Could your dog be in pain?
It can be very hard to recognise signs of pain in animals. Pain can cause lameness or apparent stiffness, changes in gait and slowness to rise or exercise, but it can also cause much more subtle symptoms like crying out, changes in facial expression, licking at painful areas, restlessness, disturbed sleep, aggression and withdrawal, also reduced appetite and weight loss and loss of coat condition.
Historically a common view was that animals didn't feel pain in the same way that humans do, and that they did not need pain relief in the same way as we might, however research increasingly shows us that dogs and other animals have a very similar response to pain as us, and that they benefit from pain relief in the same ways as we do.
Some scientists have also suggested that the role of pain in animals is to protect them from over-using an affected area and that pain relief may encourage over-use of a damaged area and thus complicate healing. However, research shows us that pain management aids healing and healthiness. Also, un-resolved pain puts strain on the heart and cardiovascular system as well as affecting breathing, reducing appetite, predisposing to vomiting, slowing healing, impairing the activity of the immune system and increasing the likelihood of the animal developing problems associated with chronic long term pain.
There are several different types of pain, which exist for different reasons and any understanding of how to treat pain requires an understanding of what pain is.
Some types of pain sensors and nerves carry information rapidly to the brain and spinal cord and react to sharp pinpricks giving an immediate response which is to withdraw the hand, or limb from the sharp, hot or cold object and hopefully avoid injury. Other types of fibres carry pain information from damaged muscles and deeper structures that give aching or deep painful sensations. It is this type of pain that produces a more emotional response due to the effect it has on the brain; it can be involved in creating a sad or depressive response to the pain that is separate from, but associated with the pain itself, and which presumably exists to dissuade the individual from repeating the action that caused the pain.
It is thought that other nerves bring information that feeds into the experience of this type of pain, so that pain sensation can be amplified by previous pain, tiredness, sadness and a whole host of other stimuli to result in more pain being experienced in the brain. On the other hand, stimulation of touch sensors results in stimulation of nerves which act to block part of the pain pathway and decrease the amount of pain experienced by the individual, which presumably accounts for why rubbing the affected area makes it feel better.
Most medical pain relieving medicines that are used commonly work on reducing inflammation at the point where sensors respond to pain (e.g. Non steroidal anti-inflammatory drugs) because inflammation is responsible for amplifying the stimulation of pain transmitting nerves. However others, such as morphine and other opiates act directly on the brain and spinal cord to block the experience of pain.
Massage and physical therapies (or even simply rubbing or stroking a painful area) work both by reducing muscle spasm which can be involved in amplifying pain, and by stimulating touch sensors which act in the spinal cord to reduce the pain information that passes to the brain.
Acupuncture is thought to work in a similar way as it stimulates the nerves that carry touch information and thereby reduces pain transmission to the brain. In addition, it is also known to stimulate endorphin release which acts like morphine to reduce the experience of pain in the body. Also, acupuncture has been shown to trigger the release of other chemicals, which promote blood flow, healing and relaxation.
When chronic pain exists, a vicious circle comes into play that involves pain reducing mobility, which in turn causes stiffness and further pain. Although this system exists to prevent the action that caused the pain it often exists long after the original injury and prevents activity which could help relieve pain. Often, if sufficient pain relief can be given that allows the individual can to become more mobile, controlled exercise can be used to improve mobility and strength which can in turn reduce the pain associated with a damaged or weak joint, limb or part of the back. Exercise also stimulates endorphin release, which in itself helps reduce the experience of pain, and with this kind of approach the 'vicious circle' can be turned backwards so the individual's pain becomes progressively more reduced, or more controlled.
Not only should any pain be treated, but also, the affected animal will probably cope best if his pain is dealt with in a combination of ways. Using prescribed anti-inflammatory medicines is invaluable and helps affected dogs to be more comfortable and have better mobility. In addition, other medicines, nutraceuticals and other mechanisms of pain relief such as acupuncture are invaluable. In addition physical therapies can aid rehabilitation and recovery from painful conditions.
