As uncomfortable and unpleasant as it is, pain has a purpose. It’s what tells a creature that it’s been injured, and it can prevent further injury by signaling danger. Amazingly, people used to think that dogs didn’t feel pain, but we know better now. The past decade has seen advances in recognition of pain in animals, the ability to assess their pain, and the understanding of how they respond to various types of pain-relief drugs.
Acute Versus Chronic Pain
Often described as short-term pain or pain with an easily identifiable cause, acute pain is the body’s way to warn of injury or disease. It usually starts out as a sudden, sharp pain that becomes an ache. Acute pain begins in a specific area and may then spread out. It can be mild or severe and may last for only a few days or for weeks, depending on the type of injury or disease. Pain is most intense within the first twenty-four to seventy-two hours of injury.
Veterinarians commonly treat acute pain that is the result of either trauma or surgery. Causes of acute pain include fractures, bowel obstructions, bladder stones, and gastroenteritis (stomachache). Depending on the cause, acute pain responds well to medication such as analgesic drugs (pain relievers). It may be also be relieved surgically.
The word “chronic” means always present, or significant for its long duration or frequent recurrence. Chronic pain is defined as pain that has lasted for six months or longer. It lasts far beyond the time needed for an injury to heal and no longer serves its purpose of preventing injury. Rather than performing its protective function, chronic pain is often associated with a disease that has a long duration, such as cancer. This is a debilitating type of pain that requires long-term specialized treatment. Unfortunately, chronic pain is more difficult to treat than acute pain. To deal with it effectively, your veterinarian may need to perform a number of diagnostic tests and try many different approaches to pain relief.
Pain resulting from surgery is one of the most obvious forms of acute pain. Unfortunately, while surgery helps to relieve an underlying problem, the pain it causes isn’t always as easy to cure. Surgery (and some invasive diagnostic procedures) can cause significant pain in dogs, but because dogs can’t communicate their level of discomfort, it’s difficult to provide proper pain medication. If dogs don’t get the necessary pain relief, they can lose their appetite and become stressed, both of which reduce the effectiveness of the surgery.
Some surgical procedures are more painful than others. These include orthopedic procedures, which involve trauma to large muscle masses; chest surgery; and surgery of the eyes, ears, nose, or teeth. Dogs undergoing these types of surgeries are more likely to have a high degree of pain and to need a certain level of pain relief. Spay/neuter surgery on young, healthy dogs tends to generate less pain.
Treating Surgical Pain
Veterinarians have learned that the best way to prevent surgical pain is to provide presurgical pain relief. Anesthesia blocks the knowledge of pain during surgery, but now veterinarians can give dogs a combination of pain-relief and anesthetic drugs. Why is this helpful? The anesthetic drugs that veterinarians use today provide quick recovery from anesthesia, which is a benefit. However, that same quick recovery can bring on intense acute pain unless the anesthetic drug is paired with a pain-reliever.
Presurgical pain relief means less anesthesia can be used, as well as less postsurgical pain relief. The improved safety of anesthetic drugs, combined with this ability to provide presurgical pain relief, also allows surgeons to perform more invasive procedures than they could in the past.
Non-Medical Pain Relief for Surgery
Good surgical techniques can also reduce the pain experienced from surgery. These include minimizing tissue trauma by making smaller incisions and preventing tension on suture lines. Bandages to pad and protect the traumatized area are also essential. After surgery, making the dog comfortable on warm bedding as he comes out of the anesthetic haze can also help.
Post-Surgical Pain Relief
Many advances have been made in pain relief for animals, but managing post-surgical and chronic pain is still difficult. That’s because not all drugs are effective in every situation. Some cause side effects when used over a long period, and some aren’t convenient for owners to give at home. Researchers have hope, however, that a new slow-release narcotic drug will be able to provide convenient, safe, and long-lasting pain relief for dogs and improve the treatment of chronic and postsurgical pain. Currently, no medications are licensed for use in dogs to treat postoperative pain, although some veterinarians, with the informed consent of the dog’s owner, may choose to use certain medications to help the dog feel more comfortable after surgery.
