Pain is personal. Anyone who has ever experienced a throbbing, wracking headache while the rest of the world went about its business can attest to just how personal pain can be. In addition, it is only when we verbalize or otherwise indicate that we need assistance alleviating the pain that anyone will even consider coming to our aid. And so it is with managing pain in the dogs in our care. They too often suffer in silence.
Fortunately this issue of pain management in pets has been a topic of high priority within the veterinary profession. The 2001 AVMA Animal Welfare Forum, presented in Chicago, was attended by over 100 veterinarians interested in developing a better understanding of pain management in dogs and other animals. It is through these types of educational efforts that our canine companions will have an improved quality of life… even though they cannot verbalize when they are in discomfort.
You play a major role in this new effort to ease canine discomfort and pain, too! Not only must you learn to recognize the cues indicating pain or discomfort in your dog, but also be more proactive in your effort. Taking a posture that you will request pain-alleviating medications whenever your dog needs a major surgical procedure is one way of being an advocate for your dog. We need to be aggressive in dealing with the various types and causes of discomfort most dogs experience during their lifetimes.
Dr. William Tranquilli, Professor of Clinical Medicine at the University of Illinois, College of Veterinary Medicine, and Director of the school’s Pain Management Program believes that a partnership between the dog’s owner and the attending veterinarian is crucial to developing pain management strategies for any canine patient. “We veterinarians must really tune in to what our clients tell us about their dog’s behavior and activity, and partner with the client, to effectively address the dog’s needs for pain management” says Dr. Tranquilli.
What is pain?
One definition presented by the Veterinary Medical Teaching Hospital at the University of Wisconsin declares pain "an unpleasant sensory and emotional experience associated with actual or potential tissue damage." Pain is very subjective and difficult to measure. In fact, it not uncommon to see a dog will hobble in to the hospital, happily wagging its tail as it holds up a limp and fractured limb, while another dog with the same type of fracture frantically yips and cries in extreme panic and pain. One patient obviously needs medication, but how does one judge the pain in the stoic patient?
There are situations where we can safely assume a dog is experiencing pain, such as with obvious injuries or after some surgical procedures. If the evidence is more subtle, we have to trust our intuition and train ourselves to be keen observers.
Most dogs that are experiencing pain will change their behavior patterns. We will see them reluctantly climb stairs, observe them becoming more withdrawn and inactive, or notice them reacting negatively to being held or picked up. These subtle changes in behavior may be our only clue that the dog is hurting. Back pain is common in mature dogs and anyone who has witnessed an older dog struggle to arise or even refuse to stand after laying down knows the discomfort these arthritic dogs must endure. Look for these or other similar yet subtle behavioral changes, as they may be the only way your dog communicates a need for pain management assistance.
In the animal hospital … If your dog is undergoing a surgical procedure, do not be timid about asking questions. "And what type of pain management will you be providing for my dog, Doctor?" Quite honestly, some surgery cases do not require postoperative pain management (obviously, to perform the surgery there will be a local or general anesthetic administered). Wart removal or minor suturing of a laceration are common examples.
However, if your dog will be undergoing major surgery, you can and should inquire about post-procedure comfort for your dog. According to Dr. Tranquilli there is a wide spectrum of attention given to pain management among small animal practitioners; there are some who have consistent pain management strategies and some who do not.
In the home … Our knowledge of how to reduce pain in dogs has taken some very positive strides in the last ten years. As a dog owner you have a number of products from which to choose to keep the quality of life where it needs to be, even in the face of the degenerative effects of aging and the traumatic damage inflicted by accidents.
The very first thing you need to address is diet! Any dog will be better able to resist degenerative illnesses and repair damaged or failing tissues if s/he is fed a high quality, meat-based diet. That said, we need to be aware of the nonverbal clues the dog provides regarding its discomfort. Once we intuitively determine that a dog would benefit from pain management, we need to provide safe and effective products to assist our canine friends.
Products that Assist Pain Management
There are generally five classes of pain reducing alternatives we can provide for our dogs: nutraceuticals, NSAIDS (non-steroidal anti-inflammatory drugs), opioids, steroids, and holistic alternatives. However, as with any medication -- especially with non-steroidal anti-inflammatory medications such as many pain-relieving "arthritis medications" -- there can be occasional adverse reactions for individual patients. Reactions can be variable, subtle, severe, or unusual.
You and your veterinarian need to discuss the pros and cons of any medication recommended for your dog, especially if s/he will be being taken it on a continuing basis. Furthermore, immediately discontinue use of any medication, and contact your veterinarian, if an adverse reaction should occur.
Image: Victor Bezrukov / via Flickr