Pain Management

September 26, 2019

It hurts, but I won’t cry
It can be difficult to tell when your pet is in pain. Your dog, and most certainly your cat, will not cry out–no matter how bad the pain may be, they will try to “tough it out.”

Look carefully for subtle changes your pet’s behavior that may indicate pain. Your cat may spend more time alone and less time socializing with you or other pets; they may miss the litter box or not be able to jump up to their favorite spot on the windowsill. Your dog may get up and lie down more slowly than usual; they may hesitate before climbing stairs or jumping into the car.

Other signs may include:

  • Panting or increased respiratory rate
  • Hunched posture
  • Restlessness

Never give human pain medication to your pet without consulting your veterinarian. These drugs can can cause severe, potentially fatal, side effects.

Acute Pain
Acute pain is most commonly caused by injuries to muscle, joints, nerves, or the spinal cord. Acute pain can also be caused by ear, skin, or abdominal disorders.

Our Class IV therapy laser can reduce this kind of pain faster than any other modality. When used in combination with anti-inflammatory medication, this is usually adequate to manage your pet’s pain until the injury heals. In cases of severe pain, we can administer narcotics and other medications to keep your pet comfortable during their recovery.

Chronic Pain
Chronic pain is one of the most frustrating problems we are faced with in the veterinary field. Unfortunately, it is also one of the most common.

The primary culprit is arthritic joints or degenerative spinal disorders. These conditions are progressive and will require monitoring and treatment for the rest of your pet’s life.

Here are a few things you can do around the house to help improve your pet’s quality of life:

  • Be “The Biggest Loser.” Start your pet on a weight control program. Fat cells naturally produce inflammatory chemicals. If your pet is overweight, an excess of these chemicals can damage cartilage and worsen or even cause arthritis. Extra pounds also put additional stress on your pet’s already painful joints and spine.
  • No more Slip n’ Slide. Put area rugs or mats over slippery surfaces like tile, concrete, or wood flooring. Add stairs or a ramp to help your pet reach their favorite spot on the bed or by the window with ease.
  • Be vigilant. Monitor your pet for changes in behavior that may indicate increased levels of pain. As chronic pain worsens, we can add additional layers of therapy to help keep your pet comfortable.

Treatment for chronic pain will usually include one of these medications:

  • Non-steroidal anti-inflammatory drugs (NSAIDS) are always the core of chronic pain management. They are extremely effective at reducing pain. Unfortunately, these drugs can cause liver or kidney damage in some patients. We encourage regular checkups for pets on NSAIDs to monitor organ health.
  • Gabapentin blocks the perception of pain at the spinal cord and brain and is especially effective at combating nerve pain. It is a safe and inexpensive adjunctive therapy that does not require monitoring.
  • Tramadol partially blocks narcotic pain receptors and suppresses other neurohormones which increase pain. It, too, is safe and inexpensive and does not require continual monitoring.

We also believe that medication isn’t the only answer. Speak with one of our doctors to learn more about these non-traditional treatment options.

  • Our Class IV therapy laser can reduce pain, swelling, and inflammation. It can also increase blood supply to the affected area to hasten healing.
  • Water or hydrotherapy provides non-weight bearing exercise to help your pet strengthen and maintain supporting structures. Pain can actually be reduced when the joint or spine is supported and kept stable by surrounding muscle.
  • Acupuncture is another homeopathic way of reducing pain.

Surgical Pain
Pain management is essential to prevent the unbearable process of pain “wind-up.” If post-operative pain is not controlled adequately at the site of surgery, it will build in intensity, working its way through the nervous system–traveling up from nerve to nerve until it reaches the spinal cord, then the brain, firing pain impulses out to all parts of the body. What was once pain from a simple foot surgery radiates out your pet’s back, hips, abdomen, chest–everywhere.

Beyond the obvious desire to keep your pet comfortable, careful pain management can actually decrease healing time.

  • Pain causes an increase in the production of cortisol, the body’s own form of cortisone. Cortisol prevents the liver from producing proteins vital to the healing process. Cortisol also impairs the body’s inflammatory system, which would ordinarily send cells into the surgically-invaded tissues to help them heal.
  • Pain leads to heightened anxiety, making it difficult for your pet to get the rest they need to recover.
  • Pain will cause your pet to lick at the incision, increasing irritation at the surgery site and dramatically increasing the possibility of infection.

Depending on the procedure, post-surgical pain can last anywhere from a few days to a few weeks. Your pet’s well-being is our first priority–we strive to keep your pet as comfortable and pain-free as possible during this time. Here are a few of the medications in our surgical pain management toolkit:

  • Our first line of defense against pain are anti-inflammatory medications, such as Rimadyl or Metacam. These medications are started before surgery so they are already working to control pain when your pet awakens from anesthesia. Managed well, these anti-inflammatory medications provide all the pain relief your pet will need after many common procedures, including simple growth removals, minor extractions, spays, and neuters.
  • Narcotic-like medications are available in many forms and are frequently used for more painful procedures.
    • An intravenous application begins working instantaneously and can be repeated until your pet is comfortable.
    • We routinely use the fentanyl patch major extractions and advanced abdominal or orthopedic surgeries. This trans-dermal narcotic-like medication is exceptionally effective, but takes twelve to twenty-four hours after application to reach effective levels.
  • For dewclaw removals, or any other surgery of the foot, we often use a ring block with a combination of two local anesthetic agents. One agent provides immediate relief; the other provides a longer-lasting pain relief.
  • We use injectable local anesthetic agents for dental extractions–just like your dentist. These local agents help immensely in the first few hours after surgery, when your pet’s pain is the most intense.

After surgery, your pet will be monitored by a Marine View staff member experienced in detecting the many subtle signs of pain. We treat each patient as an individual and give exactly what your pet requires to be comfortable during their recovery.

When your pet is discharged from our hospital, a technician will meet with you to discuss the signs to look for to determine if your pet is in pain. See our discussion of general signs of pain above.

If you notice any of these symptoms, please call us immediately so we can adjust your pet’s pain management plan.

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