Have you ever heard or thought this before? “Oh, my dog doesn’t bark at strangers anymore, he is just getting old.” Have you ever thought it could be something more?
September is pain awareness month in human medicine, so why not in vet med? Not to worry, it is! Animal pain awareness month was started to encourage pain management for all species. Animals hide their pain especially well, which is thought to be due to evolution in order to survive. If you look sick, you might get eaten! If you look sick, you may get kicked out of your group! There are lots of reasons that wild animals need to hide their pain, and it’s a trait that our companion animals may continue to do.
The mammalian pain pathway is one that has been unchanged over time and its parts include: transduction (nociception and inciting source), transmission (travels up peripheral nerves), modulation (signal moves into the spinal cord), and perception (to the brain); it’s essentially the same in humans as well as dogs, cats and other mammals too.
A painful animal may provide you with subtle clues. It could include decreased activity, not going up and down stairs, reluctance to jump onto surfaces, difficulty standing after lying down, decreased appetite, or over-grooming or licking a particular area.
I have personal experience with a painful pet. My moderately obese cat began walking a bit stiffly after laying down for long periods of time. We went to the vet and radiographs showed arthritic changes in his hips. Interestingly, it is important to remember that radiographic changes do not always correlate with clinical signs nor the degree of pain! In one study published (Hardie et al. JAVMA 2002; 200(5): 628-32), 90% of 100 cats over 12 years old, had evidence of degenerative joint disease. However, only 4% of them had any mention of arthritis in history.
We could easily be missing animals in pain. Just remember, pain can easily go unnoticed. It is up to us as veterinarians to ask the right questions, and investigate a little deeper when pain might be covertly present.