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, that is a much different circumstance.

If a patient is not given proper pain control after painful procedures, it is categorized as malpractice. 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 it is 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 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, though there are some exceptions. This class of medication is helpful when managing severe pain such as trauma, invasive surgeries and cancer pain. 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, 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. There is valid scientific data supporting the use of some of them, while only anecdotal evidence supporting others. Some of the most compelling results found have been with respect to glucosamine and chondroitin supplementation. They have been noted to be very helpful with decreasing the destruction of the joints and adding lubricating factors to protect 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 for heart disease, kidney disease and skin issues.

There are a number of other ways to control your dog’s pain that do not require medications or supplements. 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 as subtle as a mild limp to just licking of paws.

It is not acceptable to ignore pain in animals, and there is always something that can be done on any sort of budget. Please keep an eye out for further articles regarding the additional tools for managing pain in pets. Also be sure to check out my blog: https://drjoevet.wordpress.com.

[Contact Dr. D’Abbraccio at www.facebook.com/CatskillVeterinaryServices, www.catskillvetservices.com, or jdabbracciodvm@icloud.com.]