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Michael Dym, V.M.D.
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Dr. Michael Dym
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Pain Management for Pets

Like humans, pets are susceptible to pain. Pain management is becoming a routine part of veterinary medicine, and even many state veterinary medicine practice acts now implement laws for pain management in pets to help guide veterinarians. Pain can be temporary or acute, or persistent and chronic. Acute pain usually results from surgery or sudden damage to muscles, bones, or other parts of your pet's body. Surgery, traumatic accidents, bite wounds, and sudden organ inflammation are the most common causes of acute pain in pets.

Signs of pain in your pet may include behavioral changes, restlessness, increased panting, hiding, trembling, drooling, loss of appetite, tucked up painful abdomen, limping, lameness, and self-trauma. Senior pets with degenerative joint disease of the spine, hips, or stifles (joints in the legs, equivalent to the knees in humans) may be stiff or in pain when jumping up, and they may cry when picked up. Many cats will hiss or bite if touched in certain painful and sensitive areas. When giving pain medication to your pet, it is best to start the medicine early before pain becomes too intense. Many veterinarians will often use lower doses of two or three medications to help control acute and chronic pain in pets.

Several major classes of medicine can be used to control your pet's pain. However, because of the unique metabolism of drugs in cats, fewer options are available for them. For all pets, doses of pain medications should be as low as possible to control clinical signs.

Using alternatives to pain medication

Many pet owners will try more natural approaches to managing pain in their pets. Common products chosen include homeopathic T-Relief Tablets and white willow bark. Glucosamine products have also been effective. Acupuncture and chiropractic care also provide pain relief to pets for many acute and chronic conditions. Classical homeopathic veterinarians will often prescribe individualized constitutional remedies to help with chronic pain in pets. Constitutional homeopathy is the selection and administration of homeopathic preparations over a period of time to treat disorders caused by an inherited predisposition to a disease. It is aimed at an eventual cure, not just suppression or relief of immediate symptoms. Many veterinarians also offer physical therapy to help manage chronic pain in pets.

Prescribing pain medication for pets

Veterinarians often prescribe non-steroidal anti-inflammatory drugs (NSAIDs) to treat acute and chronic pain in pets. However, these drugs are not recommended for cats, as they may lead to severe kidney damage. In dogs, NSAIDs are very effective in treating chronic pain, and work better when the pain is due to inflammation, such as bone inflammation or arthritis. NSAIDs do not seem to work as well for back pain in pets. NSAIDs are routinely used by many veterinarians following most soft tissue or orthopedic surgeries, or to treat pet bite wounds or traumatic injuries. These medications reduce pain by blocking COX-1 and/or COX-2 enzymes in the body. While most newer NSAIDs are quite effective, all of these drugs have the potential to produce occasional and sometimes severe side effects. Therefore, it is important to have a complete CBC/chemistry blood profile done on all pets before starting short-term NSAID therapy and to have periodic blood work done on pets receiving ongoing therapy for chronic pain. This will detect any pre-existing medical conditions, ensure that liver and kidney function is normal, and monitor any side effects. Some popular NSAIDs available by prescription include Rimadyl, Novox, Metacam, and Previcox.

Other pain-relieving medications for pets

A popular, inexpensive narcotic medication veterinarians use along with or instead of a NSAID, is Tramadol. Its side effects seem to occur considerably less often than the ones of NSAIDs, traditional narcotics, or cortisone drugs. Gabapentin may play a role in chronic pain management in pets; however further research and studies need to be done on efficacy and safety. Amantadine has also been looked at recently in possibly controlling pain in pets, and initial studies seem positive for its use in both dogs and cats. Methocarbamol is a muscle relaxant that is sometimes helpful in pets with chronic or acute back problems, especially when muscle spasm is involved. Amitriptyline is also sometimes effective in reducing chronic pain in pets. Corticosteroids and narcotics are also used to control pain in pets. Some veterinarians only prescribe corticosteroids to pets as a last resort, or when there are limited other options as seen in certain cases with cats, because the risks and side effects outweigh the benefits when using these drugs. Opioids are the most powerful pain-relieving compounds available for pets, and are often used for acute pain. Many veterinarians use Fentanyl patches to decrease post-surgical pain in pets, and treat advanced cancer. However, these patches are often left on and effective for only a few days. Recently, the FDA has approved Fentanyl as a topical liquid for pain relief in pets marketed as the product Recuvyra. This product supposedly allows for considerably longer periods of transdermal pain relief than traditional Fentanyl patches. Buprenorphine is another narcotic medication commonly used in veterinary medicine for short-term acute pain relief in pets with few side effects. Morphine, Demerol, and Torbutrol are other narcotic options, but they are less commonly used by veterinarians.

Giving liver supplements

Liver supportive supplements are often recommended for pets on acute and especially chronic pain drug therapy. Many of these supplements can help with the added burden of processing many of these medications, as well as guard against potential liver damage and side effects. A few recommended products include Denamarin Tabs and Denosyl, as well as Canine and Feline Hepatic Support from the company Standard Process. Milk thistle and dandelion are herbs that also may be useful.

Max's Tip

It is always best to try relieving your pet's pain with alternative, homeopathic medication before giving prescription pain medication, due to potentially dangerous side effects.

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