Monday, February 1, 2010

Pain and Pet Care




One of the most important questions I am asked in my practice has to do with quality of life issues.  The most important aspect of that quality is living a pain free life. It is important to understand where pain originates and how to evaluate the symptoms that are exhibited by a pet in pain.
Historically it was thought that animals did not perceive pain the same way as humans.  Additionally, it was suggested that pain following surgery or injury was beneficial to animals because it limited movement and thus prevented further injury.
Today there is a better understanding of how pain develops. It is now well established that animals and humans have similar neurological pathways for the development, conduction, and modulation of pain. 
Preventing risk factors early in life reduces the development of pain later in life. For example, providing lifelong dental care reduces the development of oral pain caused by periodontal disease. Preventing obesity reduces the incidence and severity of osteoarthritis in breeds prone to hip dysplasia and the risk of intervertebral disc disease in breeds such as the dachshund.
When I examine a pet, I always check the following organ systems and locations that can become  sources for pain:
The heart can have congestive heart failure and create risk for blood clots. The skin is involved with ear infections, burns, wounds, abscess, urine scalding and severe itchiness.
 Dental pain comes from abscess, ulcers, oral tumors and periodontal disease. The abdomin can reveal constipation, anal sac disease, pancreatitis, obstruction and foreign bodies. Pain involving muscle and bones include arthritis, disc disease, trauma, tendon and ligament injuries.
 We see pain originating from eyes with corneal lesions, ulcers, glaucoma and conjunctivitis. In the urinary tract, bladder and kidney stones, bladder infections and urethral obstruction in cats can all result in pain.
In addition to the above, neurological causes for pain include spinal pain from disc diseases and neurological consequences of diabetes. Cancer in any form is a source of pain.
One general sign of pain is a change in normal behavior. This includes lameness, lethargy, decreased appetite, decrease in grooming, and a decrease in movement or activity.
The expression of abnormal behaviors can be a sign of pain.  Vocalization, inappropriate elimination, decreased interaction with family members and other family pets, altered facial expression, restlessness, pacing, hiding and changes in posture all fit in the definition of abnormal behaviors that can result from painful conditions.
The reaction to touch or palpation is another potential sign to look for when trying to determine levels of pain.  This can be seen as a tightening or increased body tension when gently touching certain body parts like the abdomen or limbs.
Other symptoms of pain are reflected by physiological parameters.  These include a more rapid heart and respiratory rate, increase or decrease in body temperature and dilation of the pupils.
We have the ability to mitigate the consequences of pain and improve the quality of life of our pets by having an awareness of ways to prevent the diseases that cause pain and determining the cause of pain when it appears. Your veterinarian has the ability to diagnose the source of the pain and select a treatment regimen, which can include a choice of several drugs or surgery that can alleviate the discomfort and hopefully cure the disease which is causing it.

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