Tuesday, January 26, 2016
How do I know if my pet is in pain??

                 A big part of our job as veterinarians is to ease suffering and treat painful conditions. Recognizing the signs of pain in animals is not a simple task. Animals can’t tell us verbally if they are in pain and different species (cats, dogs, birds) show different signs when they are in pain. In addition to the variation between species there is variation between individual patients. Just like with people, animals can have different “pain thresholds” and some may be more sensitive, while others are more stoic.  As veterinarians we have formal training in recognizing and treating pain in animals but sometimes it can be a challenge helping owners understand when their pets are hurting. Animals often don’t react the way that a person would expect them to when it comes to pain.  My goal with this blog is to help owners become more adept at recognizing when their pet might be in pain. We will cover cats and dogs in part one and I will post part two on rabbits and exotic pets in the coming week.

Let’s start with dogs and pain first. Many owners expect that when a dog is in pain it will yelp, cry, whimper or hold up the affected body part.  This may be true for some dogs, especially if they have an acute or sudden injury, but it doesn’t hold true in all situations. Other signs to watch for include shaking or shivering, reluctance to move or lack of appetite. If a dog has a sore abdomen it may stand with its head hanging lower than its body, or may adopt a “praying posture” with it's front legs outstretched.  Many times a dog in acute pain will be less interactive with the owners. Dogs, cats, and many small mammal have very similar physiology to people, so if they are diagnosed with a condition that would be painful to a person it is safe to assume it is painful for them. This is true even when we are not seeing any obvious signs of pain.  Sometimes we have owners phone in and tell us that their dogs is limping but that they do not think it’s in pain.  In most cases if an animal isn’t putting full weight on a leg, it is at least partially due to pain. Exceptions can include nerve damage or certain mechanical abnormalities of the leg.   Chronic pain, which is what occurs in cases of arthritis and also with dental disease is different than acute (or sudden onset) pain.  Dogs in chronic pain may be stiff to rise, slower on walks, or may want to walk shorter distances or have trouble with jumping or stairs. Often people tell us they think their dog is just getting old. Although arthritis is much more common in senior pets it is not considered a normal part of aging and there are lots of treatment options (see my blog post on osteoarthritis in senior pets from November). 
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Though cats are physiologically very similar to dogs and people when it comes to pain perception they are psychologically very different (as anyone with a cat can attest to!).  Recognizing pain in cats can be a real challenge. Some signs of acute pain can include sitting in a hunched position, lack of appetite, squinting of the eyes or hiding and decreased activity. When it comes to chronic pain and arthritis things can be even more subtle. Sleeping more, hesitation before jumping, urination or defecation outside the litter box and any changes at all in a cat’s posture when walking can be indicators of arthritis.  Usually the best way to tell if a cat has chronic pain from arthritis is to try them on a pain medication and see if there are any noted changes in behavior.  Sometimes owners will see improved mobility on the pain medication other times they might just notice their cat is sleeping less or has a better appetite. When doing a trial of pain medication I encourage you to stick with it for at least a week even if you are not seeing any changes. The inflammation in the joints has built up over months and can take time to go down when using anti-inflammatories. Just like in people, pets sometimes respond better to one medication than another and we may need to try a couple of options before we find one that will work well in your pet. 

This hunched position can mean back or abdominal pain
A quick note on dental pain: dogs and cats will most often continue to eat despite having painful mouths. They have strong survival instincts and for many food is their favorite thing. Don’t assume that because your pet is eating that means it does not have pain in it's mouth. If gums are red and swollen then there is associated pain and because dental disease is often chronic in nature, building up slowly over time, the signs of pain are not always obvious. Animals learn to get by despite the pain but this does not mean they won’t benefit from some pain medications.

Remember that most over the counter human pain medications are not safe for your pet so if you have any concerns that your pet might be in pain the best thing to do is to call your veterinarian.

Thanks for reading and stay tuned to part two on rabbits and exotic pets!

Dr Ingrid