A number of different medicines can be used for pain relief, most of which are very safe and many of which are to be recommended for those animals that need pain relief. Prescribed pain medicines should be used as advised by the prescribing vet, though the need for them may be reduced by other approaches to pain such as physiotherapy, hydrotherapy and acupuncture.
Most of the commonly used ones are anti-inflammatory medicines that are not steroids- known as NSAIDS or non-steroidal anti-inflammatory drugs (such as carprofen (e.g. Rimadyl, Norocarp, Carprodyl), meloxicam (e.g. Metacam) and firocoxib (Previcox). These medicines reduce pain, inflammation, high temperatures and swellings and can be used in the long or short term to treat conditions varying from those associated with high temperatures and pain, to low grade lameness. Widely varying doses may be used and in most cases the dose can be gradually reduced to the lowest that is effective, or these drugs can be used on an 'as and when' basis to control intermittent problems. These medicines are usually very safe but occasionally can cause severe diarrhoea, or, particularly at high doses in the long term, can be associated with a range of problems including liver or kidney disease, though side effects are probably less likely when using firocoxib. Any signs of side effects should be reported to the vet promptly, and the medicine stopped in the meantime, but most dogs experience no side effects and benefit hugely from these types of medicines. Regular monitoring of animals is important if these medicines are being used in the long term.
Similar human drugs such as Paracetamol, Asprin and Ibuprofen should not normally be used in animals as they are much less safe in dogs and can cause disease. Meadow Farm 2008
Other drugs that may be used include steroids which are very effective at reducing inflammation and may be used to help treat cancers and immune diseases that can also cause pain. Whilst these can be very useful, they do carry the risk of inducing other conditions such as Cushings disease (an hormonal condition that causes weight gain, vomiting and other symptoms), immune suppression and laminitis in horses. They are therefore used at the lowest possible dose.
A number of other medicines may be prescribed to treat pain including Tramodol, an opiate pain killer, Gabapentin, which acts on the central nervous system to reduce pain, and a number of human anti-depressant medicines which also have a pain relieving effect at the level of the brain. Such medicines may be useful in certain cases where licensed anti-inflammatory medicines are ineffective.
In all cases, animals should be monitored carefully and any problems should be promptly investigated by the prescribing vet.
Acupuncture is a corner stone of traditional Chinese medicine and has been practised on animals for thousands of years. With scientific evidence supporting it's use for treating pain, it has become a more common therapy in the west.
The placement of acupuncture needles at points where they can have an effect on the nervous system results in the release of measurable levels of the body's own opiate pain killer such as endorphins, as well as other pain relieving neurotransmitters. Research has shown that acupuncture has a number of effects including the relief of muscle spasm and pain and effects both at the point of needle insertion and at the level of spinal cord and brain to reduce pain information feeding back to the brain.
It is most often used to treat pain and to relieve muscle spasm, but can also be used in the treatment of a range of other conditions including some types of skin, digestive and bladder diseases.
Acupuncture involves placing very fine sterile needles through the skin in positions where they can have an affect on the animal's nervous system. The needles are so fine that pets and horses don't normally resent them, in fact some animals find acupuncture treatment relaxing or even mildly sedating. The needles are left in for up to 20 minutes and then removed. Treatments are normally repeated weekly for 3 or 4 weeks and then at increasing intervals as the effect becomes more long-lasting. Animals with chronic disease may benefit from regular 'top-up' treatments every 3-4 months in the long term.
Acupuncture is very safe. Mild bruising may occasionally occur and animals may experience a little muscle tenderness the day after treatment, though this passes quickly. Side effects are extremely rare.
Acupuncture treatment of animals can only be carried out legally by vets that are also acupuncturists, it cannot be carried out by other professionals.
Meadow Farm 2008
Roberta Baxter MA VetMB MRCVS
Copyright © 2008 Meadow Farm