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Managing pain in pets

Long term (chronic) pain is as debilitating in animals as it is in people. Constant pain significantly reduces pleasure in life and can lead to sleeplessness and a poor appetite. Simple measures to control even mild pain can result in a happier healthier pet.

Your questions answered

What conditions are painful?

Animals, like people, are prone to many different forms of pain. All types of injury including surgery can cause pain. There are times when pain can be anticipated such as immediately following surgical procedures. In these instances your vet will probably give your pet something for pain relief before and during surgery and then ask you to continue this at home. Relief of pain has been shown to improve recovery after surgery.

In dogs long term (or chronic) pain is often caused by arthritis (joint pain) or cancer. When managing pets with these conditions vets are trying to give your pet the best 'quality of life' and so pain control is an important part of management.

How do I know if my dog is pain?

In most cases dogs are quite open about the fact that they are in pain and do not try to hide signs. Animals in pain can show a variety of signs - some, like lameness, are obvious. Other well recognised signs are whining or howling and restlessness but poor appetite and altered sleeping patterns are also common effects of chronic pain. Animals with a painful focus may chew at or continually lick the sore area. Some animals in pain become reserved and unresponsive but others may become aggressive if they are scared of being touched.

Often owners notice very subtle changes in their pet's behaviour or appearance that allow them to identify that their pet is experiencing pain more quickly than vets can. If you are concerned that your pet may be in discomfort you should discuss your concerns with your vet. However, sometimes owners attribute signs of pain, eg poor appetite and reluctance to exercise as signs of old-age rather than pain. They can be very surprised at how much their dog improves when the pain is relieved.

How can pain be controlled?

Pain is much more difficult to control once it is well established so it is far better to treat it as soon as it is recognised. There are many different types of drugs used in the management of pain - each has different benefits and side effects. Your vet will initially prescribe what they think is the best drug for your pet but it is quite common to have to try a number of different drugs for the treatment of chronic pain before the best treatment for each individual dog is found. Never give your pet a pain relief medication not prescribed by your vet - medicines that are safe and effective in humans can be dangerous in dogs. If you are worried about your pet, or it develops signs such as vomiting, diarrhoea or bleeding when it is receiving pain relief always contact your vet and do not give any more tablets until you have done so.

NSAIDS

Non-steroidal anti-inflammatory drugs (NSAIDs) is a difficult name but one that simply means drugs that reduce inflammation but are not steroids. These drugs block the action of some of the messengers of pain and inflammation in the body (prostaglandins). NSAIDs (as they are commonly known) may be familiar to you as the common human drug aspirin, but there are many different types. Commonly used NSAIDs in dogs include carprofen (Rimadyl), ketoprofen (Ketofen), meloxicam (Metacam), deracoxib (Deramaxx -not available in the UK), tepoxalin (Zubrin) but there are many more and more are being produced all the time.

When used carefully NSAIDs are relatively safe. One common side effect in people is stomach upsets caused by damage to the lining of the stomach, although this is perhaps less of a problem in dogs and the newer forms of NSAIDS have fewer side effects. If your pet has these side effects then your vet can prescribe some additional drugs to help protect the stomach or it may be necessary to change the type of pain relief your pet receives. Many of the newer NSAIDs do not share the side effects of the older drugs.

NSAIDs can be given as tablets or liquids (and sometimes your vet will give these drugs by injection). These drugs are removed from the body by the liver or kidneys and therefore should not be used in animals with damage to these organs. Liver and kidney function should be checked in animals receiving long term NSAIDs.

Opioids

Opioids are drugs with similar action to morphine. They are some of the most powerful forms of pain relief available. Morphine is commonly used in veterinary hospitals to control severe pain after surgery but there are now new types of opioids   which are being used in dogs.  fentanyl that are 100 times as effective as morphine in pain control . Most of these drugs can only be given by injection which has previously made them unsuitable for managing long term pain in the home.  'Fentanyl patches' are a sticky patch containing fentanyl that is applied to the shaved skin. The drug is absorbed through the skin in a steady fashion and provides long term (several days) relief from severe pain. These patches are most often used for control of pain in cancer patients or after significant surgery.

Dogs receiving opioids do not appear to suffer as many side effects or hallucinations ('highs') as people do. One of the annoying side effects in pets is that these drugs can cause constipation. Fentanyl patches pose a significant risk to patients if the patch is removed and eaten by your pet so care must be taken to prevent access to the patches - also not recommended if there are young children in the pet's household.

Tramadol

Tramadol is a relatively recent arrival on the scene of animal pain relief. In recent years it has become very popular with vets for managing chronic pain in pets. There are few serious side effects with this drug although it has been reported to cause vomiting and sleepiness in some patients. Since it works in completely different ways from the other existing pain relief drugs it can be used alongside all of them.  This allows for a much greater reduction in pain with fewer side effects.

Are there other ways to control pain?

Some lifestyle changes can help to reduce pain experienced by pets. If your pet has joint pain your vet will advise that it has only controlled exercise (so that it doesn't 'over do' things) and its weight should be kept to a minimum healthy level (to reduce the strain on the joints). Ensuring that your pet does not have to climb stairs or jump into the car can reduce back pain and the pain associated with hip disease. Massaging or applying warm compresses to arthritic joints may help relieve discomfort. Some people find acupuncture to be of benefit in managing pan in their pets.

Nutraceuticals such as glucosamine and chondroitin may help to reduce inflammation in joints in people but there is not the corresponding evidence for dogs, although some individual animals do seem to respond favourably. Omega 3 fatty acids may help dogs with arthritis.

It is important that pets are not allowed to suffer with chronic pain when there are so many options for pain control today. If you have any queries about pain or how to manage it for your pet you should discuss your concerns with your vet who will be happy to help you.

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