One of the most important roles a veterinarian has is pain prevention and management in our patients. It is part of the oath we take when we join the profession. We swear to prevent and relieve animal pain and suffering. Advances are constantly being made in recommendations and therapeutics available to manage acute and chronic pain in veterinary medicine.
Balanced anesthesia is our goal for our surgical and dental patients. Combining multiple types of medication and modalities we are able to provide analgesia and use lower amounts of anesthetic agent, making a safer and more comfortable experience for our patients. Local nerve blocks are used more commonly in veterinary medicine; one example is blocking the nerves supplying teeth prior to extraction. We routinely perform dental nerve blocks on any pet having a complicated extraction and it markedly decreases the pet’s anesthetic requirements and improves their attitude when discharged. Balanced anesthetic protocols greatly improve the results and decrease complications associated with anesthesia. Pets going home the same day of the procedure look so much more awake and comfortable when using modern, multi-modal protocols.
Management of chronic pain in our patients is also a veterinarian’s responsibility. One of the biggest challenges in pain management is identifying a pet is experiencing pain. Many, if not most senior cats and dogs suffer from osteoarthritis, but most people attribute changes to age. Pain in dogs is often easier to see; they get up slower, they sometimes will limp and aren’t able or willing to run, jump and play. There are many treatment options available for dogs. The goal, like in anesthesia, is to use multiple modalities to manage the symptoms in order to decrease possible side effects of medications. We recently brought cold laser therapy into our practice, and are seeing some really positive results for dogs with chronic arthritis. Combining treatments including pain medication, joint supplement, fatty acid supplement along with weight control and low impact exercise, many dogs with arthritis can have a very good quality of life.
It is much more difficult to identify arthritis pain in cats. Cats, by nature, hide any physical shortcoming they have. In addition, when they have arthritis it often involves the same joints on both sides- so they don’t limp. It’s very difficult to make a cat move around to evaluate their gait during a medical exam. They often just squish in one place and pretend they can’t move at all. At home, things to look for in your cat include: decreased activity, difficulty jumping, standing up or taking the stairs. Some cats will stop grooming themselves, or may excessively groom an area that is painful. Some cats will have behavioral changes, including inappropriate elimination. Sometimes x-rays can help diagnose arthritis, but they aren’t always conclusive. Cats also don’t tolerate pain medications very well, they don’t metabolize medications the same as humans or dogs. Human pain medication can be deadly to cats and veterinary non-steroid anti-inflammatory (NSAID) medication also has to be used judiciously. That doesn’t mean there aren’t multiple therapeutic options available. Omega fatty acid supplements can be therapeutic, either adding fish oil to the food or using diets made with high levels of fatty acid specifically for cats with arthritis (Science Diet j/d for example). Joint supplements can also be beneficial, oral and injectable forms are available. Weight management is one of the most important prognostic factors for a cat with arthritis. Consult with a veterinarian for the best weight loss plan to avoid complications associated with weight loss too quickly. Laser therapy can help cats, and many of them enjoy the therapy sessions, laying down, purring and kneading. It’s like a massage with a warm light, probably feels like a hot stone massage to a kitty. Multiple pain medications are available including gabapentin, amantadine, tramadol, and buprenorphine. Every case is different and requires working with your veterinarian and following up to evaluate what is working and when changes or additions are needed.
Environmental management is very important for arthritic pets. There are many things that can be done to make a pet more comfortable at home. Raising a pet’s food dish so they don’t have to bend down to eat, ramp and stair placement to decrease the need for jumping, litter boxes with lowered edges for easier entry, padded bedding and providing low impact exercise activities to keep the pet’s joints mobile and to help manage weight. One product I really like for older dogs is toe grips which help increase traction on slippery hardwood and stone floors.
There is so much available to help prevent and manage pain for veterinary patients it is now considered one of the points evaluated at every exam, just like in human medicine. We just can’t ask them which face to pick on the scale to rate their pain level.
I hope I gave you something to think about and feel free to contact me with any questions or comments; [email protected], our website www.wildernessvet.com or our Facebook page. Check out the laser therapy video on our Facebook page; mention you saw it and we will give you 20% off any laser therapy treatment and package purchase through the month of March.
Following up on last month’s article, the strain of canine influenza was H3N2. We have the vaccination and would be happy to discuss if it makes sense for your dog to have the vaccination. Also remember, as the weather warms up, the fleas are going to hatch. Don’t get caught too late and have an infestation, start flea control soon.