Fish analgesia: pain, stress, fear aversion, or nociception?

The increasing use of fish resources and a greater understanding of aquatic animal medicine demands providing evidence-based veterinary care for these animals. Because fish are aquatic as well as being pokilothermic, there are several unique anatomic and physiologic considerations that must be understood when working with these animals. Veterinarians need to adapt methodologies for examining, performing diagnostics, and treating fish patients to decrease stress, decrease fear, and avoid and/or decrease nociception. This article briefly defines stress, reviews and compares fish neuroanatomic pathways associated with nociception, discusses behavioral observations, summarizes current use of analgesics for fish patients, and concludes with the ongoing controversy regarding pain on this topic.