I’ve been fielding lots of questions from you on the topic of pain relief. It seems that many of you are either confused on the subject or completely at a loss as to how to ease your pets’ pain.

And you’re in good company. Veterinary medicine is working hard to find newer, better, safer ways to treat pain. Too bad it’s not always inexpensive when we do happen upon a great new mode of treatment. 

The good news is that most pets just need a few applications of pain relieving therapy to get back to a comfy steady-state. Some, however, have to muddle through years of treatment to keep them copascetic. That’s when it gets really frustrating. 

The additional element to the good news is that it’s not always about drugs. We love using non-invasive, non-drug approaches whenever we can. Some studies even suggest these alternatives to traditional pharmacologic intervention are far more helpful. 

That’s especially true when you consider that the number one cause of pain in pets is osteoarthritis. Given that osteoarthritis is common in overweight and obese pets, it’s a no-brainer to assume that by far the best, least invasive way to treat the most common source of pain involves a double-handed grab at a too-full food bowl.

Exercise for weight loss and muscle-builing is the second most obvious. It comes in only at number two primarily because pain often precludes vigorous exercise. Consider, however, that even patients with osteoarthritis feel better when they move. Light exercise is essential for most of these pets, even if it’s something they don’t want to do, even if it makes them more sore for a few hours afterwards.

Acupuncture and chiropractics can also be helpful, though for these pain-relieving approaches you’ve got to find a veterinary healthcare provider with special skills. I always recommend one who is certified to offer these less common services. 

Nutritional supplements are the next least invasive approach. Though anything strong enough to help you is strong enough to hurt you, these products are least likely to have adverse effects. Sure, most aren’t enough to outright replace more conventional methods when severe pain rears its ugly head, but they can be helpful for certain chronic conditions (as with glucosamine and Adequan for osteoarthritis). 

NSAIDs (non-steroidal anti-inflammatory drugs) are next up. They’re the class of drugs you know most often as aspirin, Aleve, and Advil. But the human OTC (over-the-counter) versions are usually NOT safe for pets. Though aspirin is safe in small doses for short periods of time, it hasn’t been approved for long-term use in pets at pain-relieving doses. Other pet-specific NSAIDs have, however. These are the go-to drugs you should be asking your vet about. Never, ever use any other NSAID without specific veterinary approval.

For dogs, a variety of alternatives have been approved for both long- and short-term use. For cats, only an injectable version designed for short-term use has met similar success. But where there’s efficacy (and these drugs are highly effective against pain), there’s sometimes the risk of side effects (and these drugs have these in spades––more on this tomorrow). 

Corticosteroids are also commonly used. These anti-inflammatory medications target the immune system’s basic functions governing inflammation––a crucial element of the “pain cascade.” They’re incredibly effective but if you’re worried about NSAIDs’ side effects, “steroids” have some even scarier unforseens best explained by your vet. 

Then there’s the tried and true and very safe alternative of opiates, those morphine-like drugs we all know well for their addictive properties. The good news on these is that while their addictive nature for humans is a serious downside, animals don’t succumb to the same effects in the same way. Sure, that’s debatable, but I promise you won’t find your cat raiding her stash of pills in the middle of the night.

Moreover, the strongest, most pain-relieving opiates are those we reserve for the most severe, short-term cases (such as after major abdominal surgeries and those involving the bones). Other, less sleep-inducing opiates are safe and strong enough for daily use in pets who suffer chronic conditions (like tramadol for use in chronic pain from cancer or from osteoarthritis).  

And finally, there’s more good news: many of these drugs and therapeutic approaches work safely in combination with the others I’ve listed.

That’s the short version detailing pain control in pets. Pills, drops, patches, supplements, weight loss and alternative modalities are there to help. If you think your pets are in pain, you’d better start asking about them. 

Dr. Patty Khuly