Chronic Pain Management
Pain plays an important biological role in warning your pet of tissue damage, helping to prevent further harm. Left untreated, pain becomes detrimental, leading to stress, self-mutilation, immune compromise and eventual deterioration. Humans and animals share very similar pain pathways. Because dogs and cats cannot tell us where it hurts or why, it is important for us to recognize signs of pain in out pets and know which treatment options are available.
Signs that your pet may be in pain include:
– More time spent sleeping
– Inappropriate urination and/or defecation
– Poor coat from lack of self-grooming
– Less interest in playing, jumping, climbing, etc.
– Reduced appetite
– Sudden sensitivity to a particular area of the body
– Limping and/or lameness
– Self-mutilation (e.g., licking, chewing, biting)
– Change in attitude (e.g., hiding, aggression, excessive comfort seeking)
Osteoarthritis (OA) affects approximately 20 percent of our cat and dog population, and the incidence increases with age. In fact, 90 percent of cats over nine years of age show evidence of arthritis on X-rays. Working animals are also more like to develop OA due to the increased wear and tear on their joints.
Weight Reduction and Joint Supplements
Weight reduction is a crucial part of pain management. All other therapies will work considerably better if your pet is not overweight. Weight loss may, in cases of minor OA, eliminate the need to use drugs to treat your pet’s pain. Pets with OA are often stiff after periods of inactivity but become more comfortable and “warm up” with exercise. Regular, controlled exercise helps maintain or build muscle mass to support joints, stimulates production of joint fluid and encourages weight loss.
Join supplements are recommended for patients with OA. These supplements slow the progression of cartilage degradation and promote synthesis of joint fluid.
There are a number of different types of medications that your veterinarian may recommend if weight loss and joint supplements alone are not enough to control your pet’s pain. Your veterinarian will first want to do a complete physical exam and may recommend radiographs (X-rays) to diagnose the problem. They may also recommend blood work and urinalysis before starting any therapy.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are a key tool in managing pain associated with OA. There are a number of different NSAIDs on the market, and NSAIDs can be combined with a number of other pain medications. There is significant variability in individual response to NSAID therapy; the medication can have major side effects on the liver, kidney and GI tract. It is important that you never administer any of these medications without consulting your veterinarian as they can be extremely toxic, even lethal, to dogs and cats. When administered in doses prescribed by your veterinarian, these medications can be an effective way to manage pain.
Steroidal anti-inflammatory drugs (cortisone) can help reduce pain and inflammation temporarily but are typically not recommended long-term due to the number of adverse effects associated with chronic use. Steroids should never be given with NSAIDs due to the increased chance of stomach and intestinal ulceration.
Other medical therapies for chronic pain include:
– Tramadol, a medication useful for moderate to severe and chronic pain
– Amantadine, used for neuropathic pain
– Gabapentin, also used for neuropathic pain
– Opiods, such as morphine, oxycodone, etc.
Physical rehabilitation also plays a vital role in the management of chronic pain. Massage therapy, neuromuscular electrical stimulation, low-level laser therapy and therapeutic ultrasound are great adjunctive treatments. Water therapy provides low-impact exercise for dogs with chronic pain. The buoyancy of water reduces joint load, allowing for more comfortable exercise. Water pressure reduces swelling and water resistance is useful for building and strengthening muscle.
It can be hard to recognize the signs of chronic pain in your pet, but once diagnosed, with the development of new medications and technologies, our pets are able to live much more comfortably with chronic conditions that would have previously caused unrelieved suffering.