Managing Chronic Pain in Pets
— By Dr. Ryan Millington —
Pet Pain Control
Chronic pain in our pets is one of the most difficult things that pet owners deal with. It’s often a slow-occurring process. It’s also hard to determine if pets are truly in pain or if they are just “slowing down” with age. This article will discuss sources of chronic pain, symptoms of chronic pain, and effective ways to treat chronic pain.
Sources of Chronic Pain in Pets
First, Let’s discuss some common sources of chronic pain in our pets. One of the most easily recognized forms of chronic pain in dogs and cats is osteoarthritis. Other commonly appreciated sources of chronic pain include back pain secondary to spondylosis or “bridging” of the spine, oral pain secondary to severe dental disease, or even abdominal pain secondary to chronic pancreatitis or irritable bowel syndrome (IBS). All of these conditions are slowly progressive processes that begin to present subtly.
Symptoms of Chronic Pain in Pets
It’s important to understand that there are species differences when determining if your pet is experiencing chronic pain. Most dog owners have an easier time identifying the signs of pain, but cats are particularly difficult to recognize chronic pain in. Generally speaking, dogs are significantly more interactive with their families, and cats are typically much more independent and solitary.
In addition to pets becoming less active, another symptom of chronic pain in our pets is changes in appetite. Perhaps your dog is not eating as much as usual because it hurts them to bend down to eat due to cervical spinal pain. Or maybe you have a cat who has chronic pain that keeps them from reaching the food that is usually kept on the counter. More symptoms commonly associated with oral pain are pets dropping food or chewing on only one side of their mouth while eating.
Keep in mind that pain is not black and white. There are an infinite number of degrees of pain. Sometimes, there are no obvious signs that a pet suffers from chronic pain. It’s a good habit to get your pets regularly checked out by their veterinarian.
There are, thankfully, some objective metrics your veterinarian will evaluate during their physical exam of your pet to determine if they are in pain. This includes oral exams, evaluation of joints, and examinations of range of motion. Hopefully, you also see the value in regularly evaluating your pet, not just when they are older.
Treating Chronic Pain in Pets
Long-term chronic pain management for dogs traditionally comes from two main categories: non-steroidal anti-inflammatory drugs (NSAIDs) or opioid/opiate-type drugs. There are many different types of NSAIDs for use in dogs, but only one is labeled for use in cats, and it is not meant for long-term use, typically only 3-5 days. Opioids also have their source of negative attributes. Although we don’t have to worry about our pets becoming “addicted” to opioids, we do have to consider them becoming desensitized to the desired pain relieving effect.
Another drug that is commonly used these days is Gabapentin, which is thought to help with neuropathic pain. Its effectiveness in cases of musculoskeletal pain, such as osteoarthritis, is still not certain. However, it is an extremely safe medication with little to no negative side effects.
There is also a new and exciting class of pain medication for long-term chronic pain, cLLS monoclonal antibody injections. Recently there have been two monoclonal antibody injectable medications called Librela™ (for dogs) and Solensia™ (for cats). It may seem strange to think of an “antibody” as something that treats pain; however, antibodies can be used as a key that turns on a light switch. In the case of infections, antibodies will “turn on a light” on the pathogen, which identifies it, and other cells go in to kill it.
It works in the opposite manner to treat pain. The sensation of pain is a cascade of events. Let’s say you smash your finger in the door; the nerves in your finger are damaged and start firing, sending a signal up your arm, to your spinal cord, and to your brain stem, which interprets that stimulus. At each step, some chemicals are released that trigger the next response. Well, what monoclonal antibodies, like Librela™ and Solensia™ do is bind to some of those chemicals, thus dulling some of the pain perception.
One of the best attributes of Librela™ and Solensia™ is the administration of them. Pets, particularly cats, can be notoriously difficult to medicate. Perhaps the medication makes them nauseous, maybe it’s their mouth that hurts, or perhaps they get tired of taking them. Whatever the reason, the best pain medication in the world isn’t going to do a thing for you if it’s not in your body. Monoclonal antibodies are injectable medications that are only given monthly.
Chronic pain is common in our pets, and they do a wonderful job of hiding it. Whether it be their animalistic instinct to hide discomfort or they are just overcome by the excitement of being with their humans, it can be very difficult to appreciate the signs of discomfort. The key is recognizing it, identifying it, and then discussing a treatment plan with your veterinarian. We love our pets too much to allow them to live in discomfort.
For more information, questions, or concerns, please contact Springs Veterinary Care.
Librela ISI: IMPORTANT SAFETY INFORMATION:
See full Prescribing Information. For use in dogs only. Women who are pregnant, trying to conceive or breastfeeding should take extreme care to avoid self-injection. Hypersensitivity reactions, including anaphylaxis, could potentially occur with self-injection. LIBRELA should not be used in breeding, pregnant or lactating dogs. LIBRELA should not be administered to dogs with known hypersensitivity to bedinvetmab. The most common adverse events reported in a clinical study were urinary tract infections, bacterial skin infections and dermatitis.
Solensia ISI: IMPORTANT SAFETY INFORMATION:
See full Prescribing Information. For use in cats only. Women who are pregnant, trying to conceive or breastfeeding should take extreme care to avoid self-injection. Hypersensitivity reactions, including anaphylaxis, could potentially occur with self-injection. Solensia should not be used in breeding cats or in pregnant or lactating queens. Solensia should not be administered to cats with known hypersensitivity to frunevetmab. The most common adverse events reported in a clinical study were vomiting and injection site pain.