very long ago the popular wisdom was that animals not be
given pain-killers because they would be overactive and pull
open sutures or delay healing. We now know that
relieving pain allows dogs to heal faster and they do not
try to do too much. Without pain they can rest and
heal. Since this was established the next big hurdle
was to determine when the dog was in pain. Dogs tend
to hide pain. This could be because before
domestication a sick dog couldn’t keep up with the pack
and would be seen as a liability and be abandoned.
Given the numerous examples of dogs who mourn lost pack
mates – human and canine – this may be an
oversimplification. There are human stoics who can
withstand a lot of pain, but still feel it, and benefit from
having it addressed and relieved. We know that humans
with arthritis can have quite severe lesions before they
feel pain, and that it can then appears to come on suddenly
and be quite debilitating. This could well be the case
also with dogs.
are very fortunate that we have so many different drugs and
therapies to address pain, and yet people may be afraid to try them
because of a bad reaction from one of their own dogs or a friend’s
dog, or something they read on the Internet. The same
treatment could be just what the present dog needs. The good
news is we have so many different options close to 100% of dogs’
pain can be removed, we just have to match patient and therapy.
assessing your dog’s level of pain you are better equipped than
most vets. Living with him, you are able to quickly notice
changes in posture, movement, level of activity, vocalization and
general behavior. Keep a record, and if you believe your dog
is hurting insist that this is addressed. Of course, we have
all met the Beardie divas who leap and scream even if you brush
against their hair. Sometimes though, if they are really hurt
these same dogs can be as quiet and still as any other dog. If
the dog has been injured or has a surgery or procedure we know would
be painful to a human we can assume that the dog is in pain.
We should also remember that a dog in pain can act atypically, and
bite to protect himself from further pain.
are often the first line of treatment for pain. Non steroidal
anti-inflammatory drugs (NSAIDs) give consistent, predictable
results. However, 1 to 3 % of dogs will suffer from adverse
effects (remember most of these will be mild). Short term the
most common problems are gastrointestinal. The older less
specific drugs like aspirin can cause gastric ulceration, and should
be given with a drug such as omeprazole to protect the stomach.
However, even the COX2 specific newer NSAIDs (carprofen – Rimadyl;
deracoxib – Deramaxx; meloxicam – Metacam; firocoxib - Previcox)
can also cause anorexia, diarrhea and/or vomiting. Long term
these drugs can result in acute renal failure or exacerbate existing
kidney disease and sometimes liver disease. In rare cases
these may prove fatal. It must also be remembered though that
many dogs receiving these drugs chronically are elderly, may have
unidentified underlying illness, and might well have died anyway.
Before the dog is placed on any of these drugs bloodwork should be
done to rule out preexisting conditions, and the dog monitored for
potential adverse effects. If the dog is to receive these
drugs long-term, blood work must be repeated every 3 to 6 months to
look for changes in liver and kidney function or other systems.
surgical patients, anesthetics do not control pain, and the dog
should receive analgesics prior to induction of anesthesia.
Combining a fast acting drug with a short duration of action with
one whose onset is slower but which lasts longer is a good choice.
This enables the anesthetist to maintain the dog on a lighter plane
of anesthesia which is safer for the dog. Pain killers may be
given constantly throughout surgery with intravenous fluids too.
Epidurals are not used as frequently as they would be helpful in
are being used quite often for pain control. In general, I
find they are less effective for treating chronic pain like
arthritis, but they are good for short term surgical pain.
Side effects can include constipation, loss of appetite vomiting and
occasionally diarrhea; anxiety, agitation, tremors, dizziness,
tremors, and sometimes intense itching. Tramadol is the most
commonly prescribed oral opiate.
overlooked in pain management are simple procedures such as applying
heat and ice. Ice is most often used for acute injuries in the
first 48 hours. Do not apply the ice pack for more than 20
minutes at a time, but repeat frequently. It will reduce pain
and swelling. You can also apply ice to old injuries right
after activity exacerbates the injury. Most often heat is used
for chronic conditions though, relaxing and loosening tissues and
stimulating blood flow. It should not be used in the 48 hours
after injury or after activity, but it can help old injuries warm up
before exercise. (While humans can decide to play hurt, I do
question the wisdom of asking an animal to do so as it can worsen
preexisting injuries. However, if your dog is determined to do
Beardie bounces despite chronic arthritis, warming her up before
heading out on a walk will help.) You can use a heating pad or
hot wet towel, but just as over icing can cause frostbite, keep the
heat moderate to avoid burns, and 20 minutes is usually plenty for
range of motion exercises can also ease stiffness and reduce pain.
Warm up and cool down exercises before and after athletic work outs
can reduce injury and pain. For more extensive rehabilitation
work rehabilitation hospitals are springing up more frequently.
Sports medicine may soon be a board certified veterinary specialty.
Rehabilitation pools and underwater treadmills can help maintain
muscle tone during healing without putting excessive strain on
injured limbs. Electrical stimulation, ultrasound and laser
treatment are all being used to relieve pain and restore mobility.
Drugs alone do not address the loss of strength and mobility that
accompanies acute injury or chronic debilitating disease.
Together with effective rehabilitation techniques, the dog can
remain an active and engaged companion far longer than with drugs
level or cold laser therapy can be a godsend for canine athletes.
It treats immediate pain, while speeding healing thereby reducing
the duration of the pain. Acupuncture and electro acupuncture
can also produce dramatic response in some patients, and sometimes
even a single treatment can provide long-term pain relief.
Other options include supplements and herbs as well as chiropractic.
owe it to our dogs to relieve their pain and improve their quality
of life. The more we know about the options to achieve this,
the better we can serve them.
grateful thank you to Linda Aronson, DVM for this article.