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Managing Pain In Dogs

written by The Pet Center on Tuesday, September 15, 2009

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Pain is personal. Anyone who ever experienced a throbbing, wracking headache while the rest of the world went about its business knows just how personal pain can be. And unless you tell someone you are hurting nobody will know or care about your personal pain. It is only when you verbalize or otherwise indicate you need something to help alleviate that pain that anyone other than yourself will even consider coming to your aid. And so it is with managing pain in the dogs and cats in our care. They too often suffer in silence.

Fortunately this issue of pain management in pets has recently been a topic of high priority within the veterinary profession. The 2001 AVMA Animal Welfare Forum was presented in October 2001, in Chicago, by the American Veterinary Medical Association. It was attended by over one hundred 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 dog owners need to be proactive advocates for their dogs. 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 is “Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage.” Pain is very subjective and difficult to measure. I have seen in my practice numerous occasions where a dog will hobble in to the hospital, happily wagging its tail as it holds up a limp and fractured limb! Another dog with the same type of fracture might be frantically yipping and crying in extreme panic and pain. One patient obviously needs medication but how does one judge the pain in the stoic patient?

Recognizing Pain

There are situations where we can safely assume a dog is experiencing pain such as with obvious injuries or after some surgical procedures. With more subtle evidence 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 being reluctant to 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 those subtle changes in behavior where the dog seems to be guarding itself from movement or looses interest in interacting with its environment… the changing of behavior may be the only way your dog communicates a need for pain management assistance.

Treating Pain

In the animal hospital… If your dog is undergoing a surgical procedure, do not be timid about asking “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 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 it 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…

NOTE WELL!!  With any medication, and especially with non-steroidal anti-inflammatory medications such as many pain relieving "arthritis medications", there can be occasional adverse reactions for individual patients.  There are many anti-inflammatory medications that are prescribed for dogs.  You and your veterinarian need to discuss the pros and cons of any medication your dog or cat is taking, especially those being taken on a continuing basis.  Immediately discontinue use of any medication, and contact your veterinarian, as soon as a suspected adverse reaction occurs.  Reactions can be variable, subtle, severe, or unusual; individual attention to each medication's potential adverse effects should be discussed with your veterinarian.

FDA-Approved NSAIDs for Use in Dogs
Questions regarding ADE reporting should be addressed to:Center for Veterinary Medicine
Division of Surveillance, HFV-210
7519 Standish Place
Rockville, MD 20855
(888) FDA-VETS (332-8387)

Brand name Established name Manufacturer/
distributor and year of FDA approval
Indication Type of dosage Manufacturer's telephone number for assistance or to report suspected adverse reaction
Etogesic etodolac Fort Dodge Animal Health, 1998 management of pain and inflammation associated with osteoarthritis in dogs tablet (800) 533-8536
Rimadyl carprofen Pfizer Animal Health, 1996 (caplet); 1999 (tablet); 2003 (injectable) relief of pain and inflammation associated with osteoarthritis in dogs; control of postoperative pain associated with soft tissue and orthopedic surgeries in dogs caplet and chewable tablet; injection (800) 366-5288
Deramaxx deracoxib Novartis Animal Health US Inc., 2002 control of pain and inflammation associated with osteoarthritis in dogs; control of postoperative pain and inflammation associated with orthopedic surgery in dogs 4 lbs or greater chewable tablet (800) 332-2761
Metacam meloxicam Boehringer Ingelheim Vetmedica Inc., 2003 (oral suspension, and injectable) control of pain and inflammation associated with osteoarthritis in dogs drops given by mouth; injection (866) METACAM (638-2226)
Zubrin tepoxalin Schering-Plough Animal Health Corp., 2003 control of pain and inflammation associated with osteoarthritis in dogs rapidly disintegrating tablet (800) 224-5318
Previcox firocoxib Merial Ltd., 2004 control of pain and inflammation associated with osteoarthritis in dogs chewable tablet (877) 217-3543
Novox generic carprofen IMPAX Laboratories Inc./Vedco Inc., 2005 relief of pain and inflammation associated with osteoarthritis in dogs caplet (888) 708-3326

The information in the table above is copied from the U.S. Food and Drug Administration website.

There are generally five classes of pain reducing alternatives we can provide for our dogs

Nutraceuticals NSAIDS  (non steroidal anti-inflammatory drugs) Opioids Steroids Holistic Alternatives

Nutraceuticals… Nutraceuticals are non-drug nutrients that play a major role in strengthening normal body tissues, aid in repairing damaged tissues and assist in improving efficient body metabolism. Adding nutraceuticals to the daily diet has noticeably improved the life quality of many dogs. Most commonly used nutraceuticals include in their ingredients EFAs (essential fatty acids such as Omega-3 and Omega-6 Fatty Acid). Other ingredients such as Glucosamine, Chondroitin Sulfate, Methylsulfonylmethane, and Flax Seed Oil have proven to be helpful in decreasing pain and discomfort from arthritis and degenerative processes. Many believe that using nutraceuticals life-long will assist in delaying the degenerative effects and the discomfort of aging. Nutraceuticals are employed to assist with low-grade pain and discomfort and can take six to eight weeks for their beneficial effects to be noticed.