MANAGING PAIN IN DOGS AND CATS
We don’t want our pets to hurt. Whether the pain is the dull ache of arthritic joints or the sharp stab of back pain or post-surgical discomfort, unnecessary pain takes its toll on health and behavior. Pain also causes a stress response which raises adrenaline and cortisone levels, increasing anxiety and slowing healing. Fortunately, we have a variety of ways to help manage our pets’ pain.
There are many different types of pain, and just as many methods of pain control. Your veterinarian will help choose the most appropriate treatment to keep your pet comfortable. Here are some of the options:
1. Eliminate the cause of the pain. Remove the thorn in the paw or the painful tumor when possible. Treat the liver disease or the intestinal problem to relieve painful pressure or cramps in these organs. With proper diagnosis and treatment, the source of pain can often be eliminated.
2. Non-Steroidal Anti-inflammatory Drugs (NSAIDs): These medications are the backbone of treating minor pain in humans, as well as dogs. The human NSAIDS include aspirin, ibuprofen, naproxen, and many others. Unfortunately, pets do not tolerate most of these human pain-relievers, and THEY SHOULD NOT BE USED IN PETS. Newer and safer NSAIDS have been developed for dogs, and your veterinarian can help choose the right one. Some of these have been used in cats, but caution is required, as the drugs are not approved for cats and can cause side effects. Because anti-inflammatory drugs reduce inflammation as well as blocking pain, they are especially useful when pain is caused by inflammation (as with arthritis or infection).
3. Opioid medications: Morphine, codeine, and related drugs block the pain receptors on the nerves. Although they have no anti-inflammatory effects, they provide the strongest degree of pain relief. They are typically used before, during, and after surgery, as well as for traumatic injuries. They may cause sedation (which can be helpful after surgery or injury), they can be addictive (when used inappropriately), and they are “controlled substances” with legal implications.
4. Tramadol is sometimes considered a mild opioid drug, but it also has other effects on the perception of pain which make it useful for chronic discomfort. Tramadol is not currently a controlled substance, and it is widely used by veterinarians for post-surgical pain, cancer, and severe back and joint pain.
5. Muscle relaxants: These drugs are very benign with few side effects, but they are only effective when the pain is caused by muscle spasm. They are often used to treat back pain, along with anti-inflammatory medications.
6. Anti-convulsants and miscellaneous other medications: Gabapentin is a mild drug for seizures, but it also has unique effects on “neuropathic pain” caused by nerves that misfire or send pain signals even after the cause has gone away. Anti-depressants or anxiety medications are also used to decrease the brain’s awareness of pain and reduce the stress caused by pain. Cerenia is a potent new antivomiting drug which can also be effective for pain.
7. Physical modalities: Use of a therapy laser can reduce pain with concentrated light beams, giving relief for a variety of conditions. Heat or cold may also be used, but your veterinarian should give you advice on their use; heat relaxes muscles, but may increase inflammation; cold reduces inflammation, but is often uncomfortable. Acupuncture is another useful physical modality that is offered by some
practitioners. Massage and physical therapy also offer relief in many types of chronic pain.
The most important part of pain control is to use the right methods of control for the type of pain. This requires an accurate determination of the source of the pain, and knowledge of the effects of each therapy. In general, it is best to treat pain as promptly as possible, since pain tends to persist longer once it starts. This is why pain medications are often started even before surgery, and should be given regularly after surgery, even if the pet doesn’t seem painful initially. Appropriate treatment will help keep your pet comfortable and improve its quality of life.