 Combating Chronic Pain in Pets
The first step in eliminating chronic pain in pets is recognizing it. People often assume that animals who exhibit signs of pain are simply “getting old”. It is also a common misconception that nothing can be done to relieve their pain. Fortunately, modern science has provided us with many options, both medical and non-medical, to eliminate suffering in our beloved older pets.
Chronic pain, often due to osteoarthritis is common in middle aged and older dogs and cats. Animals are masters at masking their pain making diagnosis of chronic pain more difficult. Some of the more obvious symptoms include crying or whimpering with certain activities, limping or holding a limb up, difficulty rising after rest, inability to jump into the car or go up and down the steps and decreased endurance. Some of the more subtle symptoms include self licking or chewing, decreased appetite, hiding, abnormal sitting or posture, and slowing down on walks.
If you think your animal may be experiencing pain, contact your veterinarian. The doctor or assistant will ask you a series of questions to help determine if your pet is in pain. They will then do a thorough examination of all body systems including the musculoskeletal system. Each joint should be evaluated for range of motion, swelling, pain and crepitus (clicking). Muscle mass should also be evaluated in each leg. Radiographs or X rays will need to be taken to determine an exact diagnosis. Joint or bone pain can also be caused by fractures, cancer or infection.
If it is determined that your pet has osteoarthritis, sometimes there are surgical procedures, such as total hip replacement that can be done. Most often, however, medical management is the option chosen.
Non steroidal anti-inflammatory drugs (NSAIDs) are the most common drug prescribed for arthritis pain. In recent years, several new NSAIDs have been developed strictly for use in dogs. (Only one is approved for use in cats.) Most are available in flavored chewable tablets or tasty liquid to make administration simple. Although widely used and generally safe, there can be serious but rare side effects to the liver, kidney or gastrointestinal tract. It is recommended that a series of simple screening blood tests be run prior to taking these drugs. The blood tests should be repeated every 6 months if therapy needs to be long term.
The drugs should never be administered with aspirin or steroids such as prednisone.
Glucosamine and Chondroitin sulfate are nutritional supplements that are believed to help rebuild joint tissue damaged by osteoarthritis. They are usually derived from sea mollusks, shark skeletons, and cattle. They are also available in chewable tablets which are given daily or injections given monthly. Since they are neutraceuticals, not drugs, they are not regulated by the FDA.
Several other prescription drugs have gained recent popularity in treating pain. Tramadol is a distant cousin of morphine. It is very effective in treating pain but often causes some sedation. Amantidine and gabapentin are drugs that block the pain sensation pathway at the spinal cord level. They are most effective when used in combination with other medications.
In addition to pain medicine, there are many other things pet owners can do to keep their animals comfortable. Modifying the home environment is often very helpful. There are a wide variety of orthopedic beds available. These help cushion the joints during rest. Ramps are useful to avoid painful jumping in and out of the car or onto furniture. Dogs with neck and back pain may benefit from elevated food and water bowls.
Above all else, keeping your pet at a lean body weight is a must. Even a few pounds of extra weight adds unnecessary stress and causes pain in deteriorating joints. Your veterinarian can prescribe a weight reducing diet if necessary. There are also diets which contain Chondroitin sulfate and Glucosamine.
Regular light exercise is important. Daily walking or swimming is best. Avoid long periods of inactivity interspersed with vigorous exercise.
Physical therapy and massage can help increase circulation, maintain muscle mass, increase joint range of motion and relieve pain. Often your veterinarian will be able to refer you to someone to perform these therapies or teach you to do them at home.
It is estimated that 20% of dogs and cats suffer from chronic pain due to osteoarthritis. It is often not recognized and frequently untreated or under treated. Fortunately, there is hope. If we as pet owners and veterinarians continue to be diligent in recognizing and treating pain, we can help reduce this problem and give our aging animal family members an improved quality of life. .
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