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How can I tell when my dog’s pain isn’t controlled any more?

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Pain is something that we all experience, even dogs. Many of our beloved pets will unfortunately experience pain at some point in their lives, and we should endeavour to keep it appropriately controlled. Particularly in cases of dogs affected by long-term conditions, levels of pain can constantly vary. Therefore, as an owner, it is important to be aware of when your dog is not the most comfortable that they can be.

What is pain? 

The widely used definition of pain is ‘an unpleasant sensory and emotional experience, associated with actual or potential tissue damage’. This means that pain is not just what you feel, but also how this makes you feel. It generally has a protective function, but can lead to additional stress and suffering if not properly controlled.

There are different types of pain, all with different underlying causes. Pain can broadly be placed into two categories:

Acute pain 

This happens when a potentially harmful stimulus (for example, cutting, crushing or burning) is applied to the body. The purpose of acute pain is to protect, making the body aware of danger and damage. Its severity will be proportional to the stimulus, i.e. the worse the damage, the more painful it will be. Dogs can experience this kind of pain after surgery, or due to injury, or secondary to other conditions like pancreatitis.

Chronic pain 

This means the pain is persistent and long lasting. A good example of this would be arthritis (joint inflammation), which often affects animals for a number of years. Levels of pain can change over time and will be influenced by many factors. It is also important to note that even with chronic conditions, animals can experience acute flare-ups of pain, also known as breakthrough pain.

How do I know when my dog is experiencing pain? 

Even though dogs can’t directly tell us when they’re in pain, there are things that we can look out for that may suggest they are, relying mostly on behavioural changes. These may be signs that you’ve seen in your dog before, if they have already seen a vet about pain management.

  • Excessive panting
  • Limping and mobility changes (including stiffness/difficulty getting up)
  • Reduced appetite 
  • Lethargy and depression
  • Irritability 
  • Increased grooming in painful areas

Can we use pain scoring?

Pain scoring and assessments can be really useful at helping to determine the level of pain our pets are experiencing, and therefore helpful in making practical decisions about their care. There are several out there developed for use in dogs with both acute and chronic conditions. 

The Glasgow Composite Pain Score is widely used for monitoring acute pain, particularly in post-surgical cases. It looks at the following behaviours: vocalisation, attention to painful area, mobility, response to touch, demeanour and posture. While mostly used in practice, you could use it at home if you wanted to monitor your pet after they return home from surgery. 

There are several scales out there for monitoring chronic pain. These can be very useful for vets to get a better idea as to what extent an individual animal is affected. The Canine Brief Pain Inventory looks at an owner’s perception of their pet’s pain and how it has affected their daily life over the course of a week. Another questionnaire, the Liverpool Osteoarthritis in Dogs (LOAD), looks at lifestyle, mobility and exercise regime to paint a clearer picture of how a dog may be managing.

What can be done? 

In cases of acute pain, particularly after surgery, it is important to monitor your dog closely. While most will be comfortable with the medication already prescribed by your vet, no two animals are the same! It is important to contact your vet if you feel they need extra pain relief.

Managing chronic pain can be a little more complicated. It is likely that the levels of pain your animal experiences will change over time, making it all the more important to know when you think they need a little extra help. Long-term medication will help, but it may take time to work out which drugs and what doses work best for your dog. Besides medical management, you could also consider making changes within your home to make it more comfortable for your pet, including rugs of slippery floors, limiting their access to stairs, and making sure they have an extra warm and comfortable bed to sleep in. You could also consider things like hydrotherapy, acupuncture and laser therapy.

Quality of life is really important to consider in cases of chronic pain. 

There may come a point where it is very difficult to manage the pain your dog is experiencing, which will ultimately have a negative impact on them. In cases such as these, it may be necessary – and kindest – to consider euthanasia as an alternative to ongoing suffering.

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