Signs and symptoms of pain in dogs and cats can be relatively easy to identify once owners recognize the clues to watch for. Situations when this is important are during the initial post-surgery recovering from spaying and neutering, orthopedic surgeries such as fracture repairs or ligament injuries, as well as more chronic conditions such as osteoarthritis and cancer pain. Chronic pain is especially underappreciated as many pets tend to be stoic (especially older cats), and may not show obvious changes.
Recovery After Spaying and Neutering
Most pets that are sent home after a spay and neuter will need medications to alleviate pain and discomfort for at least 3 days. Spays in particular are actually called ovariohysterectomies, and are a procedure where an incision is made into the abdomen and the entire uterus and ovaries are removed. These patients tend to be sore when their incision is pressed, and should avoid jumping on furniture, running, or going up stairs during the recovery period until the sutures are removed (usually 7-10 days later). Most veterinarians will dispense some type of pain medication, most often a non-steroidal anti-inflammatory drug (NSAID) such as Rimadyl®, Deramax, Metacam or Previcox. It is important to give these medications as directed, and on a full stomach. If any vomiting, diarrhea, or decrease in appetite is noted, discontinue immediately.
Signs of Pain in Dogs
According to the International Veterinary Academy of Pain Management, the signs of pain can be seen in four ways: posture changes, movement, vocalization, and behavioral changes. Here are the most common ways to identify warning signs in each category:
- Posture changes include a hunched back, guarding or protecting a painful area (such as a surgical incision), a "praying" position with the front legs and head on floor and hindquarters in the air, abnormal sitting or laying, abnormal sleep postures, or holding their head down.
- Movement changes include stiffness, bearing no weight on a painful limb, thrashing restlessness when sleeping, trembling or shaking, holding tail low or weak wagging, slowness to rise, and limited or lack of movement when awake.
- Vocalization can include whining, crying, screaming, barking or growling, or silence (no greeting bark or noise when usually the case).
- Behavioral changes include agitation, poor or no grooming, decreased or absent appetite, dullness, inappropriate urination/defecation in an otherwise trained pet, licking a wound or surgical site, or acting out of character (a gentle dog becomes aggressive/defensive and attempts to bite when approached).
Signs of Pain in Cats
Cats can be evaluated with the same four methods, with a few unique differences. Cats may also hiss or growl, may not greet owners or ask to be fed, will show a lack of grooming, inappetence (weight loss can be a common clue with chronic pain in older cats), retreating to a quiet area of the house or hiding under the bed for a long period of time, and aggressive changes when petting or picking up. Cats often will develop a glazed, wide-eyed or vacant stare with enlarged pupils with significant pain.
Treatment Options For Acute Pain in Dogs and Cats
For pets with acute pain (immediate pain after recent trauma or surgery), the American Animal Hospital Association and American Association of Feline Practitioners have created a pain management standards of care including many medications, physical therapy, and holistic options for veterinarians. Studies now prove that there is a pain "wind up" in patients, meaning that giving medication before a surgery will actually improve the results afterwards and make additional medications more effective by staying "ahead of the pain".
Treatment options include Non-steroidal anti-inflammatory drugs (NSAIDS) (Carprofen, Meloxicam, Etodolac, Firocoxib, Zubrin, Deracoxxib, Ketoprofen), steroids (dexamethasone, prednisone), local anesthetics (lidocaine, bupivicaine), opiate class drugs (morphine, fentanyl patches, buprenex, butorphanol), Tramadol, Acupuncture, Therapeutic Laser, and Heated/warm blankets, splinting/bandaging for support of orthopedic injuries, and extra padding for bedding.
Cats have special considerations in their inability to metabolize many anti-inflammatories, and owners are urged to always discuss any medications with veterinarians. One Tylenol (acetaminophen) tablet is FATAL to cats- a very serious toxic emergency. Most commonly anti-inflammatory therapy in cats involves Metacam (meloxicam), and the most common opioid therapy is Buprenex (buprenorphone).
Treatment Options For Chronic Pain in Dogs and Cats
For chronic pain such as with osteoarthritis or cancer, additional options include physical therapy (massage, range-of-motion), acupuncture,therapeutic laser serial treatments, nutriceuticals (supplements such as bone/cartilage support) including glucosamine, chondroitin sulfate, MSM, ASU, nerve-related pain medications such as gabapentin, radiation therapy for cancer, or therapeutic surgeries (amputations or neurectomies (cutting a nerve). A series of injections called Adequan® is also available containing polyaminoglycans that can help to repair synovial cells and joint fluid/lubrication in damaged joints. These is a particularly safe option for patients with preexisting conditions such as liver/kidney disease or diabetes that can not use NSAIDS or steroids.
Recognizing the common signs and symptoms of pain in cats and dogs is an important part of responsible ownership. For additional information about pain, a video on pet pain and prevention by the Department of Anesthesiologists at the Colorado State University Veterinary School is available for viewing. An important discussion with any veterinarian before scheduling surgical procedures will involve a pain managment plan before, during, and after surgery not only for patient comfort but also to improve patient healing and overall health.
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