Pain management handouts are now available:
Long Term Pain Management in Dogs
Pain is a very real part of life for many of our pets whether it’s due to arthritis, a previous injury, growth abnormalities in our puppies, or an acute problem. As pet owners, it is our responsibility to minimize, if not eliminate, our charges’ pain. In the case of acute injuries, pain is usually readily evident but when pain is chronic as in the case of arthritis and chronic injury, it can be difficult to recognize. Symptoms of pain can include difficulty rising or going up stairs, decreased exercise tolerance, loss of muscle tone, reluctance to jump on the bed/furniture. Rarely do pets with chronic conditions cry out in pain, making their discomfort difficult to diagnose.
If you suspect your pet is suffering from chronic pain, the first step is a physical exam. The physical exam is typically followed by digital radiographs (x-rays) to localize the source of pain and evaluate severity. Following radiographs, your pet’s blood sample is sent to the laboratory to make sure his/her liver and kidneys are capable of metabolizing pain medications appropriately.
Once we have localized your pet’s source of pain and the reason behind it, we can together formulate a plan to combat it. The following is a list of different methods of pain control that we can utilize independently or in combination to control your four-legged family member’s pain. We have listed them in order from most effective to least efficacious.
- Librela (Dogs) /Solensia (Cats)
Librela/Solensia is the newest weapon against pain. It blocks NERVE GROWTH FACTOR which is a part of the pain cascade. This injection lasts for 4 weeks, has minimal side affects, and controls pain as well or better than an NSAID.
- Non-Steroidal Anti-Inflammatory Medications (NSAIDS)
This group of drugs is the mainstay of our pain management in pets. They provide the most consistent and powerful relief. Rimadyl, Metacam and Galliprant are common NSAIDS. All of these medications have reported side effects related to liver and kidney function as well as gastrointestinal distress. The potential for these side effects is minimized by checking a blood chemistry panel prior to starting medications, one week after starting, one month after starting, then every (6) months as long as therapy continues. The cost of NSAID therapy has been reduced by the release of generic Rimadyl called Carprofen.
Acupuncture is the application of small hair sized needles into specific points on the body to stimulate a response. Responses can be seen quickly and include alleviation of pain, increased blood flow, increased nerve growth, and decreased inflammation. Acupuncture is extremely beneficial for chronic pain relief from arthritis, back injuries and other painful conditions as well as immediate pain relief post surgery or injury and increased healing. Acupuncture treatments vary based on the individual. In general, severe pain or chronic arthritis are treated with (3) sessions within the first month.
- Laser Therapy
Laser Therapy is a newer approach to pain control in dogs. Many dogs respond to laser therapy even when other modes of pain control fail. The energy from the laser is absorbed by the cells enabling healing to occur. The laser also activates naturally occurring pain receptors accelerating the body’s own pain response. Laser therapy is similar to Adequan in that an initial induction period of (6) treatments is needed followed by maintenance treatments every 3-4 weeks. Laser therapy is also a form of pain control free of side effects.
Adequan is an injectable form of glucosamine that is given under the skin. It is a proven effective aid for arthritis in dogs and cats. Adequan is given twice weekly for the first (4) weeks and then once every 3-4 weeks. The best part of Adequan therapy is that it is free of adverse side effects.
- Glucosamine/MSM/Chondroitin Sulfate Supplements
These supplements in combination are an effective, easy way to help pets with low grade joint pain. They are also virtually free of side effects though we do have to be careful in pets with food allergies. At Family Pet Clinic, we carry Synovi G4 with Turmeric and Boswellia and Glycoflex III for dogs and Dasuquin Advanced for cats. It is important to remember that it takes approximately 30 days for results to be seen, so be patient! We have been consistently happy with the products that we carry so are confident when we recommend their use in patients. There are a multitude of over-the-counter products available that may work well, however, none of them are regulated by the FDA so be careful when buying.
Gabapentin is another medication commonly used as an adjuvant to NSAID therapy. Gabapentin’s effectiveness comes from its ability to interrupt the pain pathway in the nervous system its main side-effect is drowsiness. Gabapentin in useful for nerve pain, but has minimal control of other pain types.
With the above possibilities, we can work together to alleviate your pet’s pain. The first step is pinpointing the source of the pain and its severity. We can then form an appropriate treatment plan with the lowest risk of side-effects possible.