A recent topic in the news has been that of a Patients Bill of Rights and the role of effective pain management. The American Academy of Pain Management has stated that 35 – 40 million Americans suffer from some sort of chronic pain. Pain has been classified as an epidemic, causing physicians to devote increased attention to providing their patients with adequate solutions for pain relief.
Likewise, over the past decade significant advances in the veterinary profession have provided veterinarians and pet owners with increased means to alleviate or at least decrease their pet’s pain. As a profession, we are sorry to admit that we have been slow to perceive our patients pain and strive to relieve it. Veterinarians are even more limited in that our patients cannot verbally communicate their pain to us. Recognition of their pain is even more challenging since they often will only subtly display signs of pain. Surprisingly, a further complication is the predator/prey mechanism, which is still very much a part of domesticated pets genetic makeup. It may be hard to believe, but your couch potato cat or lazy Labrador may actually hide their pain, so as not to draw attention and become more susceptible prey! We have frequently diagnosed chronic conditions, such as osteoarthritis, that have obviously been present for quite some time, but only recently did the pet outwardly demonstrate signs of pain. These signs may include lethargy, inappetance, avoidance, vocalization and increased heart and respiration rates.
Veterinarians must determine whether their patients are dealing with chronic or acute pain and their treatments are often multidisciplined. Forms of chronic pain include degenerative joint disease (DJD) and different types of cancer. Common therapies include nonsteroidal anti-inflammatories (NSAIDs), cartilage protective agents (glucosamine/chondroitan sulfates) and even acupuncture. It is important to note that human medications are not necessarily safe for your pets. For example, Tylenol is a relatively safe human NSAID, but one dose will likely kill a cat without aggressive emergency treatment. Your veterinarian should always be consulted prior to giving your pets any medications.
Acute causes of pain include traumatic injuries, such as lacerations and automobile accidents. Surgeries to correct traumatic injuries, in addition to elective procedures (spay/neuters, dental cleanings and growth removals) are also a source of acute pain for pets. NSAIDS are often used for these cases, but veterinarians are increasingly administering opiods, which are narcotics, safely and effectively. Opiods include morphine, oxymorphone, fentanyl and torbugesic. For orthopedic surgeries, we frequently apply transdermal Fentanyl patches to our patients the day before surgery. These patches provide significant pain relief for up to 3 days. Over the past year we have also realized the great benefit of performing most of my surgical procedures with a carbon dioxide laser. The laser drastically decreases post-operative pain, as compared to a scalpel blade, by sealing nerve endings as it cuts through tissue.
The increased recognition and ability to treat pain has become a vital and rewarding part of the veterinary profession. Studies have shown that pain actually delays healing by damaging body tissues, whereas adequate pain relief will speed recovery. Pet owners, with the guidance of their veterinarians, are increasingly providing pain relief to their pets and significantly improving their length and quality of life.