PAIN

Pain is a sensation of discomfort, usually affecting a particular part of the body. Pain is subjective, that is, it cannot be measured directly with any instrument. Animals feel pain to different degrees, depending on the individual – just as with humans. A condition that is expected to generate moderate pain for most animals may be experienced as intense pain by a sensitive individual. Unlike humans, who can tell us that it hurts, and how much, animals simply behave in certain ways that may be the result of pain, and we must interpret the signs.

Evaluating your pet for signs of pain, and managing pain in your pet
Your pet may experience pain associated with his or her condition, injury, or procedure undergone. Once your pet is discharged into your care at home, it is important for you to recognize if or when your pet is experiencing pain, and to know how to administer any pain medication prescribed.

Signs that your pet may be in pain
To assess pain in an animal we rely on:

1. Known conditions (diseases) and procedure (surgeries, injections, etc) that may induce pain to some determined degree.

2. Behavioural manifestations compatible with pain, that is to say, ways in which animals may indicate that they are hurting. These include:

• loss of normal behaviour (becoming less active, decreased interest in food and decreased grooming [cats])
• abnormal behaviours (loss of house training, whining or whimpering, acting aggressively towards housemates – human or animal)
• hiding
• altered posture (hunched, tucked, limping)
• restlessness, inability to settle
• pacing
• panting
• reaction to touch (increased tension in the body, flinching when touched, whining or whimpering, yelping)

Events or circumstances known to be associated with pain
This is a partial list of conditions or procedures that may generate a degree of sustained pain:

Mild to moderate pain
(The animal may lick or shake the affected part, may rest longer than usual but appear comfortable and able to stand):

• Moderate infections such as bladder infections (cystitis); ear infection (otitis)
• Minor surgeries such as a lump removal; dental extraction.

Moderate pain
(In addition to the signs for mild pain, the animal may favour the affected part; may be stiff or slow to stand and move):

• Diseases of muscles and joints, such as moderate disk damage, muscle soreness, etc.
• Invasive surgeries such as bone and joint surgery (ACL); abdominal surgery (spay, neuter, eye removal); extraction of major teeth

Moderate to severe pain
(The animal may be panting and salivating; ears may be pinned back; there is restlessness and uncomfortable appearance; may be lame and guarding the affected area; may appear hunched with a tense back and abdomen; may not be eating):

• Severe infections of the abdomen and bones
• Bone fractures
• Declawing of cats
• Torsions
• Extensive trauma
• Cancer

Severe to excruciating pain
(The animal may be too sedate to asses; it may be crying, barking, whimpering, groaning, hissing or screaming; it may be rolling or thrashing; the pupils are dilated; it may be aggressive, biting others):

• Pain from nerve damage/neuropathic pain (eg cervical intervertebral disc rupture, nerve entrapment)
• Extensive inflammation (eg peritonitis)
• Damage to the pancreas/necrotizing pancreatitis
• Bone cancer

Beneficial and adverse effects of pain medication

1. NSAIDS: (Metacam, Deramaxx, Tolefidine, Previcox)
• Beneficial aspects: anti-inflammatory, anti-fever, anti-pain, long duration of action.
• Potential adverse aspects: gastrointestinal upset (vomiting, diarrhea, lack of appetite), lethargy

2. Steroidal: Prednisone
• Beneficial: anti-pain, anti-inflammatory
• Potential adverse:
Expected: Drinking more, peeing more, eating more, panting
Unexpected: gastric upset (vomiting, lack of appetite), restlessness
It is important to follow the label instructions, to slowly decrease the dose and frequency of this medication.

3. Tramadol
• Beneficial: anti-pain, good for chronic pain management.
• Potentially adverse: sedating

If your pet experiences any of the potentially adverse reactions to a pain medication, please contact the hospital immediately at 865–8110.

For after-hours service, please contact the Metro Animal Emergency Clinic, 201 Brownlow Avenue, Dartmouth, NS: 468-0674