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1 Anxiolysis, to include both pharmacological and nonpharmacological measures.Anxiolytics such as trazodone and gabapentin administered the morning of surgery, even by the owner at home prior to transport to the hospital.Fear‐free experience, low‐stress handling, pheromone therapy, comfortable species‐specific housing (see 6.6 Fear Free Concepts).Anxiolytic administered as part of in‐hospital premedication, e.g., midazolam, dexmedetomidine, acepromazine (when administered with opioids).

2 Opioid – while this remains the most effective drug class for acute pain, veterinary clinicians are advised [5] to follow the shift in human medicine to use fewer opioids, lower doses, shorter frequency, and insofar as possible shift from full mu agonists (morphine, hydromorphone, fentanyl) to partial mu agonists (e.g., buprenorphine) and mu antagonists, kappa‐agonist (e.g., butorphanol). Consensus statements support the aggressive use of opioid‐sparing strategies (the other modalities discussed in this section), and reserving full mu agonists for the prospectively more painful procedures and patients.

3 Nonsteroidal antiinflammatory drugs (NSAIDs).

4 Local and locoregional anesthetics and techniques – the “missing ingredient” for many if not most surgical procedures in small animal medicine (but not in large animal or in human medicine); nevertheless industry guidelines stipulate that local anesthetics should be utilized with every surgical procedure (even if just an incisional block but there are dozens of local and locoregional techniques within the scope of any veterinarian – and veterinary technician – to master).

5 Adjunctive pain‐modifying medications and modalities: these are deployed with patients undergoing predictably more painful procedures and/or are at higher risk for maladaptive pain, e.g. those with nerve injury, severe trauma (preexisting or surgical, soft tissue or orthopedic), or with long‐standing previous pain and inflammation. These include but are not limited to constant‐rate infusions of ketamine, systemic lidocaine, dexmedetomidine, oral gabapentin, amantadine, and others.

6 Nonpharmacological interventions such as cold compression, physical rehabilitation, possibly acupuncture, and energy‐based modalities such as therapeutic laser, pulsed electromagnetic field, and others.