Pain is miserable. We all know that.
It has its purpose, of course: it keeps us from touching a hot stove more than once in a lifetime (at least intentionally).
When pain remains past its usefulness, though, and turns chronic, it becomes a problem. We all know that, too, but when it comes to recognizing and treating pain in our pets, there are a few differences between people and animals that are worth knowing.
1. Probably the biggest misconception many of us have about pain in our pets is that it should be easy to recognize. When we hurt, we often groan, cry out, or talk about our pain. We often talk about our pain a LOT, actually. If anyone around us wants to know how much pain we’re in, it’s not difficult for them to find out.
Animals don’t do any of this. Actually, most of them seem genetically programmed to hide pain. Even pets in severe pain will often continue to eat and drink normally, wag their tails, and sometimes even still get excited to play or go for walks. It’s quite amazing, actually.
But, while an animal in pain won’t necessarily communicate his suffering to you, he will do anything he can to avoid making the problem worse. Often, this results in subtle slowing-down or avoidance of common actions. Your dog might take longer to stand up or lay down than she used to, or avoid using the stairs if they’re not absolutely necessary. Or your previously-crazy cat may become gradually less playful, and avoid jumping up into the windowsill the way he once did. These symptoms are important to notice and take seriously, both because they’re indicative of suffering, and because pain is easier to treat in its early stages.
2. Directly related to #1, but distinct enough to deserve its own number: sometimes, the only obvious sign that an animal is painful is that his behavior changes for the worse. This can mean a dog or cat who becomes crotchety or aggressive (about 20% of the patients who come to see me for behavior problems actually have hidden underlying pain).
Aggression makes sense, when you think about it. Occasionally, however, the behavior change can be a bit more counterintuitive: pain can sometimes result in dementia-like symptoms, especially in older pets. Dementia certainly exists in dogs and cats, but if an older pet is both painful and acting confused, it’s worth treating the pain and paying attention to what happens to the confusion.
3. Most of the time, chronic pain is due to chronic inflammation or muscle tension, often stemming from dental disease or arthritis. But sometimes, the painful tissue itself relatively normal, and the pain is instead coming from overactive nerves. This sort of pain may be triggered by a wound or injury, but it persists long after the tissue itself has healed, often to a debilitating degree that is way out of proportion to the original damage. This is a little-known syndrome called neuropathic pain, and is a close cousin to the phantom-limb syndrome that you may have heard of in amputees.
Neuropathic pain is interesting, because it is a completely different phenomenon altogether than normal pain. What this means for the body experiencing it is that its treatment differs from what’s used for more common types of pain. To treat neuropathic pain, we have to communicate directly with the nerves at fault. This means using electrical impulses (see below), acupuncture, or drugs or herbs that alter the nervous system. Typical anti-inflammatories and pain medications won’t touch it.
Thus, if you know your pet is in pain, but the first treatment tried doesn’t seem to help, keep looking.
This is Indy. He suffers from chronic pain, and has tried just about every pain medication in existence. It turns out, however, that something completely different helps him far more. These pictures were taken on a day when he was too painful to walk, and had to be carried into the clinic. On the left, he’s hooked up to needles and electricity (it sounds painful, but it’s really not). On the right (thirty minutes later), he’s smiling and walking out of the room.
4. When it comes to treating pain of any sort, whether neuropathic or ordinary, what works for one pet doesn’t necessarily work for another. Often, combinations of treatments are needed, especially if the pain is the sort to escalate with time.
Cats are especially tricky when it comes to treatment, because, odd as it may seem, they are quite sensitive creatures. They often can’t handle (or won’t tolerate) many of the medications that work wonders for dogs. This doesn’t mean nothing can be done for them, but it often means that we’re quicker to jump to alternative/holistic treatments than we might be in a dog. Fortunately, the flipside of cats’ sensitivity is that they often respond to more subtle or gentle treatments quite well.
…As a foot note, combination treatments can sometimes be expensive. While I have mixed feelings about pet health insurance in general, I have been surprised by how much some insurance plans will cover. If you suspect your dog or cat may be arthritic down the line, investing in a plan that covers treatments like acupuncture might really pay off.