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One of the challenges veterinarians face on a daily basis, as compared to our human medicine counterparts, is the fact that our patients are not able to “speak” to us. One of the areas where this causes the most problems is in the control and management of pain.
More and more people are coming to realize, and maybe more importantly are coming to accept, that animals feel pain in much the same way that we do. Thus we can quite safely assume that things causing us to experience pain will also cause pain in an animal. When we become veterinarians we swear to adhere to an oath which includes “the relief of animal suffering”, a clear edict to include pain management in our practice.
Pain has its benefits. After all without pain we wouldn’t know to take our hand out of a fire. However, when pain becomes too great or when it goes on for too long, it actually becomes detrimental and has been shown to slow healing and cause problems in other organ systems. Not to mention diminishing quality of life.
However, how do we recognize pain? Animals tend to hide their pain. Research has shown that this stoic nature is more common when animals are in front of others. So with them being such great dissimulators, the assumption that their pain would be the same as mine in a similar situation is made more complicated. Even on a human level, a medical doctor would quickly dissipate this train of thought since they will point out that pain in people is a very individual experience, with human pain thresholds varying greatly. In my experience this individual nature of pain also translates to the Pet world. Since we know they feel pain and that pain varies by individual, how can we pick the best pain management for each of our patients?
Some pain is easy to anticipate. Pain caused by surgery, dental extractions or trauma (such as that following an accident). However, other pain is more covert, especially chronic pain and pain experienced by older Pets with osteoarthritis or a “toothache”. It is in cases such as these that the Pet parent plays a key role in not only helping detect their Pet’s pain, but also in assisting the veterinarian in treating and assessing the appropriate level of pain management required. No one knows their Pet better than you. Your bond with your Pet and your knowledge of their daily routine gives you the best tools with which to evaluate your Pet’s pain or lack thereof. Subtle changes, such as hiding, slowing down, reluctance to eat or reluctance to eat certain foods, decreased levels of play or changes in temperament can indicate your Pet being in pain. More obvious clues could include constantly licking of a certain body part, such as a paw, stiff gait or vocalizing. All of these clues should prompt you to seek veterinary assistance so that, as a team, you and your veterinarian can find the cause of your pet’s pain, and start treatment.
Treatment for pain if often multi-modal, encompassing a number of different tools at our disposal. Medical management, using pills or liquids, is often warranted but the ideal pain management system, especially for chronic pain like osteoarthritis, should include other pain control modalities. Other things your veterinarian may consider include: weight management, diet and diet supplements, moderate exercise, massage, acupuncture and muscle or bone manipulation. This multi-modal approach will ensure that the optimal pain control is achieved with the smallest amount of damage to other systems in your Pet’s body. Once a plan of action has been tailored to your Pet, make sure you discuss any potential changes with your veterinarian. For example, do not change the dosing of your Pet’s medication without checking with the veterinarian, as these changes could be harmful to your Pet. Also make sure that you never give any human pain medication to a Pet without your veterinarian’s approval, since common human pain control is often poisonous to Pets.
Remember, our Pets have become experts at minimizing the outward appearance of pain. However, by paying close attention to them, we can uncover their secrets and by treating that pain, we can once again enjoy their “joie de vivre”.