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If you think your dog shows signs of pain and you would like to know how to manage your pet dog pain, you came to the right place.
All animals, humans included, can experience pain. To what degree may vary, but pain receptors in some fashion exist in all mammals, amphibians, reptiles, and birds. Even insects can feel pain (Tiffin, 2016). But not all species show pain in the same way.
While humans may seemingly rule the animal world, we are frail overall regarding pain tolerance. However, other species, like many dogs, tolerate pain or hide it with ease.
Regardless of the type of pain and how stoic or wimpy your dog is, there are some telltale signs that your dog may be in pain. Knowing these signs, monitoring for them, and, if noted, seeking veterinary care when pain first starts is critical to ensure your dog remains healthy and happy.
Reasons your dog may be in pain
Dogs can be in pain for assorted reasons. For example, they may have underlying diseases causing secondary pain issues, primary diseases, orthopedic injury, arthritis, or neurologic diseases.
Pain can be acute (less than 2-3 weeks in duration) or chronic (greater than 2-3 weeks duration).
Ideally, treating pain early on prevents chronic long-term pain and complications.
These disease states commonly cause varying levels of pain in our canines.
- Arthritis (commonly of the hips, knees, elbows, and shoulders, but it can occur at any joint).
- An inflammatory condition that causes degeneration to the joints over time and leads to pain, decreased ability to get around, and other changes (Tramuta-Drobnis, 2020)
- Teeth pain (dental disease, gum disease)
- Ear infections
- Skin infections
- Your pet may seem itchy, not necessarily painful, but itch and pain run along the same nerve pathways, so they have similarities.
- An itchy dog and a painful dog can have comparable signs and should be evaluated by your veterinarian.
- Back disease, for example, spinal dysfunction aka a slipped or herniated disc)
- Pancreatitis – Inflammation of the pancreas (visceral aka internal organ pain)
Signs of pain in dogs
Dog Pain – What Signs Should You Look For?
Signs of pain will vary depending on what hurts. Some dogs are very stoic; they hide pain, so even no pain can be a sign of discomfort in some.
Many breeds will not seem to show pain, while others are the exact opposite, being babies about a tiny cut. Pitbulls, for example, are notorious for being either stone-faced, showing no signs of distress despite severe injury or illness, or acting like complete wimps. Huskies routinely err towards the melodramatic, being more likely to show signs of distress early on.
General signs of pain may include (American Animal Hospital Association (AAHA), 2007; Epstein, 2018; International Veterinary Academy of Pain Management (IVAPM), 2017a, 2017b; Tramuta-Drobnis, 2020)
Before discussing pain management, we need to discuss signs of pain. To be proactive for your pet, you need to recognize signs that your dog is in pain early on.
- Panting (outside of exercise or hot environments)
- Hesitating to jump on or of things, or before climbing the stairs
- Tolerance for other pets or younger family members may dwindle.
- No longer enjoying being picked up or brushed
- Eating may decrease or cease – but remember, many dogs will still eat when painful
- Changes in sleeping patterns
- Sleeping more
- Sleeping less
- Restless sleep
- This may be when getting up or laying down
- Or could be laying down or sitting differently than normal
- Restlessness – Increased pacing, not wanting to settle down
- Hiding or less socialization
- Licking excessively in one location may indicate pain in that or a nearby area.
- Decreased playing
- Holding the eyes closed or squinting
- Some say the eyes lose their luster. Some feel that they can just sense a problem but just cannot put their fingers on it.
- Crying out in pain with movement or suddenly
- Howling in pain or in general
- However, remember that not vocalizing doesn’t rule pain out!
- Exercise intolerance –
- Failing to walk as far as they used to
- Stopping in the middle of a walk and not wanting to proceed.
- Behavior changes
- Dogs who never have been aggressive or bitten in the past may become so if the pain is significant or unrecognized
- Often occurs when startled
- Having accidents in the house
Signs of pain specific to arthritis may include (Epstein, 2018; Tramuta-Drobnis, 2020)
- Limping on one or more legs
- An abnormal gait (such as hopping, dragging a leg, a change in their run, or not wanting to run)
- Readjusting positions often
- Cracking of the joint when shifting positions, exercising
Remember, it is never normal for a 4-legged animal to walk on only 3 legs, so if they are holding a leg up, there is a reason, and they are painful.
General pain management options
Let’s talk about some pain management options regardless of the reason for pain. We’ll discuss the broad categories and modes used to treat pain, such as orthopedic, neurologic pain, visceral (organ) pain, or a combination.
One key thing to remember is that even what is considered ‘natural’ may cause harm. You can drink too much water, have too much salt, even take in too much oxygen.
What is safe for one species is not always safe for other species. Additionally, ingredients in some of the human products can be toxic to animals.
Do not give your pet medications of any kind without consulting with your veterinarian.