Pain management is important for any condition that interferes with your dog’s normal activity, appetite, interaction with you, and ability to have a good day. How pain is managed depends on the type and cause of the pain. Some pain can be cured, while other types of pain can only be managed. In any case, preventing and relieving pain is an important goal that you and your veterinarian can work toward together.
Effective Pain Relief
Because different animals have different responses to pain, different signs of pain, and different reactions to treatment, finding the most effective form of pain relief can be a complex and difficult task. There’s no one-size-fits-all solution. Cost can also be a factor; pain relief isn’t always cheap.
The first thing to realize is that complete elimination of pain isn’t necessarily possible or desirable. The main goal is to help your dog cope with pain so he doesn’t suffer. Successful pain management allows a dog to continue to engage in normal activities, such as eating, sleeping, moving around, and interacting with people or other animals. Factors your veterinarian will take into account in approaching pain relief are your dog’s breed, age, health status, personality, the drugs and techniques available, and the type, cause, and degree of pain.
Medication is probably the first form of pain relief that most people think of, and most veterinarians use drugs with pain-relieving properties as the first line of defense against pain. Opioids, for instance, usually have the effects of dulling the senses, relieving pain, or inducing sleep. Opioid patches placed on a dog’s skin can provide long-lasting and steady pain relief, unlike shorter-acting medications that can wear off before the next dose is given.
Some analgesic drugs include local anesthetics, which numb only a particular area. Certain medications known as nonsteroidal anti-inflammatory drugs (NSAIDs) are often used to treat the chronic pain of arthritis or cancer. NSAIDs don’t directly eliminate pain, but they can decrease it by treating inflammation. Several NSAIDs have been developed specifically for use in dogs, including carprofen, etodolac, meloxicam, and deracoxib.
Dogs process drugs differently than people. Never give your dog any kind of pain-relief medication without first checking with your veterinarian. Tylenol and ibuprofen, for example, are toxic to dogs even in very small amounts.
Different types of drugs have a sedative effect. They work to decrease anxiety and can enhance the effectiveness of analgesic drugs, but they don’t necessarily relieve pain in and of themselves. Never assume that a sedative or tranquilizer by itself will be enough to relieve your dog’s pain. Acepromazine, or “”ace.” is a commonly used sedative that does not provide much in the way of pain relief.
Remember that your veterinarian is tailoring the type of drug, dose, and frequency of administration to your dog’s individual needs. Just because your neighbor’s dog is getting good pain relief from a certain medication doesn’t mean that your dog will respond the same way. The dose and duration of effect of analgesic drugs varies greatly from dog to dog. Your veterinarian may also choose to use a combination of analgesic drugs from different drug classes to achieve the best pain relief and reduce the risk of side effects. As your dog’s needs change, your veterinarian may modify the dose or frequency of administration. He may also require periodic blood work to make sure the drug isn’t affecting liver function, which is a common side effect.
Non-Medical Pain Management
Effective pain management goes beyond drugs. Keeping your dog comfortable will also help him feel better more quickly. If he’s recovering at home, place his bed in a quiet, well-ventilated area. Take steps to limit any stress on him. Your dog may love your kids and the neighbors’ kids, but he’s not up to dealing with them right now. Keep visits short and quiet. Your dog will probably enjoy some gentle petting for a brief time, but high-pitched shrieks and kids running around are likely to put him on edge, and rough play is not appropriate.
Your dog needs to eat well to recover, so diet is important too. He may be in so much pain he doesn’t feel like eating, but he needs nutrition in order to heal. Tempt your dog’s appetite with canned food. If that doesn’t work, try warming his food in the microwave. The heat will improve his ability to smell the food, which should help his appetite. Test it with your finger before giving it to him to make sure there aren’t any hot spots.
Weight loss is another aspect of diet that can help relieve your dog’s pain, especially if he suffers from an orthopedic condition such as arthritis or hip dysplasia. (See Chapter 15.) Veterinarians now believe that overweight dogs with painful hips and lameness caused by osteoarthritis may improve through weight reduction alone. While there’s no cure for osteoarthritis or hip dysplasia, a weight-reduction plan may delay the need for surgery. This is especially important for large-breed dogs, whose size puts more stress on the joints, or active dogs such as sporting breeds, who enjoy lots of running or hunting.