Photo by Dr. Teri A. Oursler
If you ask someone if they are empathetic, chances are they will answer in the affirmative. Most of us have been brought up to value empathy and consider it a good thing to be. We like to think that we can imagine and literally “suffer with” the discomfort and pain of another, which is what empathy is. However, when push comes to shove, it’s often tough to be empathetic to another’s plight. For example, I have no idea how much suffering is involved with a “man cold,” and I’d bet there are few 18-year-olds who can empathize with the aches and pains of the elderly.
Veterinarians are often frustrated when they see a patient who they believe is in pain and recommend a treatment, only to have the client flatly deny that the animal is in pain and/or claim that the suggestion is only a means of siphoning money from their wallets. We animal docs have, after all, dedicated our lives to the relief of animal suffering and after four years of veterinary medical school, perhaps an internship or residency thrown into the mix and years of clinical experience, it’s tough to hear a client say out loud or in so many words: You have no idea what you’re talking about.
The fact is that our dogs and cats don’t send out the same signals we humans do when we’re not feeling well. Our species cries, screams, moans, curses and has a whole range of words and body language that make it pretty obvious something is amiss. Yes, there are those folks with high tolerances for pain who go about their business and keep their aches and pains to themselves, but they are probably the exception to the rule. Humans like to kvetch and complain.
Our dogs and cats are often much more subtle. While the client may deny that their four-pound Yorkie or 11-pound bruiser of a tabby has dental pain because they’re “still eating,” the fact is that teeth that are fractured and/or dripping pus and gums that are the color of a fire engine are painful. The dog or cat with dental pain is still eating because, frankly, what other option do they have? Our companion animals with painful mouths are pretty clever in getting food into their tummies: They chew on the side of their mouths that hurts less; they swallow their food without chewing; or, they take their time - lots of time - with their portion. So while it doesn’t necessarily take the skills of Sherlock Holmes to ferret out the problem, humans who live with companion animals need to watch for clues, especially subtle ones, as indicators that something is amiss. Your friendly veterinarian hopes that not only will you be astute and realize that Fluffy or Sampson isn’t up to snuff, but you’ll also want to do something to relieve the owwwww.
Orthopedic pain, in the form of degenerative joint disease (arthritis), hip dysplasia and other problems of the bones and joints often can be maddeningly difficult to identify, especially in the early stages. However, you might notice that your adult dog is sitting preferentially on one hip over another. That’s called puppy sitting, and while it’s normal in pups, it’s not normal in adult dogs. Cats with arthritis will often start avoiding the graceful floor-to-window sill catapult and start jumping from the floor to another piece of furniture, like an ottoman, and then cruising over to the sill and waiting patiently for their arch-enemy cat from down the block or the taunting squirrel to make an appearance. Folks who are owned by cats often don’t think too much of that sort of thing, but I typically ask about that type of behavior, because I know that it’s indicative that the kitty is probably unable to make the leap due to pain. In the exam room, when I’ve palpated an uncomfortable spot in a cat, I often get only a quick side glance from Purrsy or the flick of a whisker. Rarely do I get claws extended and aimed at my face as a response.
Some clients are attuned to their dogs and cats and recognize discomfort and pain, but don’t want to bring their companion to the veterinarian and desire an at-home treatment. This is a big no-no, despite what the esteemed snake oil salesman Dr. Google might say. You may think your medicine cabinet holds benign medications, like aspirin, Tylenol, Aleve, Advil and the like, but those can and frequently do kill cats and dogs and should be off-limits. Fortunately, there are pain relievers specifically designed for cats and dogs that are much safer options.
I became a veterinarian just as the profession was acknowledging the fact that dogs, cats, and other critters should have good pain control, especially after surgical procedures. It used to be that dogs and cats were sent home from their spays or neuters without any medication to help relieve the pain and discomfort. In fact, clients were typically told by the old-timey docs that pain control was contraindicated because pain “kept the animal quiet” and in some way helped with recovery. The good news is that no veterinarian worth his or her diploma or license nowadays believes that sort of rubbish and the profession is making great strides not only in providing pain relief before, during and after surgery, but also for the aches and pains that come with aging and physical exertion. Pain control for animals is no longer limited to medications and includes an array of modalities, including acupuncture, spinal manipulation (chiropractic), laser therapy and rehabilitation.
In fact, there is a worldwide organization of veterinarians interested in pain control: The International Veterinary Academy of Pain Management. The organization’s website includes information for the public, which not only addresses how animals show us they are painful, but also how to find a veterinarian who is particularly interested in pain management in companion animals. Take the time to review the list of behaviors that are associated with pain in your favorite animal buddy. In doing so, you’ll find that your kitty who is urinating or defecating (or both) outside the litter box is not dissing you, but is trying (mightily) to alert you that she has arthritis or other disease processes; and your dog who is chewing that one area on his wrist or hip is trying to relieve his ouchiness. Many of these behaviors that we attribute to neuroticism in our animal companions are not as much signs of mental illness as pain. And knowing that should make us all feel a bit sheepish. As I tell my clients: Our dogs and cats aren’t nearly as crazy as we are.
The IVAPM correctly states that age is not a disease, but pain is. The good news is that working with your veterinarian, you can help your animal companion live a happy, healthy and pain-free life.
And that’s what we all want, right?
September 25, 2021
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VIN News Service commentaries are opinion pieces presenting insights, personal experiences and/or perspectives on topical issues by members of the veterinary community. To submit a commentary for consideration, email firstname.lastname@example.org.