Silver Sands Veterinary
Pain or No Pain-In Search of a Pet Hero!
DH DeForge, VMD 16May2013
“Of pain you could wish only one thing: that it should stop. Nothing in the world was so bad as physical pain. In the face of pain there are no heroes.”
― George Orwell, 1984
― George Orwell, 1984
Orwell states, "in the face of pain there are no heroes!" As advocates of the companions we love, I would like to revise the Orwell statement. The companion supplies to its caretaker unconditional love in return we can become their heroes by removing pain!
Pain exists and it is real in the companions that we love. The pet owner must be knowledgeable about pet pain; anticipate its presence in different conditions and life stages; and most importantly seek help to eliminate that pain.
Below is a partial list of pain problems in our companions (i.e. dogs and cats):
- Orthopedic pain and osteoarthritis/degenerative joint disease
- Disc slippage; Disc Prolapse
- Muscle, tendon, and ligament injury
- Trauma injuries during play and exercise
- Oral Disease including broken teeth, cavities, advanced periodontal disease, TMJ pain, and jaw fractures
- Cat and Dog Stomatitis-advanced oral inflammatory disease
- Cavities or Caries-i.e. Resorptive lesions with pulp exposure in cats
- Advanced ulcerated skin conditions
- Post-surgery pain after spaying and neutering
- Post surgical pain after exploratory surgery; mass removals; bone fracture repair; and other general surgery experiences
- Advanced outer ear infections
- Advanced anal sac impaction and abscessation
- Constipation
- Cystitis and urethritis
- Protracted Vomiting and/or diarrhea
- Cancer-soft tissue and bone cancer
- Intestinal blockage
- Pancreatitis
- Male Cat: Urinary Tract Obstruction
- Male Dog: Urethral obstruction
- Glaucoma
- Eye Ulceration
- Eye Trauma
- Broken nails
- Airway obstruction with Stridor
- Long Bone Trauma from auto accidents
- Abdomen and Chest Trauma from auto accidents
- High-Rise Syndrome Trauma-High-rise syndrome is the phenomenon of cats or dogs falling from higher than two stories (7–9 m / 24–30 ft). This is generally from high-rise buildings, or skyscrapers, and is also used to refer to the injuries sustained by a cat/dog falling from high up.
The most dangerous pain is hidden pain or occult pain. Some have described this pain as "bad pain!" It is a form of pain that is not expressed. It is generally chronic in nature and the pet learns to live with that pain believing there is no life without pain. That is the tragedy of "bad pain!"
Buscaglia teaches us that defeat is not as important as "regret"! Pets with pain have a terrible quality of life. They are helpless and alone. They become emotionally detached with constant anxiety and fear. Working with your veterinarian you must recognize and offset this pain. It requires just a few moments of our day to recognize and find help for our pet in pain. There will be no regrets after this is accomplished.
Once pain is suspected, it is time to visit the veterinarian to discuss the testing necessary to allow definition of the cause of that pain. Once the cause is defined, the pain is graded and a pain treatment plan is established by the doctor. Your veterinarian will teach you how you can grade your pet's pain at home by observing:
- Movement or Activity level changes
- Behavior Patterns altered
- Vocalization-Crying-Loud Meowing-Barking pattern change
- Sleeping habits-not consistent with past-not resting enough or maybe sleeping more
- Tactile Behavior-no able to be touched or help-i.e. guarding when lifting
- Quietness
- Restlessness
- Unable to move neck left or right; and up and down
- Snapping or hissing at family members
- Well groomed patient develops and unthrifty coat-esp. in cats
- Teeth chattering or Grinding
- Excessive licking
- Rubbing face-dermatolgical or oral pain
- Increased eyeball size-possible glaucoma
- Limping
- Difficulty getting up or difficulty lying down
- Not wanting to go on walks or exercise
- Not wanting to play fetch or chase balls
- Drinking excessive water
- Difficulty urinating or defecating
Pain is REAL. Do not stop giving the pain medicine that your doctor prescribes after surgery. If you have not been given pain medicine, please speak to your doctor about a pain control program during recovery.
There are many alternatives that are very safe for pain control. Please do not pain medicate on your own. Never take another pet's pain medicine and give it to a different pet that you feel is in pain. Seek the guidance of a veterinarian. Never change pain medicine dosage without talking to your doctor. Make sure that all pain medicines are in a medicine cabinet or a locked cabinet where pets and children are protected from accidental ingestion.
The pain medicines that veterinarians use are varied depending on general health of the patient; age; breed; weight; and condition being treated. See the list below for common pain medicines that veterinarians are utilizing today.
- Opiates: Morphine-Oxymorphone-Hydromorphone-Buprenorphine
- Fentanyl Transdermal Pain Patches-care and caution in geriatric patients
- Tramadol-a central acting opioid-minimal side excepts except for lethargy
- Gabapentin-useful in dogs and cats-minimal side effects-groginess can occur
- Steroids-cannot be used in all patients because of pre-existing medical conditions
- Non-Steroidal Anti-Inflammatory Drug-NSAIDs-talk to your doctor about side effects with concurrent conditions. Do not use human NSAIDs in pets. There are specific animal NSAIDs that your veterinarian will prescribe if they feel this is the best drug for your pet's pain
- Alternative Therapy including: low-level laser therapy; targeted pulsed electromagnetic therapy; acupuncture; massage therapy; Eastern herbal analgesics etc.
Before starting any analgesic program, the veterinarian should seek help in diagnosing the cause of pain with a veterinary pain specialist; an internal medicine doctor; a radiologist; a neurologist; or an orthopedist.
Pre-treatment laboratory testing is essential to be sure the drug chosen will not complicate a pre-existing medical condition. Patients in liver, kidney, or heart failure may need reduced dosage amounts of pain medicine because it could take them longer to remove these pain drugs from their body. Other pain medicines cannot be used at all because of problems with detoxification due to liver or kidney failure present along with pain. Other choices for pain control must then be chosen by your doctor.
Finally, in the cancer patient or terminally ill, seek the assistance of a doctor that provides a Hospice setting for animals. The cancer patient or the terminally ill patient needs a home hospice setting. The hospice veterinarian will work with your regular DVM; an emergency center; and your family to be sure there is a pain free quality of life during these precious days in the End of Life Stage for your pet.
Remember, pain control is not just for the terminally ill. Pain control is for all patient in each life stage: Puppy/Kitten; Adulthood; Geriatric; and End of Life Stage. Our companions supply to us "unconditional love" in return it is our obligation to find and remove pain in conjunction with a trained health professional. Become your pet's HERO today. It will become an important journey of love!
“Unconsciously we all have a standard by which we measure other men, and if we examine closely we find that this standard is a very simple one, and is this: we admire them, we envy them, for great qualities we ourselves lack. Hero worship consists in just that. Our heroes are men who do things which we recognize, with regret, and sometimes with a secret shame, that we cannot do. We find not much in ourselves to admire, we are always privately wanting to be like somebody else. If everybody was satisfied with himself, there would be no heroes.”
― Mark Twain
― Mark Twain
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