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This may be painful as this is my first attempt at a blog, folks, so please be patient.  That’s okay because pain is the subject of today’s entry!

A topic that has come up many times in the last couple of weeks is pain.  I have heard more times than I can count that “my animal is not in pain because he/she is not vocalizing.”  While vocalizing, or crying out is a sign of pain, I feel it is MUCH more important to learn the subtler signs of pain.

People can verbalize when they are in pain.  Some people are very stoic and others are very vocal about their pain.  Often, we can look at those we know best and just tell when they are hurting.  Animals speak their own language of and show signs of pain.  We just need to know how to understand them.

Although animals have been domesticated for MANY, MANY years, they still default to natural programming when it comes to pain and illness.  Animals in the wild that show pain or illness easily become victim to those higher on the food chain.  The default is to try to hide pain.  Some animals hide it better than others.  Cats and dogs show signs of illness much sooner than most exotic pets like birds.

Acute vs. Chronic Pain in Pets

First, we need to differentiate acute and chronic pain.  Acute pain is typically due to some form of trauma or rapid onset injury.  If you have ever stubbed your toe, stepped on a dog toy or kids lego, or broken a bone, you know what acute pain is.  This is the form of pain, depending on severity, that will cause both you or your pet to cry out.   Acute pain is typically treated with medication and/or definitive therapy and resolves once the underlying injury is resolved.

Chronic pain involves conditions that are long term, degenerative and require management.  For those of you suffering from osteoarthritis, fibromyalgia, rheumatoid, herniated disks, you know exactly what I am talking about.  I have met MANY people that are in pain all day long from some of these conditions.  That is why we have pain specialists, surgeons, physical therapists, chiropractors, rheumatologists and medications for these conditions.   What strikes me as very odd is the disconnect MANY pet owners have with understanding chronic pain in their pets.   I have had pet owners that know their pets have osteoarthritis or some other painful condition and still think the pet is not in pain due to lack of vocalizing.  I have arthritic knees.  Yes, I am in pain.  I don’t vocalize (my wife may say differently) but it still hurts.  Yes, I diet, exercise and take medication to help manage my pain.

Think of chronic pain as a being on a continuum from very little pain to excruciating pain.  Imagine if I put your hand in a vise.  I slowly start to tighten the vise.  At some point, it will start to get uncomfortable.  If I continue to tighten the vise it will become painful.  You will likely be asking me to stop at that point.  If I continue tightening to the point of injury or bone fracture, we move into acute pain and vocalizing.  Pets with chronic pain are somewhere in the middle of that spectrum.   Your pet has not cried out yet but would really like the pain to stop.

So how can I tell if my pet is in pain?

I want to review some signs you should be watching for that may indicate your pet is in pain.  Below is a list I have collected from professional experience and from reading several sources.

We will start with dogs:

  • Change in interactions with the family/other pets
  • Lethargy/sleeping more
  • Urinating or defecating in the house
  • Guarding an area of the body
  • Limping
  • Hiding
  • Grimacing
  • Shaking/trembling
  • Panting at rest
  • Licking at an area on the body
  • Difficulty or slow getting up and/or down
  • Reluctance to jump up
  • Difficulty with or refusing to do stairs
  • Difficulty getting comfortable
  • Reluctance to move
  • Stops normal grooming behavior
  • Becomes aggressive or if normally aggressive becomes quite/disinterested
  • Change in posture (arched back, head tilt, etc.)
  • Ears flat or back (especially in cats and dog breeds with upright ears)
  • AND YES: groaning, vocalizing, yelping

Cats:

  • Hiding
  • Lack of interaction
  • Frequent urination or attempts to urinate
  • Previously affectionate cat resenting being handled
  • Decreased appetite
  • Urinating and/or defecating in the house
  • Ears not erect – flat
  • Reluctant/slow to move
  • Limping
  • Arched back
  • Trembling
  • Sits with feet tucked underneath
  • Won’t jump up
  • Decreased or no grooming
  • Frequently shifting positions
  • Protecting or guarding an area of the body
  • Licking/biting the area that hurts
  • Becomes aggressive
  • Vocalizing- possibly growling- IN CATS, PURRING, WHEN IN COMBINATION WITH SOME OF THE OTHER SIGNS ABOVE, CAN INDICATE PAIN.

These lists are not comprehensive.

Today, there is no excuse for a pet to be in pain.  DO NOT USE THE EXCUSE “HE/SHE IS NOT CRYING OUT.” That is not fair to your pet.

What can I do if my pet is in pain?

Is my pet in pain?There are many ways to address pain in pets.  These include: pain medication, physical therapy, laser therapy, acupuncture, chiropractic, therapeutic massage, weight loss (extremely important with arthritis management), nutraceuticals, low impact exercise, herbal and holistic treatments, etc.

Which pain management options do you recommend Doc?  That depends on your pet’s ailment, your ability to medicate your pet, pet response to medication, availability of the different modalities and how they fit into your schedule.  A pain management plan is made on a case by case basis.  This is not a one-size fits all treatment.

It is important to note that YOU SHOULD NOT GIVE OVER-THE-COUNTER PAIN MEDICATIONS to your pet.  Some drugs like ibuprofen can be toxic causing liver issues.  Tylenol is extremely toxic to cats and has a very narrow therapeutic to toxic window.  Aspirin causes gastrointestinal ulceration in MANY pet patients.  If you medicate with something at home, it will limit what we can prescribe due to medication interactions.

Now that you know what to look for, please watch for any of these signs.  Honestly evaluate if your pet is in pain.  Don’t wait for or depend on vocalizing.  If you feel your pet is in pain or may be in pain, please call us to set up an appointment so we can develop a pain management protocol for your pet.

If you have any comments or questions or if you have any other topics you would like to see covered, please feel free to email Dr. Steve at drsteve@vetcetera.com.