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The Daily Vet by petMD

The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets.

Listen With Your Eyes to Tell if Your Pet is in Pain

Six months ago I injured my back while attempting to train for a half marathon. I pushed through for a couple of months as I fell further and further behind my training buddies, until finally it occurred to me that needing to stop every couple of minutes to punch my fist into my left hip was probably not a normal thing.

 

As far as everyone in my everyday life knew, I was fine. I was still working and lifting things as usual, perhaps stepping a bit more carefully on uneven footing and pausing to brace myself before coughing. When I didn’t get better after a month of rest I wound up in a physical therapist’s office, where she figured out that my entire left pelvic wing was rotated out of whack. After a lot of therapy, ice, and Advil, I’m back on track.

 

I think about this a lot when I’m working with senior pets. One of the most common things people say to us when they bring in older pets is, “Oh, he’s just old and slowing down.” When we suggest that perhaps there is a painful condition, such as osteoarthritis, the client often replies, “Oh, he’s fine — he’s not crying.”

 

I would like to state for the record that for all the times I winced as shooting pain went up and down my spine, each gritting of the teeth and slow roll out of bed in the morning while I worked out the kinks in my pelvis, I never once cried out. The times I have cried out in pain? When I shut my finger in the car door and when I dropped the vacuum on my foot. That is the difference between chronic and acute pain.

 

Acute pain — that sharp, blast in the face sudden hurt — comes quickly and, usually, hopefully, also departs quickly. Chronic pain is any pain that persists past the normal expected point of inflammation and healing. While that is a somewhat simplistic explanation, it’s important to understand that pain is a very complicated phenomenon that involves many different pathways: the initial pain picked up in the periphery by a noxious stimuli, the part of the brain that recognizes the stimulus as pain, and the various places along the way where it can get tripped up, triggered, or amplified.

 

How do we know a person is in a state of persistent, low grade, chronic pain? They tell you.

 

How do we know a pet is in a state of chronic pain? They can’t talk, but they can tell us with their behavior.

 

These subtle indicators, when evaluated objectively and looked at in a sum total, are often striking. A dog who resists climbing stairs, jumping on the bed, tires after a short walk, doesn’t want to get up in the morning, those are all strong indicators of potential pain. Cats are even harder to interpret. Sometimes we only get one sign; the cat’s no longer on the kitchen counter, perhaps, or maybe the cat is urinating outside of the litter box because the edges are too high to climb over comfortably.

 

Why is this important? Because we can help, but only if you "hear" the pets ask.

 

The American Animal Hospital Association and American Association of Feline Practitioners just released the updated 2015 Pain Management Guidelines for Dogs and Cats, the most comprehensive and up-to-date recommendations for practitioners when it comes to recognizing and treating pain. Their number one recommendation? Realizing that behavior changes are a primary indicator of pain in veterinary patients.

 

There was a time, not too long ago, when pain medications were considered “optional” after a major procedure such as a spay or neuter. We’ve come a long way since then and we’re only getting better. There’s no need for a pet to suffer, not with the extensive toolbox all practitioners now have access to.

 

The best pain control in pets, as in people, comes with multimodal pain management: using more than one approach that addresses pain from multiple fronts. It’s good stuff. We’re blessed to be able to provide these comforts for our pets.

 

If your pet has any changes in behavior, from reluctance to eat to a change in exercise tolerance, give your vet a call. We’ve got lots we can do.

 

 

Dr. Jessica Vogelsang

 

 

Image: Anna Hoychuk / Shutterstock

 

Comments  14

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  • A Shill for vets and ads?
    03/20/2015 12:00pm

    I've been a subscriber to this site for five weeks and have come to the conclusion that it is a shill for advertisers and the veterinary industry. The ad pop-ups are relentless and interfere with reading the columns. And when read, the advice is often facile. I've found that the current crop of vets are idiots: I want to discuss nutrition and they say "I'm not a nutritionist." I have a question behavior and they say "I'm not an animal behaviorist." What they are "good" at is administering as many shots as they can talk you into buying. Also, the ads found on your site are for substandard food and "health" products. I doubt this will be posted, but I won't know because I'm opting out!

  • 03/20/2015 12:15pm

    I'm sorry you feel that way. I read your comment several times to try and see if it in any way correlated to the topic of chronic pain but I guess it was more of a vent in general, in which case, thanks for the input and I'm sure the folks at petmd will see it. I've only been here five weeks as well so I can't address the user experience.

    Sincerely,

    Idiot Number Five

  • 07/03/2015 12:48pm

    I 2nd comment

  • 07/05/2015 10:08am

    There's a very easy way to solve this. Ad and Pop up blockers! This will make is much easier and tolerable to read all sites. There are very good blockers out there for both PCs and Macs. You can disable them for specific sites if you need to. I use uBlock Origin for Macs.