Medications safe for humans may be toxic to your pet. Never give them medicines without talking with your vet and without knowing the side effects. Sometimes a drug may be safe but may interact with something the vet would want to prescribe.
Please remember that your vet may prescribe human medications for your dog. However, unless directed by a licensed veterinarian, you should never give any over-the-counter medications (OTC) to your dog or share your own medicines (prescription or OTC) or another pet’s medication,
We will not go into how all these drugs work and what drugs are used when. That is a blog for another day. But we want you to know what medications your veterinarian may prescribe. They may be used alone or in combination to help manage your pet’s pain. Some are used short-term, say for the duration of an injury, or long-term, to manage chronic conditions, such as arthritis.
Types of medications veterinarians may use to treat pain include
- Non-Steroidal Anti-Inflammatory (NSAIDs) pain medications such as Deramax® (Deracocib), Rimadyl®(Carprofen), Onsior® (Robenacocib), Metacam® (Meloxicam), Galliprant® (Grapiprant)
- These drugs decrease inflammation and provide pain relief
- Gabapentin: This drug was originally designed for human epilepsy. However, it was found to work better for neurologic and generalized pain conditions. It will not treat inflammation itself. But in combination, therapy helps support dogs with arthritis and other conditions when added to a pain management protocol. It is very safe and well-tolerated.
- Amantadine: This was initially created as an anti-viral drug in humans. However, it was found to be ineffective. Still, it was found to minimize the over-sensitization of the brain to chronic, often untreated pain. See the following for additional information https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4952766
- Tramadol: This drug may be used by some veterinarians alone or in combination. It is the only drug in this class. Some veterinarians find that in combination with other medications, it can help with the pain. It can negatively affect appetite and cause constipation. It is not an effective pain medication by itself in dogs.
- Opioids: Narcotics. These are commonly used in the clinic for pain management and surgical procedures. In severe cases of pain, oral products such as codeine may be sent home with your pet.
Additional medications may be used depending on the dog, underlying conditions, the ability of the pet parent to afford frequent blood monitoring and re-evaluations, age of the pet, and other factors.
Nutraceuticals and Supplements
Those prescribed by your veterinarian likely use evidence-based medicine. Vets try to recommend products that the ingredients have been shown to help support and improve function, decrease inflammation, or a similar related factor. There are a ton of products out there, both prescription and OTC. Some have scientific merit others do not. So while you may not hurt your pet by giving something you buy, make sure to mention the brand and the product ingredients to your vet to ensure safety.
Examples in this category include
- Glucosamine Chondroitin Sulfate supplements – provide the regular makeup of the joints and can help with the protection of joints, and some products can even help decrease inflammation over time
- Hyaluronic acid such as Adequan® an injectable medication or an oral formulation
- Methylsulfonylmethane (MSM)
- Omega 3 fatty acids: In large doses, these fats can be anti-inflammatory. To provide them orally at a dose high enough to do so isn’t feasible, but they can support coat health and other immune functions in oral form.
Examples of specific products can be provided by your veterinarian as the formulations vary from one product to another. However, generally speaking, products that require prescriptions or are obtained directly from your veterinarian have more rigorous evidence to support their use.
Ensuring a healthy diet is vital for many reasons. As animals age, their nutritional requirements change. Ensure you are feeding either a prescription diet for weight loss, joint mobility, or other underlying disease states. Or, choose an OTC food right for your pet’s age.
This author would be remiss if she didn’t mention weight management. Many dogs who have arthritis, among other diseases, are often overweight or obese. This only increases inflammation and pain. If we treat pain but fail to provide a safe and effective means for weight loss, the pet’s quality of life will not improve sufficiently. Additionally, it puts the pet at risk of other diseases, making arthritis worse. Exercise programs, prescription diets, and physical therapy all play a role in weight management.
Always make sure you use a measuring cup when feeding. If your pet is overweight, talk with your veterinarian about what food to feed and feeding amounts. If you feed what is on the bag and continue to feed treats, wet food, and people food, you will not ensure weight loss success.
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Research done by several food brands demonstrates that certain ingredients can help decrease inflammation and treat pain over time. By feeding these foods, one can reduce the need for oral medications or higher doses of medications over time. They use various ingredients to support mobility, such as hyaluronic acid, omega 3-fatty acids, and more. These foods can be combined into a weight loss mobility formulation when needed to help your pet achieve its ideal body weight and remain as comfortable as possible.
Medicines, food, and supplements are not the only means to help provide pain management. We have complementary options out there supported by varying degrees of scientific evidence. Some have more supportive evidence than others. Their use is often based on successes in human medicine, for which scientific evidence may also be lacking. Individual veterinarians have different recommendations, and the availability of these will vary in your area. Examples include (Davies, 2013; Tramuta-Drobnis, 2021)
- Transcutaneous Electrical Nerve Stimulation (TENS) Therapy
- Massage therapy
- Massage therapy may reduce pain associated with the muscles and related tissues and help to improve a patient’s posture, gait, daily activities, and more. Massage studies are limited. But evidence suggests that, when used in combination with other forms of pain management, massage likely improves overall comfort and function with orthopedic and muscle type injuries as well as arthritis (Riley et al., 2021).
