The word pain can cause a visceral reaction in people—especially when it is used to describe someone you love, like your dog (or cat).
Many people have not been educated to recognize the gradual onset and subtle signs of pain. Often, pet owners interpret the symptoms and behaviors they see as normal signs of aging or rule out pain as an issue, because their pet is not vocalizing. But pain can be insidious and life altering for your pet. Pain is always bad, and aging does not have to be painful.
An important part of keeping our pets happy and healthy is to recognize and treat pain when it occurs. Acute pain, which is associated with trauma, surgery, or injury, is generally easier to anticipate and to understand. In the case of surgery, we can, and should, treat preemptively to minimize pain and continue that treatment until we feel confident that our pet is recovered and comfortable.
We cannot be proactive in the cases of injury or trauma, but we can treat for as long as is needed for the circumstances around each condition. Managing pain should never be one-size-fits-all approach; but rather it should be customized for each pet’s needs. Some acute states become chronic and may require long-term management, and for some pets, this can mean for the rest of their life.
Chronic pain is insidious and more challenging to recognize and interpret than one might think. Many signs come on gradually and are subtle. Often, the signs are thought of as acceptable changes associated with aging, and in most cases, pain is not an all-or-nothing phenomenon. Pain can come and go, and pain can come and stay and grow.
Animals, by nature, may not demonstrate all the same types of signs of pain that you and I do. Most significantly, they rarely whine about it. They will get up each day and go through their activities of daily living as best they can. A dog with an injured or sore knee might still eagerly chase a squirrel, but that doesn’t mean he is not in pain.
In some instances, chronic pain is discovered at a veterinary visit. In others, the family might realize the subtle changes are indicators of chronic pain. Sometimes, chronic pain is discovered on a routine examination. The earlier chronic pain is diagnosed, the more effective the treatment can be. This early treatment can slow the progression of some disease states and minimize the development of compensatory problems.
Crying or whining is an obvious indication of pain. While this sign is easy to interpret, it is not very common. The absence of whining does not mean there is an absence of pain. More common signs include limping, slowly rising, grunting on rising, or lowering into a down position, slowing down on walks, and difficulty getting into the car or onto furniture. Some pets will show a difficulty in going into a down position by circling and circling and circling before they actually lie down.
In addition, you might notice your dog is restless at night, panting, and he may be pacing as if he cannot get comfortable. Others will become resistant to grooming or being touched, or grumpy with other pets or kids in the family. You may also see a change in appetite or elimination habits, and some pets might exhibit reclusive behavior.
Any of these signs should be discussed with a veterinarian who is current in assessing, treating, and managing pain. The assessment should include observing your dog’s transitions—going from standing to sitting, into a down, and back to standing. In addition, a good gait evaluation is an important part of pain assessment. This can include watching your dog walk, trot, and maneuver stairs or a slope, or make turns and circles. There should be a discussion of your dog’s ability to complete his activities of daily living, including any recent changes at home. This may stimulate discussion of things you had not considered, such as the ability to posture to eliminate or straining to reach the bowl to eat or drink. The final part of the evaluation is a thorough palpation of muscles and joints. This is important because muscle atrophy, heat, soreness and trigger points can only be found through good palpation. If it is found that your dog is experiencing discomfort or pain, a further investigation may be needed to determine a more specific diagnosis of the cause. An accurate diagnosis can lead to a directed effective multimodal pain management plan.
Dr. Erin Troy practices at Muller Veterinary Hospital and The Canine Rehabilitation Center in Walnut Creek and was raised on a small farm in Contra Costa County. She received her bachelor’s degree from UC Davis and her doctorate of veterinary medicine from University of Wisconsin. Troy began working at MVH as part of the nursing staff before veterinary school and later returned as an associate veterinarian, purchasing the practice from her mentor in 1999. Continuing education has always been a priority for Troy who has traveled to many conferences on internal medicine, surgery, and physical medicine and rehabilitation throughout the country. Troy enjoys spending her spare time doing many outdoor activities with her husband, John, and their dog, Buoy.
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Main article photo by: Mary Shattock-Creative Commons