Pain Management for Pets
In recent years, veterinarians have made great progress in understanding how pets feel pain and the best ways to manage that pain. Many dogs and cats will instinctively hide their pain as a survival mechanism, which, in the past, led well-meaning experts to presume that animals did not feel pain the same way humans do. We now know that dogs and cats have a nervous system very similar to humans, and we know better how to recognize and manage their pain.
Pain has as many manifestations as there are injuries, conditions, and individuals. Pain experts define pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage.” It is very subjective and difficult to measure. Because pets instinctively hide their pain to prevent potential predators from targeting them when they are injured, pain assessment in animals can be challenging. The outward demonstrations of pain vary widely from dog to dog and cat to cat. It is important to recognize that just because a pet does not cry, limp, or show other obvious signs of pain, that does not mean it is not in pain. A good general rule is that if it would hurt you, it would hurt your pet.
Identifying Pain in Pets
With obvious injuries or after surgical procedures, it can reasonably be assumed that a pet will experience pain. Although the signs may be subtle, careful observation will often reveal signs of pain in most animals as they alter their behavior in some way. For instance, a dog may be reluctant to climb stairs, jump into the car, show decreased activity, or resist being handled or picked up.
A cat may decline to jump into their favorite resting spots, avoiding the windowsill or the back of the sofa. They may still be able to get there, but take several small jumps to get there, for example from a chair to a table to a windowsill. A cat may decide that the stairs are too difficult to navigate and remain on a single level of the home. Some cats that are in pain will sleep more than usual, while others may be restless and unable to settle into a comfortable position. A cat that begins to soil out of the litter box may in fact be feeling pain and is avoiding the step or jump into a high walled litter box.
Arthritic pain is common in older dogs. Anyone who has witnessed an older dog struggle to rise or be unable to stand after lying down can imagine the discomfort these dogs must endure. Other signs of pain include (but are not limited to):
- whimpering or vocalizing
- becoming quiet, withdrawn, and anti-social
- showing uncharacteristic aggressiveness when approached or touched (an attempt to protect themselves from further pain)
- holding the ears flat against the head
- increased licking of a painful/sensitive area
- decreased appetite
- reluctance to walk, run, climb stairs, jump, or play
- stiffness or limping
- lagging behind on walks or stopping altogether while on walks
- changes in personality
- increased panting and/or restlessness
Arthritic pain is common in older cats as well and may manifest in many different ways depending on the area of the body that is affected. Some additional signals that a cat could be in pain include (but are not limited to):
- resisting handling or being picked up
- withdrawal from family activity/anti-social
- aggression or unexpected reactions when approached or handled
- decreased grooming and unkempt haircoat (mats, dander, or greasy fur) OR increased grooming in specific areas
- stiffness or limping
- changes in personality
If your pet is undergoing a surgical or dental procedure, do not be afraid to ask what pain management will be provided. Most of these procedures require some postoperative pain management, though the duration of treatment will vary with the procedure. Generally, your pet will receive pain-relief medications before, during, and after the surgery or a dental procedure.
There are many types of drugs used to prevent and lessen pain and your veterinarian will choose the appropriate drugs based on your pet’s specific needs. Common veterinary pain-relief medications include Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), opioids and more. In addition, Harmony is proud to offer a number of additional approaches to help pets with pain management:
- Nutraceuticals and supplements. This category includes supplements and other nutritional support products. Many of these are designed to support a specific tissue type, like joint tissue, allowing it to function better and relieve pain.
- Herbs. When considering herbs, it is important to ask the questions: is it safe, is it effective, and is it worth considering for my pet? There are many herbs, such as boswellia, feverfew, cordyceps, and others that have been shown to be effective for pain without a lot of side effects.
- Homeopathy/Homotoxicology. These therapies involve using very small amounts of certain plants, enzymes, and minerals to affect change in the body. While this field is as much an art as a science, new research shows the role it can play in pain management. One study compared the Homotoxicology remedy Zeel to the pharmaceutical Rimadyl in treating arthritis pain in dogs. The Zeel group showed as much improvement as the Rimadyl group (although the effects took a little bit longer). And the Zeel group had no side effects, while the Rimadyl group had a 27% rate of ill effects. Combining Zeel with a non-steroidal anti-inflammatory can allow immediate pain relief short term, with long term management using the Zeel alone.
- Acupuncture. While this technique may look a little odd to our western minds, there is actually a lot of science behind acupuncture. Inserting thin needles into certain locations in the body has been shown to cause endorphin release (the body’s natural morphine), cortisol release, other hormonal changes, changes in blood flow, and improved healing. This is a great technique to use for arthritis and other chronic pain.
- Therapeutic Laser. The therapeutic laser emits a low energy light wave that penetrates tissue and creates changes at the cellular level. These changes ultimately speed healing. This is a non-invasive tool to use in wound healing, arthritis and nerve pain. Because it is essentially hands off, it works especially well on cats.
- Massage Therapy. Often, the initial pain of an injury or disease is compounded by compensatory muscle spasm—the muscles around the injured area tighten and spasm in an attempt to protect the area. However, the muscle spasm also closes off blood flow to the area, shutting off the input of vital nutrients and ultimately delaying healing. This muscle spasm can outlast the original pain and can be more severe. Massage therapy is a great way to relieve this muscle spasm and return blood flow to injured areas, allowing them to heal. Patients frequently improve with just massage therapy, and most really enjoy it as well.
- Rehabilitation Therapy. Rehabilitation includes a variety of techniques, from stretching to swimming therapy, that allow return of movement to injured areas. This alone can help alleviate pain. Techniques such as ice and heat therapy can take away acute pain, while ultrasound can break up scar tissue and the underwater treadmill can strengthen weakened muscles.
- Stem Cells. These are not the embryonic stem cells at the center of such debate. This process actually involves taking a strip of fat from the abdomen or shoulder blade, and overnighting it to a lab in San Diego where it is processed to recover the patient’s own stem calls. The stem cells are returned two days later and are injected directly into affected arthritic joints. The cells then change into cartilage cells to help support the joint and relieve arthritis pain. Studies are currently underway investigating the use of these cells in healing tendon injuries and bone fractures.
- Joint Modifying Compounds. Many joint modifying compounds are available to provide some cartilage building blocks to damaged joints. While these don’t allow the formation of new cartilage, they can help the cartilage remaining in the joint to function better and relieve arthritis pain. Depending on the product used, it can be injected directly into the joint or can be injected under the skin by the owner.
- Chiropractic/Veterinary Orthopedic Manipulation (VOM). VOM is a variant of chiropractic where a tool called an activator is used to cause tiny micro-adjustments in muscle, bone, and nerves along the spine. This technique is designed to help with pain secondary to nerve issues, muscle spasm, and minor injuries. Chiropractic uses larger manipulations to actually adjust vertebrae that are out of alignment. As in people, the misaligned vertebrae can create muscle and postural problems that cause pain.
- Medical Qigong. Medical Qigong is an excellent adjunct to western medicine. Therapy consists of a series of energetic treatments by a trained practitioner to regulate the patient’s qi (vital energy). The aim of a qigong treatment is to correct the bio-energetic imbalances, or blockages, in the patient’s system so as to strengthen and regulate internal organs, the nervous and immune systems, ease emotions or anxiety, and relieve pain.
Untreated pain is something that no pet should experience. By closely observing your pet for subtle signs of pain and working with your veterinarian, you can help your dog or cat enjoy a pain-free life.