Integrative Pet Vet column: Dogs experience pain
Integrative Pet Vet
It is clear that animals experience pain. The importance of recognizing the presence of pain and providing pain control have become vital aspects of optimal health.
Pain is a complex experience that has been divided into two basic components: 1) the sensory part of the pain stimuli and 2) the mental and emotional perception of the unpleasant sensation. This means that pain is not just the sensation you feel but also how it makes you feel and the memories that it evokes. Conditions like the level of inflammation at the site of injury and the activity of the nerve feedback loops impact on the intensity of the pain sensation.
As a result of the complex nature of pain, the experience of pain is unique to each individual. This can make it challenging to recognize the signs of pain in dogs and to effectively monitor their response to pain management. Signs of pain are sometimes subtle and include reduced activity, reluctance to jump onto the couch or into the car, not going up or down stairs, reduced appetite, episodes of constipation, difficulty lying down or getting up, change in interaction with people or other pets, and excessive grooming or chewing at a specific area. For chronic pain, subtle signs are more common than vocalizations associated with pain. However, some dogs will groan when lying down or growl when touched.
Chronic pain is often associated with conditions like long-standing injuries, joint degeneration and cancer. Acute pain, on the other hand, is present after surgery or around the time of an injury. Assessment tools (pain scales) have been developed to aid in recognizing and managing pain. Some of these methods of assessment are focused on acute pain, and others are used for chronic pain situations. While some appear to be subjective measures, others use observations of behavior to assess pain levels. Even though not all pain scales have been validated, with regular use, they can still provide consistent information, and they help to increase awareness of pain.
Once the presence of pain has been recognized, management of the pain is important. There are many approaches to pain management, and the approach depends on a combination of factors including the source of the pain, the intensity of the pain and the pet’s overall health status. Regardless of the pain management method used, the goals are reduced pain and improved quality of life. General approaches to pain management have been developed. However, it is critical to tailor the approach to the individual pet. This is vital because pain medications have types of pain that they work best on, and they can have side effects that limit the way they can be used.
Some pain drugs, like the nonsteroidal anti-inflammatory drugs (NSAIDs), opioids and local anesthetics, work at the site of injury. Other drugs work to block the nerve signals that transmit the pain message to the spinal cord. Still other drugs work in the spinal cord to modulate the pain signal or at higher nerve centers to influence the perception of pain. Drugs like the NSAIDs and opioids work at multiple places in the pain pathways. Depending on the cause of the pain and other health-related issues, using a combination of drugs may be valuable for improved pain management. Using multiple drugs at the same time is known as multimodal pain management. This is valuable because drugs with different actions can be combined, which can aid in keeping individual drug doses lower and reduce the potential for side effects.
While drugs have a valuable role in managing pain, it is critical to recognize that there are other important ways to address pain. Many of these work well alone or in combination with drugs, depending on the cause of the pain. For example, an overweight dog with osteoarthritis can have a significant reduction in joint pain just by losing weight. Manual therapies like chiropractic or osteopathic manipulations, rehabilitation methods like massage, controlled exercise, application of heat or cold and hydrotherapy, and integrative therapies like acupuncture, laser and herbal therapies can be helpful, depending on the cause of the pain.
If you have concerns that your dog is experiencing pain, contact your veterinarian. They can assist with assessing your dog’s pain and providing an appropriate evaluation for a diagnosis. This information will be valuable for developing a tailored pain management plan.
Ron Carsten, DVM, PhD, CVA, CCRT was one of the first veterinarians in Colorado to use the integrative approach, has lectured widely to veterinarians, and has been a pioneer in the therapeutic use of food concentrates to manage clinical problems. He is also the founder of Colorado Animal Rescue (CARE). In addition to his Doctor of Veterinary Medicine, he holds a PhD in Cell and Molecular Biology and is a Certified Veterinary Acupuncturist and Certified Canine Rehabilitation Therapist. He practices integrative veterinary medicine in Glenwood Springs.
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