Senior Pug

It’s so easy to tell when our animals — even older pets — are happy or joyous. We know that they are glad to see us or excited about going for a walk or passionate about chasing a laser toy. But there’s one thing they will hide from us at all costs: that they’re in pain.

Managing pain in animals is always a challenge. First of all, cats and dogs can’t tell us where or how much it hurts. Second of all, they probably wouldn’t tell us even if they could. Animals, especially older ones, instinctively try to hide pain or weakness because it puts them at risk from predators. Age is a factor, too. As our pets live longer, they are more likely to develop chronic illnesses that cause pain. And pain in senior pets can be difficult to manage because treating their health issues may conflict with treating their pain.

Fortunately, we know a lot more these days about recognizing pain in animals, how to relieve it and how to know when our pets are feeling better. Let me share with you some tips that can help your golden oldie stay comfortable even when faced with the chronic pain and disability that so often accompany aging.

Signs and Causes of Pain

You are probably used to seeing your dog or cat jump with ease onto the bed or sofa, trot up and down the stairs, and twist himself into pretzel-like shapes during grooming. When you notice changes in these activities, it may be the first inkling that your pet is in pain. Common signs of pain in cats and dogs include changes in sleep patterns or locations, obsessively licking or grooming a particular area, a reluctance to be petted or groomed, difficulty jumping up or down, lameness, lack of appetite, nausea and lethargy. Cats may groom themselves less often or start to miss the litterbox.

Any such unusual behavior can be a hint that your pet hurts. Even if you take your pet to the vet, an examination doesn’t always give clear evidence of pain. It’s helpful to your veterinarian if you write down the things you’ve noticed, such as the pet being sensitive in a particular area or having trouble getting on and off furniture. Your veterinarian may also note some physiologic signs that can be associated with the stress of pain, such as tachycardia (rapid heart rate), hypertension (high blood pressure) and tachypnea (rapid breathing).

Pain is often related to diseases that pets develop as they age. The most common diseases we see associated with chronic pain — long-lasting pain that doesn’t serve any real purpose — include urinary tract disease, inflammatory bowel disease, chronic ocular disease such as glaucoma, chronic pancreatitis, megacolon or chronic constipation, cancer, periodontal disease and stomatitis (inflammation of the tissues lining the mouth). We don’t always think of some of these diseases as being painful, but they definitely can be. Other causes of pain include degenerative joint disease or osteoarthritis, as well as the aftermath of injuries or surgery.

Some people assume that cats don’t get arthritis, but that’s not true. We can see evidence of it on radiographs the same way we do with dogs, and cats have joints that can deteriorate with age. Whatever the cause, chronic pain can affect pets in many ways. It may persist long after an injury or surgical site should have healed. Sometimes pain in one area can cause greater sensitivity to pain in other parts of the body. Other animals may experience pain in response to light touch or pressure or mild temperature changes — things that wouldn’t normally cause discomfort. The bottom line? Chronic pain is a distinct disease of the nervous system and it is underdiagnosed in cats and dogs.

Treating Pain

How we go about treating pain depends on the individual animal and his condition. There is no one-size-fits-all remedy. We often have to go through a process of trial and error to find the best ways to manage pain. When pets come in with severe pain, we use powerful medications to put a stop to it as quickly as possible. Then our goal is to bring in more moderate or mild medications to control the pain over the long term. Medication options for pets include NSAIDs (nonsteroidal anti-inflammatory drugs); opiates, which can be used alone or in combination with NSAIDs; and some antiseizure and antidepressant drugs that have been found to be effective for managing pain.

Which drugs your veterinarian chooses depends on your pet’s species and overall health. Drugs that are safe for dogs aren’t always safe for cats or might need to be used differently in cats. All drugs have the potential for side effects, and with some you will need to have your pet’s liver and kidney functions checked every few months to make sure the medication isn’t causing any problems. Call your veterinarian if your pet starts vomiting, becomes lethargic or loses his appetite after starting any medication.

Veterinarians also like to use what’s called multimodal, or layered, treatment. That might involve combining different drugs or using drugs in partnership with complementary therapies like acupuncture, massage, physical rehab and nutraceuticals such as glucosamine/chondroitin sulfate (an oral joint supplement) or fish oils. Together, the treatments can be more effective than a single drug or treatment used alone.

In severe cases, it can be a good idea to ask your veterinarian to refer you to a specialist who can work with the two of you to develop a pain management plan for your pet’s specific needs. Simple changes to your pet’s environment can also help sometimes. Get some pet steps or a ramp so it’s easier for him to get onto the furniture. A temperature-controlled bed can help warm and soothe achy joints. If he’s overweight, talk to your vet about how to safely adjust his diet and introduce safe forms of gentle exercise and play every day.

Sometimes we’re not sure if a pet is in pain, but if he has a condition that is normally painful, there’s a good chance that he’s in pain and just isn’t willing to tell us about it. In those cases, we might treat for the pain we expect and see what happens. Oftentimes, we can tell from the response — for instance, he’s moving around more and enjoys being petted again — that he was in pain that has been relieved.

More On