As I continue through my series on aging in pets, I’d like to focus on chronic pain and how it is often missed by pet owners. When I diagnose a likely painful condition in an animal, especially during a routine wellness visit, the most common response from the pet owners is “But they’re not crying…”. People often forget that chronic pain, even in people, is not something that often elicits a vocal response. Think of history before medicine and how many people likely walked around with painful joints, teeth, etc. They would suppress the pain to get through their days. This is even more pronounced in animals as there is the included survival drive. A hurt animal that cries out in the wild would be quickly eaten. So, it is very rare for any kind of audible signs of pain to come from dogs or cats.
So how do vets know when pets are painful? The first is by extrapolating what we know from people. In dental disease, the first sign a human has of a problem with their teeth is pain, sometimes excruciating. This can even be with a simple, single infected tooth. So, when a dog comes in with a mouth full of smelly, infected teeth, we know they must be in a lot of pain. Most clients are amazing at the positive change in personality once their pet’s dental disease is finally addressed. What many thought was simple “slowing down” was actually depression from severe, chronic pain.
Visible cues are the next thing that we use. There are the obvious ones, such as limping or reacting defensively when a certain area is touched. But there are less subtle signs as well. Panting usually makes an owner feel their dog is hot, but it is also a sign of pain or stress. Body language is next. Most pets in pain tend to have their heads hung, tails limp, and often stare at nothing. If the pain is localized to a certain spot, they can either under- or over-groom that spot. Changes in both appetite and exercise will begin to cause weight loss and muscle wasting of the painful limbs. These are all things that lead us to look for a source of pain.
The last are “behavioral” changes at home. Some animals become timid to aggressive with pain (grouchy=ouchy), especially if they are guarding a painful spot on their bodies. They can also become restless, especially at night with a lot of repositioning. One of the biggest changes we see with arthritis pain is accidents in the house, especially with females. While males can stand straight to urinate, females must hold a squat. If they can’t, they don’t fully empty their bladders. This leads to infections and bladder stretching that force them to go in the home. Both sexes must squat to defecate so if they aren’t able to hold themselves up to fully empty out, feces will build up and the body will begin to just passively push it out. Unlike a pile of poop with a normal behavioral “accident”, these patients will tend to drop pieces as they walk and it will be spread along the floor. These patients should have their joints assessed ASAP.