Dr. Anna Dunton-Gallagher
OFF THE LEASH
So, I recently wrote an article on identifying and preventing surgical pain in my patients, but did you know that most of the pain we see is ongoing? We depend on owners to help us identify this chronic pain.
Do you know how to accurately identify pain in your pet? If your pet isn’t walking on three legs or screaming, do you know how to tell if they are in pain? On physical exam we identify areas of osteoarthritis, muscle loss or reactivity on your pet, and people are amazed once we start treating it. Often, they realize looking back how many things changed, but when it is gradual, we struggle to see the small steps.
We all feel that familiar twinge, creak or snap from our joints as we age and they suffer more wear and tear. However, many pets have OA as well. Twenty percent of middle-aged dogs and up to ninety percent of elderly dogs have signs of joint damage and osteoarthritis at some point. That is nine out of ten older dogs! While these numbers are lower for cats, since cats are living longer lives these days we are seeing joint changes in an increasing number of cats too. This is far and away the most common cause of pain in our pets.
Osteoarthritis is caused by repetitive joint trauma, or can be secondary to auto-immune conditions. While trauma is a dramatic wor
d, this can be as simple as chasing a ball daily for five years. Your dog doesn’t have to be an athlete or big jumper, the trauma of carrying around an entire body is often enough. As the body ages, the ability to repair the cartilage in the joint decreases. Remember how quickly you used to heal, compared to how long it takes as you get older? When this is combined with years of activity and often a few extra pounds, joints begin to suffer dramatically. It is especially common in pets with underlying joint problems.
While we cannot stop osteoarthritis from developing, we can slow down its progression. Keeping your pet at a lean body weight is the first and most important step. A combination of the proper amounts of food and exercise make a big difference in the strain on joints, especially the vertebra of the back. As arthritis develops, switching more dramatic exercise for less strain can help. Swimming and long, slow walks can be a great alternative to running and jumping. Cats often enjoy running after food or feathers on string. Instead of incorporating stairs or jumps, have them do this on an even surface without a lot of turning.
If you have a high-energy animal, or one that has an underlying joint problem, consider starting a joint supplement early in life. Both of my dogs run and jump most of the time they are awake, so are on supplements though they are both healthy and not in pain. Supplements with glucosamine and chondroitin help joint lubrication and cartilage repair. I always recommend starting this in young pets that have long backs and short legs, any joint changes, or athletic animals that run and jump constantly.
Luxating patellas (loose kneecaps), previously torn ligaments, extra weight and conformational abnormalities can all contribute significantly to the development of arthritis. Any of these changes warrants starting a supplement for joint health and making sure your pet is at their ideal lean body weight.
Signs of pain
Animals are very adept at hiding pain, and many try to fight through pain to do what they love. Just because your dog has pain doesn’t mean they still won’t run after a tennis ball. Pets don’t always give us a clear indication that something hurts. This is why we need to keep a watch on subtler signs.
You may notice that your pet is slower to get up and down, stiff after resting, especially slow a few hours after a big physical exertion, reluctant to jump up to their normal places, or other behavioral changes. Imagine how you would feel if you went from no jogging to a five-mile day. The way you feel and act is similar to these pets.
Some pets are simply less enthusiastic greeting you at the door. The signs can be subtle, and can go unnoticed for a long time. Cats can start to use the litter box less or miss it because it is hard for them to get in and out or posture. Pets may move their typical resting place, usually to an easier to access place. Some pets even become upset or snap when certain areas of them are touched, or will become defensive during petting they used to enjoy.
Luckily, we have many, many options for treating pain in our pets. When we do a physical exam, we can isolate areas of discomfort. Sometimes x-rays are needed to further evaluate joint changes. Once we have isolated a problem, there are many tools in our arsenal to treat pain.
Many pets do extremely well simply by starting a joint supplement when they have mild joint changes or pain. These supplements aren’t well regulated, so just choosing the cheapest one off the pet store shelf won’t always get you the best results. If you buy it from a source other than your veterinarian, make sure that you are giving the correct amount. Additionally, it is a good idea to make sure that the brand you are buying guarantees the quantity. Many supplements don’t actually contain the amount listed, so make sure your company does quality/quantity checks.
There are also many types of NSAIDS (non-steroidal anti-inflammatory) medications. These can be given at home as needed or daily, depending on the severity of the pain. Most of these medications last 12-24 hours. Some pets simply need them occasionally after big hikes or outings, while others need them on an ongoing basis. Just like people may respond differently to different types of medications, so do pets. Certain medications work better for one dog than the next, so it may take a few tries to find the perfect match.
These NSAIDS are the equivalent of Advil or Aleve in humans. However, they have different formulations and human medication should NEVER be given to pets unless advised by your veterinarian. Many of them can cause serious illness. Additionally, never change the dosage of your pet’s medication without checking with your veterinarian. Just because one works well doesn’t mean two will work better. Often, if you exceed the dose you will risk organ or stomach problems.
Other options to treat pain are herbal remedies, acupuncture, chiropractic or cold laser therapy. These are all very safe and are often good additions to other protocols. These alternatives are especially helpful if older pets are battling organ problems, since they don’t require organ metabolism in the same manner. These should all be through a veterinary professional if possible. Chiropractic and acupuncture courses for veterinarians are, of course, different from humans.
Steroids are occasionally used to treat arthritis pain, but are not a good long-term option. These are especially harmful long-term in dogs. They have more negative effect on the body over a period of time. While potent anti inflammatories, they are a poor long-term option. These should never ever be given with an NSAID, as severe gastrointestinal issues can result from mixing the two.
If your pet is on a protocol for pain that you don’t feel is working, speak to your veterinarian. Combining a couple or changing medications, lifestyle changes and exercise updates can often make a big difference.
Keeping your pets in good shape throughout their life is one of the most important things to delay pain later. Make sure that you keep an eye on the subtle changes. Our pets may have changed a lot of their behaviors, but when it comes to pain they still often hide it as a survival mechanism. Small details like a change in the level of excitement to go on a walk or eating less can actually be a pain indicator. You are your pet’s best advocate, so remember that they feel pain too.