Dealing with Pet Pain: The Truth Hurts

Successfully diagnosing and treating the pain in pets often means getting pet owners to see the problem first.

If you’ve ever experienced pain following surgery, an accident or injury, or if you have to cope with the chronic pain of arthritis or another medical condition, you know only too well how dealing with pain has a negative impact on not just your physical health but also your emotional health and well-being. Now imagine the frustration of not being able to communicate that you’re in pain, where it hurts and how it impacts you. It’s no wonder that pain can cause significant changes in an animal’s behavior.

Unfortunately, pet owners often don’t recognize when their animal is in pain, particularly if it’s an aging animal whose activity has changed over time. They may attribute it to ‘my dog is just getting old, so he’s been slowing down and getting lazy’ and miss the fact that their pet in is pain. Since animals often change their demeanor once they walk into the clinic, it can be difficult for the veterinarian to recognize subtle signs of pain. Asking the owner if and how the pet’s behavior has changed is an important first step to seeing the big picture and successfully diagnosing and treating the problem.

Behavior as an indicator

A change in behavior is often an appropriate reaction to the pain condition. If it hurts, you want to avoid doing it! For cats, one of the first signs may be litter box avoidance, particularly if the box has high sides that are difficult to climb over. They may stop hanging out in their favorite spots if it becomes too painful to jump up or down from the windowsill, cat tree or favorite chair. Cats are usually fastidious groomers, but when it hurts too much to turn and groom themselves, their change in appearance is an obvious clue.

Dogs may stop wanting to go on walks or play and be reluctant to move off their bed or favorite resting spot. Conversely, they may become restless and pace or whine excessively to try to relieve discomfort. Pets in pain may feel more at risk and express higher levels of anxiety. Usually friendly dogs may start to distance themselves from people or other pets and start to growl or snap to be left alone. Reluctance to walk across slippery floors or uneven surfaces is often a sign of pain, and some dogs may even start resource guarding.

While degenerative arthritis is a top-five condition among both cats and dogs, there are several issues that can cause chronic pain. These include inflammatory bowel disease, a central or peripheral nervous system disease, dermatology conditions (particularly ear infections), dental disease, and discomfort as a result of obesity. Once the cause of the pain has been diagnosed, there are a number of options to treat or prevent it.

Treatment options

Often, the most effective treatment plan is multimodal pain management, using a combination of pharmaceuticals, supplements and nonpharmacological treatments like laser therapy, acupuncture, massage, hydrotherapy, or thermotherapy – the therapeutic application of either heat or cold.

Superficial thermotherapy is one of the most easily accessible and safest treatment options for pain management when applied correctly. Thermotherapy affects tissues in three main ways: changes in blood flow, pain reduction and tissue metabolism. All three effects are interrelated and can help a pet return to their maximum quality of life. Hot and cold gel packs and heating pads or warming units with safety features to protect pets are items your clinics should keep on hand. More practices are investing in hydrotherapy units that can treat large parts of the body or the entire body in a water bath, whirlpool or underwater treadmill.

Laser therapy – or photobiomodulation therapy (PBMT) – not only opens the door for a number of treatment possibilities but also the opportunity to build customer loyalty with regular, effective pain management treatments. Everything from injuries or surgical incision sites to ear infections, impacted anal glands and hot spots can be treated quickly in the exam room with the owner present.

Many pets with chronic osteoarthritis are unable to take NSAIDs due to liver or kidney disease or gastrointestinal ulceration. With a treatment protocol using PBMT, a veterinary nurse can typically perform the therapy, allowing the veterinarian to re-evaluate the patient as needed. Laser therapy is particularly important treating OA in cats that can’t take chronic NSAIDS and won’t tolerate acupuncture or thermotherapy.

When it comes to cats, NSAIDs are the most prescribed medication, but felines have a unique metabolism that needs to be considered when prescribing them. A panel of experts from the International Society of Feline Medicine and the American Association of Feline Practitioners published the “2024 ISFM/AAFP Consensus Guidelines on the Long-Term Use of NSAIDs in Cats” in June of this year. The guidelines aim to enhance cats’ quality of life while minimizing potential risk from long-term NSAID therapy. They include advice to help pet owners provide the best care to reduce chronic pain in the home. Another client education tool to mention to your practices is the AAFP pamphlet “Treating Chronic Pain with NSAIDs.” It’s an excellent handout for vets to start a discussion on recognizing and managing pain with their cat owning customers and can be ordered from the AAFP’s website, catvets.com.

Untreated pain suppresses the immune system and slows healing time, interferes with sleep, decreases mobility and impacts overall well-being. When it comes to animals, there isn’t always pain with a behavioral issue, but there is almost always a behavioral issue with pain. Your knowledge of the wide spectrum of treatment options for acute and chronic pain will help your clients provide the optimal care to maximize their patients’ well-being.

Pain and Problem Behavior in Cats and Dogs

A study published in 2020 by Dr. Daniel S. Mills, et al. found that over 80% of all behavior problems have their basis in pain. Since behavior issues are one of the top five reasons pets are surrendered, attempting to treat unwanted behavior without treating underlying pain causes frustration for the pet and pet owner that can have serious consequences. In other words, pain should be ruled out first before treating behavior alone.

Dawn Singleton-Olson has more than 25 years of experience in the animal health industry, including distributor sales, manufacturing, practice management and as a zoo supervisor. She is a volunteer, fundraiser and board trustee for several humane organizations and the Omaha (Neb.) Police Mounted Patrol.

Image credit: istockphoto.com/Natali_Mis; istockphoto.com/Photoboyko