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It can often be difficult for people to identify signs of pain in their cherished companions for several reasons. Animals rarely cry out in pain, unless the level of discomfort is very high. This is a protective instinct from living in the wild, and helps to prevent predators from knowing that a creature is wounded. The cues that our companions provide are most often very subtle, and people may not necessarily associate them as signs of pain. Additionally, pet caretakers traditionally see their buddies on a daily basis. This can make it difficult to identify slight changes in behavior or mannerisms. Many pets live outside, so caregivers may not see how they act when they are getting up and down, eating, or other daily activities. Also, pet owners associate many of the signs of chronic pain as typical signs of old age in their companions, and don't realize that there could be a significant health problem.
Pain can be manifested in several ways. In general I recommend for pet owners to look for changes in their companion's daily routine. Is your buddy suddenly hiding a lot, or less interactive with the family, or less active overall? Are you seeing limping or difficulty getting up and down? Is there muscle loss? Does your dog or cat seem restless, and is he or she trying out several different positions in an attempt to get comfortable? Is there now a lot of panting or pacing? Is your canine or feline suddenly more aggressive, not wanting to be handled or disturbed? Does your pet appear to be protecting a certain area of his/her body? Is he or she licking a certain area of the body with increased frequency? Are you seeing a decline in grooming? Are you seeing a decline in appetite? Are you seeing vomiting? Is there weight loss? Is it more difficult for your companion to posture to have a bowel movement or urinate? Is there straining or a change in frequency in these activities? Sometimes a caretaker can feel muscle tremors or tension in certain areas when an animal is painful; but this is more subtle, and not something I expect most pet owners to be able to do.
Once you identify a problem, it is important to consult with your veterinarian for the proper treatment. During an examination, your veterinarian can look for elevated heart rate, elevated respiratory rate, increases in blood pressure, changes in pupil dilation, and other abnormalities. Using palpation techniques, an orthopedic exam, and/or a neurologic exam, the area of pain can be localized, and then treatment options or diagnostics can be discussed.
Many pet owners want to give over-the-counter pain killers. These products can be harmful to animals, especially cats. Cats are less able to metabolize medications, and many drugs can cause significant and permanent kidney or liver damage. Also, many painkillers can be damaging to the digestive systems of our buddies. Pain medications can also mask underlying health issues. Your veterinarian has products that are safer for companion animals, and he or she should decide when and what type of medication is needed. If pain medications are recommended, your veterinarian will typically recommend blood work. Just like in people, it is important to know the underlying status of vital organ systems prior to starting therapy.
Your veterinarian may also recommend diagnostics in addition to blood work such as x-rays, ultrasounds, and others to look for the underlying cause of your dog's or cat's discomfort. Organ malfunction is a common cause of illness in both dogs and cats, especially as they approach their senior years (7 years and older). A blood and urine panel can help to evaluate the kidneys, liver, pancreas, thyroid, protein levels, and a complete blood cell count. As pets get older, they are also susceptible to cancer, just like in people. Sometimes this illness is identifiable as a mass on palpation, on an x-ray, or sometimes a biopsy is needed. Exploratory surgery may be suggested; and sometimes a referral to a specialist is needed.
Chronic pain that is not curable by surgical means, or when surgery is not an option, is generally addressed with medication. Non steroidal anti-inflammatories or NSAIDS are the cornerstone of therapy. Products such as Previcox, Metacam, Deramaxx, and Rimadyl are similar to Aspirin, but are safer for canines and felines. They not only decrease inflammation; but also provide pain control. They do still have side effects. Most commonly they cause stomach upset, and can be damaging to the kidneys and liver. For patients who cannot tolerate NSAIDS, Tramadol may be recommended. It only provides pain control, and is somewhat similar to Morphine. Alternative treatments such as water therapy, physical therapy, acupuncture, and massage are now becoming part of traditional pain control regimens, and are more readily available.
It is only in the past 15 years that pain control has become an important and universal consideration in the field of veterinary medicine. More products that are animal specific are being developed to provide quality, comfort, and care for our cherished companions with fewer side effects. As a care provider, you can do a lot to monitor and treat pain in your canines and feline friends.