  • Pain!
    03/20/2015 06:58pm

    I once saw a video of a dog in the animal clinic. The cage was covered with a towel. When the dog thought no one was looking, it looked miserable and in pain. When voices drew near, the dog hopped to its feet and looked quite happy.

    Just went to prove the critters mask pain quite well because you KNEW the dog was in pain.

  • 03/20/2015 07:35pm

    Wow, that's amazing. I wish we did this more often. A veterinarian friend of mine related a very similar story about a woman whose Golden was in hospice care and was very different with the owner than when the owner left the room.

  • Vet care
    07/03/2015 12:21pm

    I do find the articles lack depth but am sure there are many pet owners that do get information they need. Unfortunately I am very negative on vets at the moment. Way to many seem to be in it for the money. I used to live in a small town and the vet understood many of his patients families could not pay a bill in total so took payments. I now live in the city and my dog has been refused care for that very reason. If they cannot offer palliative care in my book they are money grubbing pigs! With the amount of ads on this site I sure hope you check the companies out and make sure they either donate food to shelters and food shelves and have philanthropic programs helping the poor and elderly to care for their animals.

  • 07/05/2015 08:31am

    To refer to vets as 'money grubbing pigs' because they don't readily provide free services to clients because of the client's ongoing financial problems is unrealistic. I work at an animal clinic and I cannot tell you how frustrating it is to hear clients complain about how 'expensive' we are. They will try to lay a guilt trip on us because their pets are in need of care but they have no money, therefore we are painted as the heartless bad guys. It is great that you lived in a rural area at some point where the vet you saw worked out payment plans for you. We have payment plans too, but there are still times when doing so in good faith still results on the clinic being left high and dry to eat the expense. I wish that people would understand that having a pet is a financial commitment, and just as with people there will be times when an acute situation will arise that is going to cost money! Too many times I see instances where a client drops major dollars to purchase some exotic breed of dog or cat, only to neglect getting the animal neutered or vaccinated or put on heartworm prevention because 'it's too expensive'. Give me a break!!

  • 07/06/2015 06:20am

    It's absolutely true that veterinarians these days are better equipped, have more options and can work wonders - but they also undeniably have profit targets which they must meet, and unfortunately, this seems to manifest itself in needlessly padded treatment bills.

    I have a cat which, for three consecutive years has managed to get into a scrape with another cat during the spring. A bite on the arm turns into an abscess, which needs to be drained, cleaned and dressed. A handful of common antibiotic tablets and we should be on our way. Straightforward and unglamorous. Yet in each case, my vet has found ways to pad the bill so that it never falls below $250. Without listing all the detail, it is very obvious that in addition to receiving good care, my cat and its owner are being bilked.

    I'm not implying greed on the part of the vets. Instead, I'm convinced that skyrocketing medical costs have found their way into veterinary medicine. The cost of doing business is through the roof, one reason being large amounts to insure against malpractice or some nuisance suit. Just as in the healthcare industry, perhaps the biggest driver of these outrageous costs are the tort lawyers who crouch outside like vultures, sniffing for some opening in which to ply their "skills."

  • How to examine for pain?
    07/03/2015 12:56pm

    I don't care about your aches & pains, I got enough of my own. What I want to know is if my dog is in any pain and how to help her. How do I examine her?

  • 07/03/2015 01:17pm

    Wow Jim, you don't sound so jolly....
    Are you qualified to examine your pet to see if it's in pain? I don't think most of us are which is why the author of this article suggested to look for behavior changes, and if we see any, bring our pet in to the vet. I would trust their expertise before my own. Maybe you should do the same.

  • Best med for arthritis
    07/03/2015 11:02pm

    I really do not like to give our dog meds unless really needed. Our 10 year old lab is showing some of the behaviors that you described in your article. I do not want her to suffer and am not sure what medication is best for her. What medication do you suggest for arthritis pain, that has the least side affects. I refuse to use Rimadyl. Seems vets always want to give this medication and it caused seizures in our first dog and heard too many negative things about the med. She has also recently been diagnosed as Diabetic.

  • 07/04/2015 05:10pm

    My dog's vet prescribed the very same medicine for him to take for pain and he got to where he started to fall around, he had bad diarrhea, and he also had a loss of appetite from it. I got rid of it and started giving him a low-dose aspirin every 4-6 hours as needed and he seems to be doing a lot better. He has his appetite back and he's not falling around like he was. While he was on the Carprofen (generic for Rimadyl) he would go out side and fall off the front stoop. Thank goodness it wasn't very high. I just kept a watch on him when I first started the low-dose aspirin and he's doing good on it.

  • 07/04/2015 09:04pm

    I heard that it was actually tried on animals with the intent of using it on people but had so many side-affects, including death from liver issues, that it never made it to the next phase. Cannot believe that people give this med to their pets. Know some people that use it, but I just do not want to ever take the chance with my guys. May try the low dose Aspirin - need to watch the GI issues too

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