Margaret C. Saiki, D.V.M.,
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How to detect if your dog is experiencing chronic pain

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  How to detect if your dog is experiencing chronic pain

 Margaret Saiki

 

As part of our mobile veterinary house call practice in the San Jose, Ca. area, we use many of the topics discussed in this blog to assess chronic pain in your dog. Pain and pain management is an integral part our pet hospice care service. In addition, it helps in the evaluation for decision making concerning humane pet euthanasia.

Introduction

In this website as well as on an earlier blog post you will find a discussion on how to determine the quality of your pets’ life using the HHHHHMM QOL scale. “Hurt” is the first “H” is this quality of life scale and is the subject of this blog article.

Dogs tend to mask pain mainly as a species based protective mechanism. Not outwardly showing pain does not mean they don’t feel pain. In addition there are also differences in each individual dog in their ability to tolerate pain. Differences are noted in different breeds and different personalities of the patient. In most cases the best way for an owner to determine if a dog is painful is to note changes in their behavior and posture. It is therefore imperative that owners understand this for they are the best resource for determining the changes in their pets’ behavior.

In pet hospice care, it is usual for veterinarians to give your pet the benefit of the doubt, and treat for pain sooner rather than later. It is also not uncommon for owners to note how their pets’ respond to pain management and then realize the signs they missed.

Some sources of pain in the palliative of hospice care patient

·        Osteoarthritis (OA)

·        dental disease

·        malignancy/cancer

·        congestive heart failure (difficulty breathing)

·        pulmonary disease (difficulty breathing).

 

 

Arthritis and dental disease are by far and away the most common conditions which cause chronic pain which is difficult for owners to detect.

Assessing Pain

It is difficult to accurately assess pain in our companion dogs. Obviously it is difficult for them to describe the location, type of pain (burning aching, etc.) and severity (1-10). Therefore our best clues come from pet owners who are in the best position to relay nuanced changes in their pets’ behavior, psychological attitude, level of activity and estimated level of comfort.

Since signs of chronic pain cannot be accurately assessed other causes for behavioral of psychological changes should be ruled out with a work up. This may include a history, physical exam, comprehensive lab work and radiology.

There are 3 basic categories used to help determine if a dog is painful.

1.                 Psychological or Behavioral Changes.

Psychological changes include differences in general well-being and general attitude. Is your dog happy, curious, paying attention to what is going on around them and seeking attention? Or not interested in interacting and staying away.

Some behavior changes seen that may indicate pain

•    changes in activity

•    loss of brightness in the eyes

•    agitation

•    aggression

•    licking at painful area

•    altered appetite

•    altered interaction with family members

•    changes in sleep pattern

•    loss of house-training

•    altered response to handling

•    vocalizing

•    facial expression

2.                 Changes in Posture

Chronic pain may be displayed in abnormal positioning of the body. Again, it is helpful for owners to recognize what is normal for their pet in order to detect what is abnormal. 

·        Limping or lameness in one or more limbs.

·        Head bobbing. Usually a dog will head bob trying to take weight off the painful leg.

·        Sitting abnormally with one hind leg extended. The leg extended can have a painful stifle or knee because they are reluctant to flex it to sit.

·        Hunched back

·        Stiff short striding hind legs. This can mean pain in the hips or pain in both stifle or knee joints.

·        Reluctance or slow to rise from a sitting position

·        Difficulty getting up on the bed, couch or into a car.

 

3.                 Lastly, pain can be detected through palpation. This procedure is usually done by a veterinarian as part of a physical exam.

 

CSU Canine Chronic Pain Assessment Scale.

csu Chronic pain scale

 

This scale describes the psychological, behavioral, postural and palpation changes seen and corresponds these signs to the level or severity of pain. It is a valuable resource not only for veterinarians, but owners as well.

 

AAHA/AAFP Pain Management Guidelines for Dogs & Cats

These are guidelines are used by veterinarian to manage pain in companion animals therefore its content is quite in depth and technical.

Many dogs mask their pain even more when presented for examination by a Veterinarian. They will therefore not present the more subtle behavior and postural signs they would when at home this is all the more reason for owners to be versed in these signs.

Hopefully the information in this blog helps owners determine if their dog might be in chronic pain. Owners are a valuable resource for information especially in determining the psychological, behavior and postural signs of chronic pain. Knowing and understanding these signs will help the Veterinarian to select the proper treatment or medications to relieve pain.

Future blogs on this topic, the HHHHHMM QoL scale, will cover each aspect of this scale in depth. We hope you book mark this site and return to this blog for these future articles. 

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