Pain Management in Dogs

Beatrix enjoying acupuncture.

Last April, my beagle Beatrix would yelp or cry out unexpectedly. Sometimes it was when she was getting out from under the covers, when she would run out the door, or even when she was out walking. When it would happen, I’d rub her from head to toe and watch her for a bit, but she seemed to go back to normal quickly, as if nothing was bothering her.

Until one day, she didn’t bounce back.

I also noticed that she couldn’t lift her head to look up at me, so she’d keep her head low and just watch me with her eyes. She’d cry out when she tried to take a treat from my hand. She had a hard time climbing stairs or jumping up on me in my chair or couch -- she loves to snuggle at night. She was eating, but not as enthusiastically as usual -- my beagles get The Honest Kitchen for dog food, so they are usually quite excited for nummies. I noticed that she had slowed down on our walks, acting like she didn’t want to go for that second mile, and she seemed to be panting more than normal. When I would pat her down to try to determine where the source of pain was, she’s stiffen up, making it nearly impossible to locate the source -- and sometimes, just cry out or yelp when I’d reach toward her to see if I could find the issue.

Many of these symptoms/signs Bea was displaying I knew were signs of pain. It was definitely time to go to vet.

My vet started her on a regimen of pain meds, and we were under strict orders not to be as active as usual, which is easier said than done for a beagle who loves her daily walks, chasing balls and scent work. After a few trips, and one emergency vet visit on a Sunday, we had an x-ray done that showed she had a herniated disc in her neck. This herniated disc was pressing on a nerve in her spine, and causing her to be in incredible pain. A couple of times, we thought the only option Bea would have was surgery to remove the herniated disc, so we started looking into other integrative approaches such as laser therapy and acupuncture.

Some 10 months later, Bea is leaps and bounds better -- literally. She’s bounding after balls, challenging Cooper and I to continue on to a third or fourth mile, and chasing squirrels and bunnies as if she were on a hunt. It’s great to see her this way, but I continue to do a lot to manage her condition. And, I’d like to share what I learned with you.

Pain Medicine
Often, it will take several different medications before your dog will begin to improve. Below is a list of the medications that you may encounter if you need to help manage pain in your dog.

1. Amantadine: This is another drug that is used to help control pain -- often used for arthritis or to treat pain from a nerve injury. It is mainly used in combination with pain relievers to improve their effects.
2. Gabapentin: This drug controls nerve related pain and arthritis, and can work to normalize the electrical activity in the brain. It’s most often prescribed to help control seizures in dogs and cats.
3. NSAIDs: The drug group most vets will prescribe are the same type of medications that we often take ourselves when we have a headache -- NSAIDs, or non-steroidal anti-inflammatory drugs. Like the name suggests, these are generally used to reduce inflammation, and can be removed once the inflammation has gone down. Commonly used NSAIDs include Rimadyl, Metacam and Previcox. These medications are generally safe, but are known to cause liver or kidney damage in some dogs with continual use. Please speak with your vet immediately if your dog is taking an NSAID and their behavior or appetite changes, they vomit or have loose or tarry stools -- they may be having a bad reaction to the drug. If you do give your pup Rimadyl, be sure to check out the Rimadyl Rewards Program. For every bottle purchased, you'll get points for a refund. You'll also receive credit on a special Rimadyl card to use for future meds or yearly blood tests. Be sure to talk with your vet about this program. Please note: Aspirin, a common over-the-counter NSAID, should not be administered without a vet’s direction. And other pain relievers such as Tylenol should never be given. Please consult a vet before you give your pet medication for pain management.
4. Robaxin: This drug relaxes muscles in your pet, helping to provide relief from the pain associated with muscle spasms.
5. Tramadol: Another drug group vets will use for pain management are opiates. Tramadol, which is a mild opiate, and isn’t a drug that will reduce pain, but reduce the response to pain. This medication was prescribed to once before when I was trying to make my dog Lucy comfortable while going through bone cancer.

At one time, Bea was taking what my vet and I referred to as a cocktail of all five of these medications to manage her pain. I’d say it took a few months of her being on this cocktail, and not being as active as normal for us to get her pain under control. Currently, Bea is taking a quarter of Rimadyl and one Gabapentin every day -- and hopefully we’ll be able to come off of that in time.

Other Approaches
Fortunately, I also learned about a few other treatments for pain that were a bit more natural to help Beatrix improve.

1. Acupuncture: This prickly technique is said to encourage the body to heal itself by correcting energy imbalances in the body. Acupuncture involves the insertion of needles into body tissue where nerve bundles and blood vessels come together called acupuncture points, which run throughout the body on what is referred to as energy channels. These channels permit a cycle of energy to occur throughout the whole body over 24 hours. Acupuncture enhances blood circulation, nervous system stimulation, and the release of anti-inflammatory and pain relieving hormones. And for Beatrix, worked wonders. Within two, roughly 10-15 minute treatments, I saw a major difference in her level of pain and could tell she was feeling better. We started by going to a couple of treatments a week, and eventually those tapered off to going every three weeks, which we are still scheduling. When we go, I simply rub her chest while the needles are doing their job -- I think she quite enjoys the treatment. I also feel confident in saying these helped me reduce the medications she was taking, and helped her feel better the quickest. (I’ve even started going to acupuncture for myself.) Currently, Animal Medical Center of Wyoming allows Kate Johnston of Gillette Acupuncture to come to the clinic and provide acupuncture treatments to pets on Tuesdays.
2. Laser therapy: Laser therapy can treat injuries, sprains and strains, arthritis, and swelling due to back disc problems, among others. It also helps to regenerate nerve tissue after surgery. With laser therapy, an intense beam of laser light is directed into tissues to help promote healing by reducing inflammation and increasing blood flow, which will also help reduce pain. Thankfully, three veterinary clinics in town offer this service: Gillette Pet Veterinary Clinic, Red Hills Veterinary Hospital and Thunder Basin Veterinary Clinic.
3. Supplements: These offer an over-the-counter approach to pain management. The supplements that I have chosen to use include Glucosamine and fish oil. Glucosamine helps with the production of joint lubricants and shock absorption that helps maintain healthy cartilage and joint function. Glucosamine is also involved with the formation of nails, tendons, skin, eyes, bone, ligaments, heart valves, and can help with digestion, breathing and urinary tracts. This supplement is extracted from crab, lobster, or shrimp shells and here are three forms of it--so, if your dog has a shellfish allergy, this is not an option for you. For dosage and recommendations on which form your pet should take, be sure to consult with your veterinarian. Fish oil can have a positive effect on the skin and coat of your pet as well as the heart, kidneys and joints (and others), but it is also a great treatment for inflammation. For dosage information, be sure to consult with your veterinarian. Another note about supplements: Some of the over-the-counter options may not work well together with prescribed medications. It's a good idea to speak with your vet beforehand before adding something to your pet's diet. 

One of the best articles I read about pain management came from the December 2015 edition of The Whole Dog Journal titled Pain treatment for dogs now commonplace in veterinary medicine, by Denise Flaim. And here is another website that I referenced a couple of times, International Veterinary Academy of Pain Management, https://ivapm.org.

It certainly helped me to research Bea's condition but the best partner for Bea and myself in all of this was our vet, Dr. Darren Lynde at Animal Medical Center. I kept him busy with questions, and many updates on how Bea was doing, and having his counsel certainly helped. 

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