Pain in Pets: Signs and Treatment Options

At some point during your pet’s lifetime, they will unfortunately experience pain, whether from an injury, surgery, or disease. Seeing your beloved companion suffer is heartbreaking, but did you know that many pets silently hide their discomfort? To help you more easily detect pain in your pet, watch for the common discomfort indicators, and learn how to manage their condition.

Causes of pain in pets

Pets feel pain for many of the same reasons as people, but, unlike people, they cannot tell us when they hurt. As your pet’s advocate and protector, you must be perceptive to their hidden pain signals. Your furry pal may experience discomfort for a variety of reasons, such as:

As your pet’s advocate and protector, you must be perceptive to their hidden pain signals.

  • Infections
  • Dental disease
  • Muscle, ligament, or tendon injuries
  • Surgery
  • Arthritis
  • Cancer

If you’ve ever had a toothache or a urinary tract infection, you understand how excruciating these conditions can be, and why you seek immediate relief. Pets can suffer silently for months—sometimes years—from slowly escalating pain, usually termed chronic pain. Acute pain, such as a broken leg, is much easier to detect, whereas chronic pain can creep up and go unnoticed until a certain discomfort threshold is reached. For example, most pets have some form of dental disease by age 3, but many pet owners notice only their pet’s bad breath until much later when their pet has difficulty chewing. Osteoarthritis is another commonly missed painful condition, as reluctance to rise and slowing down are often chalked up to old age rather than uncomfortable joint disease. Keep a close eye on your pet to ensure they don’t suffer needlessly because you missed the signals.

Pain signals in cats

One study revealed 61% of cats over 6 years old had arthritic changes in at least one joint, while 48% had two or more affected joints.

Hopefully, your cat will never need to communicate they’re in pain, and you can focus instead on the ways they display their affection and happiness. However, cats can suffer many painful conditions, and they’re highly skilled at hiding signs that they hurt. To help veterinarians and pet owners detect pain in cats, researchers have made many recent advancements in assessing feline pain [1]. If your cat is suffering from an inflamed bladder, skin allergies, pancreatitis, or osteoarthritis, you may notice the following pain and discomfort signs:

  • Decreased appetite
  • Inappropriate elimination
  • Hiding or withdrawing
  • Hunched posture
  • Growling or hissing when petted
  • Biting and licking at the affected area
  • Poor coat condition from lack of grooming

The Feline Grimace Scale is an excellent, relatively novel method of determining a cat’s discomfort level [2]. Veterinarians at the University of Montreal in Canada developed the scale, which evaluates ear position, orbital tightening, muzzle tension, and head and whiskers position. Several unique facial expression changes are reliable indicators of feline pain, such as squinted eyes, and an increased distance between the ear tips compared with a pain-free cat. Osteoarthritis, a common painful condition experienced by cats, is greatly underdiagnosed, because achieving accurate diagnostic tests is extremely difficult [3]. However, one study revealed 61% of cats over 6 years old had arthritic changes in at least one joint, while 48% had two or more affected joints [4].

Pain signals in dogs

Dogs are often less shy than cats about hiding pain, but many breeds and personalities are too stoic for their own good, and make pain perception difficult to spot. Common cues that your canine companion is in pain include:

  • Whimpering, whining, or moaning
  • Decreased appetite
  • Limping or lameness
  • Decreased activity
  • Avoiding interaction
  • Lack of interest in favorite activities
  • Licking or chewing at the affected area
  • Irritable behavior
  • Inability to get comfortable and relax
  • Trembling
  • Difficulty rising
  • Excessive panting when at rest

As your dog’s best friend, you’re in the best position to monitor their health and happiness. By detecting subtle pain cues quickly, you can seek immediate diagnosis and treatment and help your furry pal along the road to recovery.