- It can be taught by a veterinary physical therapist and done at home by you, the pet parent.
- Osteopathic therapy (manual therapy)
- Photobiomodulation Therapy AKA Laser therapy AKA Laser Light Therapy
- Current research shows slight favor in support of their use for different chronic pain conditions. Still, most of the information provides only insufficient evidence in support of laser light therapy use. However, clinically and anecdotally, many veterinarians feel it is beneficial as part of a multi-modal pain management plan. In other words, it should not be the only pain management tool but can be helpful in combination with other tools.
- Physical therapy (physiotherapy)
- Strengthening exercises and exercises geared to help improve range of motion, strength, function, and more.
- Water therapy (underwater treadmill or pool therapy)
- It can be used after orthopedic surgeries, traumatic injuries, or for long-term arthritis management.
Talk with your veterinarian about what they recommend and about options near you.
Suppose your dog has arthritis or general signs of pain, or you perceive your pet to ‘just be getting old.’ In that case, we want to not only treat pain but also make getting around easier. This can include several assistance aids to help them, such as
- Carpet runners on hardwood floors or uncarpeted stairs
- Carpets vs. flooring
- Stairs or ramps to aid in getting on and off furniture or in and out of the car (Reisen, 2020)
- Harnesses that help you lift them and support them to stand, posture to go to the bathroom, and more.
For example, the Help-em-up harnesses are perfect for dogs with arthritis and back issues
When thinking about pain, keep the following things in mind (Tramuta-Drobnis, 2020)
- Age is not a disease.
- Just because your dog still eats well doesn’t mean your canine friend isn’t in pain.
- Animals are more tolerant of pain and hide it well! They often will still do things they love when in pain, so we must be their advocate.
- Controlled exercise is beneficial when pain is well maintained in dogs with arthritis.
- Many OTC supplements, nutraceuticals, CBD products, and others claim to treat arthritis or another condition. Remember that non-prescription products are not regulated. Claims made on these products should be discussed with your veterinarian. Some products have scientific research behind them, while other products have none.
- Testimonials do not suggest that a product is safe, effective, or even has been studied. They may act as a case study but should never be used as the sole reason to select a product.
- Some OTC products can cause harm if combined with other drugs.
- Some human products are toxic to dogs, such as Ibuprofen, Aleve, Naproxen, and more.
- Some may have a safe dose range but are not used because of risks. For example, veterinarians no longer recommend giving aspirin to dogs.
- We have much better, safer, and more effective drugs labeled for use in dogs.
Studies have shown that dogs given aspirin have microscopic degrees of bleeding in their GI tracts (Whittemore et al., 2019).
- Suppose the owner gives aspirin before coming to the clinic. In that case, we cannot use another dog-specific, dog-safe NSAID for 2 weeks due to how aspirin works and the risk of GI ulceration. Thus, limiting our ability to control pain and inflammation.
CBD, Cannabinoids, hemp, and related products (American Veterinary Medical Association (AVMA), 2021)
Many people ask veterinarians about various products related to Marijuana, such as CBD, hemp, and others. You may be wondering why this author didn’t list them as options above for treatment. She didn’t mention them for the same reason your veterinarian may not discuss it with you in the clinic.
Don’t get mad if your veterinarian won’t discuss this. In most states, the veterinary medical associations have prevented veterinarians from discussing CBD therapy for pets. This is because
- Marijuana is not legal at the federal level.
- CBD products are not yet regulated federally by the FDA (Federal Drug Agency).
- Both human and animal CBD products across the United States have no quality control mandate. So, unless the product has been third-party tested, we have no idea if what is in the product truly is.
- Veterinarians recommend products based on scientific evidence. While studies are being conducted as I write this and the number of studies is increasing, they are still few and far between. Evidence suggests that these products may be helpful for epilepsy and pain management. Still, more research is needed before the American Veterinary Medical Association and individual states allow the use of these products under a veterinarian’s license.
Until the individual state veterinary associations permit discussion with owners about the possible benefits and risks and the types of products and until there is oversight for the products to ensure safety and demonstrate that they work, veterinarians in most states will not even bring up this topic. Some may simply respond that they cannot legally discuss it with you. This does seem to be on the horizon, though, so keep an ear out for more updated information.
Early recognition of pain in your dogs will help prevent undue suffering.
We have techniques and medications that can ease your pet’s suffering. Some are short-term solutions; others may be long-term. But using various methods to control or ideally resolve pain gives your pet the best likelihood of improving or recovery. Ultimately, our goal is to improve the quality of life of you and your pet.
Last update on 2021-09-25 / Images from Amazon Product Advertising API