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Managing
Pain In Dogs
This article by Dr. T. J. Dunn appeared in
the Dog World Magazine
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…
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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.
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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.
All may have
side effects |
These products can be
ordered online so be sure to consult with your veterinarian
prior to using any of the products shown below. |
All may have
side effects |
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COMMON
NUTRACEUTICALS USED IN DOGS AND CATS |
 |
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 |
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 |
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| Flax
Seed Oil |
MSM
Methylsulfonylmethane |
Omega
Fatty Acids |
Glucosamine/
Chondroitin/other |
Herbal Products |
The
Missing Link |
Bee
Pollen |
NSAIDS…
(Non-Steroidal-Anti-Inflammatory-Drugs) These non-hormonal products include
non-prescription aspirin (and other pain relievers) and prescription required
products such as Rimadyl and Etogesic. These
and other NSAIDS interfere with the body’s production of inflammatory
molecules that actually trigger pain and swelling.
Some non-prescription NSAIDs should not be used in dogs. All these products must be used with caution because there is
potential for stomach and intestinal problems and prolonged blood clotting time.
NSAIDs are used for low to moderate pain and discomfort.
Opioids… Used for
more severe pain, this class of pain relief medication includes morphine,
codeine, Demerol and other prescription products.
Used in advanced cases of cancer or severe arthritic pain, opioids do
have a place in selected cases where the quality of life for the dog can he
maintained. (Although not opioids,
some antidepressant medications such as Amitriptyline may be used to treat
severe chronic pain.)
Steroids… Cortisone
and synthetic cortisone-like drugs such as dexamethasone and Depo-Medrol are
potent anti-inflammatory medications and can have a very soothing impact on the
patient. However, they are always a
double-edged sword and you should question any long-term use of corticosteroids
when they are employed to reduce arthritic, allergic or dermatologic discomfort. Unfavorable side effects can be a deterrent to their use.
Chiropractic care…
There is mounting evidence that acupuncture, body manipulation and massage can
noticeably decrease discomfort and improve function in many dogs.
There is a wide range of skill levels among practitioners and therefore
benefits to be derived from canine chiropractic care; nevertheless it may be
rewarding in selected cases.
If you notice a diminished
enthusiasm for daily activities or other signs of subtle discomfort in your dog,
try to assess the possibility that pain or discomfort is a factor. Work closely with your veterinarian regarding medical tests
and radiography to evaluate the true medical status of the dog.
Remember, as Dr. Tranquilli said, to develop a partnership with your
veterinarian to do whatever is needed to manage and control pain and discomfort
in your dog. Pain is personal… it’s up to you to get personally involved
with pain management for your dog.
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America's Pet Store
On
The Web
87 Brands
of dog, cat, fish, bird and other pet foods! Treats, Supplies,
Accessories for Birds, Fish, Pocket Pets, Horses, and Wellness/Holistic
Products
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