Pain management for pets

With so many manifestations of pain in pets, rooting out the underlying problem and treating the discomfort at its source is key. Depending on the cause of your pet’s pain, the following management or treatment options may be beneficial [5]:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) — Often a front-line treatment for pain, your pet may be prescribed a course of NSAIDs by your veterinarian to reduce pain and inflammation.
  • Opioids — Opioids can help in severe acute or chronic pain cases, and are used most often after surgery or other painful events. Fentanyl patches and oral opioids can be administered to pets who are uncomfortable with NSAID therapy alone.
  • Adjunctive drugs (e.g., amantadine, gabapentin, amitriptyline) — These medications are not typically used as the first line of defense against pain, but they work well as part of a synergistic, multi-modal treatment plan.
  • Supplements — While supplements may not be strong enough to battle severe pain, they can help alleviate mild pain and slow the progression of painful conditions, such as osteoarthritis.
  • Surgery — Most commonly used for pets with orthopedic conditions, such as hip dysplasia and cranial cruciate ligament injuries, surgery can repair a painful limb to full function.
  • Glucocorticoids (e.g., steroids) — Steroids work a bit differently than NSAIDs, but they also reduce inflammation. However, they cannot be used together without risk of serious side effects.
  • Diet and exercise — Maintaining an ideal weight goes a long way toward reducing your pet’s pain, as fat incites inflammation. Additionally, exercise helps maintain muscle mass and keeps joints strong and healthy.
  • Physical therapy — Physical therapy encompasses many different techniques, including those listed below. Stretching and range of motion exercises can be especially beneficial for alleviating pain.
  • Chiropractic — Chiropractic care is based on spinal manipulation and uses the body’s own healing abilities, and the relationship between the spine and nervous system, to restore and maintain good health.
  • Acupuncture — Acupuncture stimulates the release of natural pain-relieving and anti-inflammatory chemicals, relaxes muscles, improves circulation, and assists with the removal of metabolic wastes and toxins.
  • Massage — Massage improves blood flow to stiff muscles, and reduces muscle spasms, by using varying pressure when kneading and stroking muscle groups.
  • Hydrotherapy — Hydrotherapy is an excellent way to help repair your pet’s muscles, ligaments, and tendons to improve their ambulatory mechanisms. Underwater treadmills are most commonly used, and cats and dogs can build strength and recover from injury with this low-impact exercise.
  • Thermotherapy — Thermotherapy involves applying external heat with a warm, moist towel or heating blanket to reduce inflammation and promote relaxation. This modality is often used prior to exercise or massage, as it improves flexibility.
  • Cryotherapy — Cryotherapy involves applying cold with gel packs to reduce pain, inflammation, and muscle spasms.
  • Laser therapy — Using a lower light wavelength than surgical lasers, cold laser therapy reduces inflammation, speeds healing, improves nerve regeneration, and increases tissue metabolism.
  • Electrical stimulation — Transcutaneous electrical nerve stimulation (TENS) units use electrical impulses to stimulate muscle contraction, which increases your pet’s range of motion and improves circulation.
  • Phonophoresis — Phonophoresis is a physical therapy technique that combines ultrasound therapy with a topical medication, such as a steroid or anesthetic cream, to reduce inflammation and pain.
  • Pulsed electromagnetic therapy — The Assisi Loop is a common pulsed electromagnetic therapy tool which creates an electromagnetic field over the injured area to reduce inflammation and promote healing.
  • Shock wave therapy — A shock wave therapy unit generates a series of focused high-pressure sound waves that travel through the skin and soft tissue. When the waves meet tissues of different densities, energy is released to stimulate the body’s natural healing mechanisms

Avoid treating your pet’s pain yourself, as cats and dogs cannot safely metabolize many human pain relievers. For example, paracetamol can easily kill a cat, while long-term aspirin use in dogs can create gastric ulcers. Always ask your veterinarian any questions you may have about your pet’s pain management plan, and contact them immediately if you notice potential side effects. Watch for the following adverse reactions after administering any medication to your pet:

  • Vomiting
  • Diarrhea
  • Black, tarry stool
  • Change in drinking or urinating
  • Change in behavior, such as depression, appetite loss, or restlessness
  • Yellowing of the skin, gums, or whites of the eyes

Never change your pet’s medication dosage or frequency without first consulting your veterinarian, as they have been carefully calculated to stay in the therapeutic, non-toxic dose range. By learning to detect your pet’s subtle pain signals, you can quickly seek help, and eliminate their needless, silent suffering. Partner with your veterinarian regarding pain management medications, alternative therapies, and supplements to keep your beloved pet comfortable and pain-free.

References:

[1] Steagall, P. V., & Monteiro, B. P. (2018). Acute pain in cats: Recent advances in clinical assessment. Journal of Feline Medicine and Surgery, 21(1), 25–34. https://doi.org/10.1177/1098612×18808103

[2] Cayetano Evangelista, M., Watanabe, R., O’Toole, E., & Steagall, P. V. (2018, March 13). Facial expressions of pain in cats: Development of the Feline Grimace Scale. ResearchGate; unknown. https://www.researchgate.net/publication/323830301_Facial_expressions_of_pain_ in_cats_development_of_the_Feline_Grimace_Scale

[3] Medicine, C. for V. (2019). Osteoarthritis in Cats: A More Common Disease Than You Might Expect. FDA. https://www.fda.gov/animal-veterinary/animal-health-literacy/osteoarthritis-              cats-more-common-disease-you-might-expect#endnote6

[4] Slingerland, L. I., Hazewinkel, H. A. W., Meij, B. P., Picavet, Ph., & Voorhout, G. (2011). Cross-sectional study of the prevalence and clinical features of osteoarthritis in 100 cats. The Veterinary Journal, 187(3), 304–309. https://doi.org/10.1016/j.tvjl.2009.12.014 [5] Mathews, K., Kronen, P. W., Lascelles, D., Nolan, A., Robertson, S., Steagall, P. V., Wright, B., & Yamashita, K. (2014). Guidelines for Recognition, Assessment and Treatment of Pain. Journal of Small Animal Practice, 55(6), E10–E68. https://doi.org/10.1111/jsap.12200

[5] Mathews, K., Kronen, P. W., Lascelles, D., Nolan, A., Robertson, S., Steagall, P. V., Wright, B., & Yamashita, K. (2014). Guidelines for Recognition, Assessment and Treatment of Pain. Journal of Small Animal Practice, 55(6), E10–E68. https://doi.org/10.1111/jsap.12200