We know the issue of pain management is of great concern to pet owners today. As in human medicine, we have a variety of medications available to manage your pet’s pain both before and after surgery and in the event of trauma. We would be pleased to discuss the options available to you and your pet under any of the above circumstances.

One of the most commonly used “pain killers” are non-steroidal anti-inflammatory drugs or NSAIDs. The primary uses for NSAIDs in veterinary medicine are reducing inflammation, pain, and fever.

Like all forms of medical intervention, NSAIDs carry with them potential benefits and risks. Anybody who has taken a human-approved NSAID to treat joint pain, fever, etc. can attest to the upsides: less pain, greater mobility, and an improved quality of life. And the same is true for our pets.

The most common adverse events associated with NSAID use in veterinary patients are vomiting, loss of appetite, depression, and diarrhea that resolve with discontinuation of the drug and appropriate treatment. Rarer but more serious side effects include stomach/intestinal ulcers with possible perforation, kidney and liver failure, and death.

There are species-specific concerns with respect to the use of NSAIDs in animals. For example, cats lack the enzyme systems to efficiently break down NSAIDs, and thus are at a much higher risk of developing potentially serious side effects when given these drugs over extended periods of time. As an example, a single acetaminophen tablet may kill an average-sized cat. In the USA, no veterinary NSAIDs are approved for long-term use in cats, although in Canada and other countries there are approved products for use in cats.

Our pets deserve to live a life that is as pain-free as possible, and NSAIDs are often the most cost-effective way of providing pain relief. The best way to determine whether the benefits of NSAID use outweigh the potential risks for your pet is to talk to your veterinarian, since each pet is unique and in many cases the benefits to your pet outweigh the risks. For pets that are unable to be given NSAIDs, your veterinarian can provide you with advice about other available options.

Cats and Pain: provided by Tiffany Plageman, AAHA staffer.

Cats have a tendency to hide when they’re not feeling well, so it can be challenging to detect or see subtle changes in your cat. Their survival instinct gives them a unique ability to cover a painful condition and because cats are such masters at hiding pain, it’s a good idea to follow an established timeline for veterinary examinations.

Research has shown that many more cats are suffering from osteoarthritis than we are aware of, especially cats past the age of 11. Diagnosing osteoarthritis in cats can be difficult. Your veterinarian will rely on you to tell them about changes you’ve noticed in your cat. They may ask if your cat is moving around less, not climbing or jumping on and off of things as well and if you have noticed any changes in their behavior. Other things that you should be aware of and look for include weight loss, loss of appetite, depression; change in general attitude, poor grooming habits, and urinating or defecating outside of the litter box. A common symptom of osteoarthritis in dogs is lameness, but this symptom is not seen as often in cats.

Osteoarthritis in cats usually affects their joints including the elbows and hips, shoulders and ankles. And, the most frequently affected areas in cats is arthritis of the vertebrae and sternum. Truly, the second biggest challenge of pain management in cats is that they have a low tolerance and higher risk for toxicity to most drugs as compared to other species.

There are fewer pharmaceutical options available to treat pain and osteoarthritis in cats. Because there are fewer options, other treatments include working with your veterinarian to design a weight loss program if your cat is overweight, increasing exercise and/or play. Another area where you can make a difference for your cat is by changing things in your home including things like moving food and water dishes to a more convenient location and providing soft or therapeutic bedding. Purchasing a litter box with low sides, cutting down high sides, or constructing a ramp around the box may also help cats gain entry into the box more easily.

It’s important to be aware of changes in your cat’s behavior, especially as your cat ages. If your cat doesn’t seem to be his/her normal self discuss the changes with your veterinarian.

Pain Management Guidelines for Dogs and Cats

Our pets can’t tell us when they’re in pain – we have to notice the signs. If your puppy steps on a thorn and starts limping, it can be fairly obvious that his foot hurts. But often animals instinctively mask injury and illness to protect themselves from predators, so it can be challenging to detect when they’re in pain. To help veterinarians provide excellent care and educate pet owners about how to recognize when their pets are in pain and what to do, the American Animal Hospital Association (AAHA) and the American Association of Feline Practitioners (AAFP) worked together in 2007 to create the AAHA/AAFP Pain Management Guidelines for Dogs and Cats.

Unexpected and easily overlooked sources of pain

Recognizing when your pet is in pain and quickly seeking treatment not only helps alleviate your pet’s suffering, but strengthens the bond between the two of you. Even subtle changes in your pet’s behavior are reasons to contact your veterinarian because these are the first signs of illness and pain. Sometimes these symptoms can be easily overlooked, particularly in cats. Often, for example, arthritis is attributed to “old age” in cats, rather than pain. Similarly, a cat that urinates inappropriately may have a painful lower urinary tract disease rather than a behavior issue.

Signs of pain

Because cats and dogs tend to hide pain as a protective mechanism, pet owners need to be aware of signs that their pet is in pain. General signs include a change in normal behavior, such as decreased activity, lethargy, decreased appetite, and in the case of cats, decreased grooming. Abnormal behavior such as inappropriate elimination, vocalization, aggression, or decreased interaction with other pets and family members, altered facial expression, altered posture, restlessness, and in the case of cats, hiding can also be expressions of pain. Another sign to look for is how your pet reacts to being touched – if they have increased body tension or flinch in response to a gentle touch in an injured area, it’s time to seek help. Finally, elevations in their heart rate, increased breathing, higher body temperature and blood pressure, or dilated pupils are other pain indicators. In all cases, see your veterinarian to discuss your concerns.

The importance of prevention

By taking steps to reduce the potential for painful conditions in the future, you’ll help your pet avoid unnecessary problems in the future. For example, providing lifelong dental care reduces the development of oral pain, and preventing obesity reduces the incidence and severity of osteoarthritis. Good nutrition and exercise combined with regular wellness checks at your veterinary clinic will go a long way to helping your pet have minimal pain and a healthy life.

Managing pain

Treating your pet’s pain will depend on the source. Once the source of the pain has been determined, surgery may be necessary for acute pain. Because fear and anxiety can amplify pain, and physical restraint can contribute to pain, do your best to keep your pet calm. Often animals in pain can be temporarily distracted and calmed by interaction or handling.

If your pet suffers from chronic pain, many basic lifestyle changes can reduce their pain. For example, controlled exercise and weight management are used to decrease joint stress and improve muscular support of the joints. Easy access to litter boxes (no hood, ramp or stairs, and a low-entry side), soft bedding, raised food and water dishes, nonslip floor surfaces (especially in the food and litter areas), baby gates to prevent access to the stairs, modified access to the outdoors (particularly in hot or cold weather), and appropriate warm-ups prior to exercise may all contribute to pain alleviation. Now there are also more options for pain management, so talk to your veterinarian about your options. Perhaps most importantly, positive and consistent interaction with your pet can improve his or her demeanor.

Monitoring pain

No one knows your pet better than you. While veterinarians are trained to detect pain and illness, the first person to recognize if your pet is hurting will be you. Noticing and reporting any changes in normal behavior is the “front line” to getting the problem resolved. Once the treatment begins, if your pet has had surgery or a traumatic pain, monitor them at least every two hours. For pets with chronic pain, it’s good to keep an eye on them as much as possible, and take them to see their veterinarian at least every three months. By working with your veterinarian to prevent and manage your pet’s pain, you’ll be helping them enjoy a happy life. …..adapted from AAHA website