In recent years, pain management has become a greater concern of pet owners as well as veterinarians. Even looking back 10 years, pain management was not a topic of conversation for veterinarians or pet owners. Today it’s a different story. It is categorized as being malpractice if a patient is not given proper pain control after painful procedures.

Pain has many manifestations, as there are injuries, degenerative conditions and individual variations. It is difficult to measure pain, as it is subjective with respect to animals. A dog cannot simply point to the sad or happy face on a zero-to-10 pain scale, as is done in human care. Given their stoic nature, dogs must be evaluated on an individual basis. It is important to appreciate that just because a dog does not cry, limp, or show other obvious signs of pain, that does not mean they are not in pain.

Obvious injuries as well as surgery result in pain, and a simple rule of thumb would be that if it would hurt you, then it hurts your pet. Most dogs experiencing pain will have changes noted in their behavior, and at times those changes are subtle. Signs of pain include:

• Holding the ears flat against the head

• Increased licking of a painful/sensitive area

• Stiffness or limping

• Change in personality

• Whimpering or vocalizing

• Panting or breathing heavily

If your pet is undergoing a surgical or any other procedure at the veterinary office, be sure to ask what their pain management plan is. It is important to plan ahead for pain and start medication prior to the event. This actually allows for less anesthetic drugs to be used and less pain medication after the procedure. Veterinarians select a number of different medication types to control pain. This is referred to multi-modal pain management.

Nonsteroidal Anti-inflammatory Drugs (NSAIDS): These drugs block the body’s production of inflammatory markers that trigger pain and swelling. NSAIDS must be used with caution because there can be potential side effects with the liver, kidneys, stomach and other intestinal issues.

Opioids: These medications are used for severe pain and include drugs like morphine, codeine, fentanyl, buprenorphine, and hydromorphone. Typically they are not dispensed to owners to give at home. This class of medication is helpful when managing severe pain such as  that experienced with trauma, invasive surgeries and cancer. They are also used for patients suffering from severe arthritis.

Corticosteroids: Cortisone and synthetic cortisone-like drugs such as prednisone, prednisolone, methylprednisone and dexamethasone are potent anti-inflammatory medications and can be very helpful for severe inflammatory conditions. These medications are used to treat patients with arthritis, allergies, or skin discomfort. Steroids also have side effects and therefore require close monitoring. Such side effects include increased urination/drinking, panting, restlessness, increased appetite, and the potential for causing diabetes and inducing pancreatitis.

Supplements: There are a wide variety of supplements and additives available through veterinarians, pet stores, feed stores, and online markets. Some of them are supported by valid scientific data, others only by anecdotal reports. Some of the most compelling results from supplements are in respect to glucosamine and chondroitin. They have been noted to be very helpful with decreasing the destruction of the joints and adding lubricating factors to protecting the remaining cartilage. Another very helpful supplement is fish oil, which contains powerful anti-inflammatory and antioxidants in omega-3 fatty acids. Omega fatty acids can be found in most commercial foods, but additional supplementation can be very helpful not only for arthritis but also heart disease, kidney disease and skin issues.

Alternative/Complimentary: Therapies such as cold laser therapy, physical therapy, magnetic energy fields, acupuncture and spinal manipulation therapy are all now considered helpful and recommended therapies.

You should always consult your family veterinarian prior to starting any new supplements or additives. Pain comes in many forms, and the symptoms can be subtle. It is not acceptable to ignore pain in animals and there is always something that can be done on any sort of budget.

 There are a number of other ways to control your dog’s pain that do not require medications or supplements. Please keep an eye out for further articles regarding the additional tools for managing pain in pets.

[Joseph A. D’Abbraccio, DVM, of Catskill Veterinary Services, PLLC, can be contacted at catskillvetserv@gmail.com. For more information visit https://www.facebook.com/CatskillVeterinaryServices or www.catskillvetservices.com.]