. Additionally, I would like to applaud the organizers for putting this particular workshop together. It is an important step forward for both veterinary and human medicine to improve our understanding of pain.

Cresta:
It is truly an incredible advancement. Thank you for your time and best of luck with your presentation!

BioTraceIT™ Corporation

PainTrace® The only patented devices and technologies for non-invasive and continuous pain monitoring.

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