Saturday, one of my techs mentioned to me that he’d heard me go into my pain spiel more often this week than he’d ever heard before.
 

It’s an interesting and frustrating subject to discuss with clients. One variation of the speil takes place in the exam room, generally when they bring in a geriatric dog for its annual checkup. I ask the client if they have any concerns or issues regarding the health of the pet: "Anything going on?" 

They usually reply, "Oh, he’s fine, just getting old. He’s sleeping more." That’s when the dance begins. In my mind, I start the check list.

Veterinarians are taught that "old age is not a disease," and usually there are reasons the dog may "act old." Here are a few:

• Suffering from some insidious organ dysfunction or issue that’s not making him overtly sick, just slowing him down
• Pain
• Loss of hearing (I’m a little jealous of old dogs in this aspect; they sleep so deep, so relaxed. I never sleep that well.)
• Vision loss; It will affect their overall activity level sometimes too

Only after I’ve ruled these out do I allow myself to conclude: "Yeah, he’s just old."

So, for the older dog and cat set, I generally recommend an annual blood and urine panel to try to stay on top of those internal things that wear out. They get a full exam to look for problems on the outside. I quiz the clients to see if there is any change in water intake or appetite. Is there any intermittent vomiting? Weight changes? What’s the poop quality? Urine quantity? All those fun, glamorous things that may tip me off that there is something amiss.

Then, I have to tread lightly into the pain issue. I haven’t figured out a way to do this diplomatically yet. If I suggest the dog could be in pain, clients seem to get defensive.

"No, he’s not in any pain; he’s not crying or anything."

"He takes awhile to get up and get going, but then he moves around and goes on his walks, no problem."

"Sure, he’s stopped jumping on the couch and he can’t make it around the block anymore, but he’s not in pain, he’s just getting old."

In my mind, all those statements are signs that maybe the dog is suffering from arthritis or another type of pain-related condition.

More on pain and how animals "vocalize" it in next week’s post.

Dr. Vivian Cardoso-Carroll

Pic of the day: Sad Puppy by TheGiantVermin