For the first time in his life, Lincoln, my 12-and-a-half year old standard poodle, had a hard time jumping into my car. My heart sank.
I have always had a very empathetic approach to practicing veterinary medicine and life in general. Veterinarians are generally empathetic people, but when it came to pain, honestly, it took my profession a while to come around. I remember adding morphine to our post-op regimen in the late 1980s, and we were literally the only practice in town to do so.
Thankfully, all of that is in the distant past and pain management is now a big part of all of our practices. Where once all we had was aspirin and ibuprofen (not recommended anymore), we now have an array of medications and procedures like acupuncture, chiropractic, massage, joint injections, regenerative medicine, surgery and physical therapy.
We even have a professional association dedicated to pain management: the International Veterinary Academy or Pain Management (IVAPM). The IVAPM was founded in 2001 and lists among it’s goals the education and standardization of all aspects of pain management.
The types of pain
So, what should you do when your pet is in pain? Of course, seek professional advice from your veterinarian. Your veterinarian will perform a complete physical examination to determine the origin of the pain and then categorize it as acute or chronic pain.
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Many orthopedic injuries are acute in nature and require rest and anti-inflammatories. Based on what we see during examination we may recommend radiographs or x-rays. These are best done under sedation, which usually includes a narcotic pain medication as well as sedative. Often times, we will just prescribe rest and anti-inflammatory medication.
Post-op or post-dental pain is also considered an acute problem and is easy to manage using a variety of medications. Usually these only need to be administered for a few days to a few weeks. Every post-op patient should be sent home with pain medication in my opinion.
Then there’s chronic pain. Unless the underlying condition can be corrected, long-term pain management is required. Most of our chronic pain patients either have arthritis, intervertebral disk disease, spondylosis or cancer.
I cannot stress enough the importance of getting an accurate and early diagnosis. Often times, clients will ask, “Can’t we just go by what you think from your exam and forego the x-rays and blood tests?” “No,” I reply, “there are a number of different medications and therapies, and based on your pets’ medical condition and organ function, we will formulate a treatment plan and discuss the options.”
According to lectures I have attended at the IVAPM, many arthritic conditions in older animals are the result of injuries to a young animal that were not treated properly or timely enough. Hip, knee, elbow and shoulder injuries are common in young animals. And while it may be true that many are from overuse, many are also due to joint and or cartilage damage that needs aggressive treatment. I always tell my clients, “aggressive doesn’t necessarily mean heavy drugs and meds, but rather a focused, multi-modal plan of attack.”
And that word, multi-modal, brings up my last point regarding pain management in pets. All of our research and clinical experience tells us that there is no one magic bullet to manage pain. I can’t just give you a pill and have the problem disappear. Multi-modal means using all of our tools, be it medication, physical therapy, chiropractic, acupuncture or other treatments.
Pain management requires a consistent and diligent effort. I hate seeing Lincoln in pain. I am bringing him in tomorrow to get a handle on his pain and formulate a game plan. If your pet is in pain, I suggest you do the same.
Stephen Sheldon, DVM, practices at Gypsum Animal Hospital. A member of the IVAPM, he is also a past president of the South Florida Veterinary Medical Association and current industry consultant. He can be reached at 970-524-3647, drsteve@gypsumah.com or by visiting http://www.gypsumah.com.
