Pain, Pain Go Away

A handful of years ago, I noticed that my dog's gait was slightly off-kilter as she bounded up the stairs. The change was so subtle that I wondered if it was a figment of my imagination. Regardless, I took her to the vet for radiographs, expecting a diagnosis of a pulled a muscle or a strained ligament. What the doctor uncovered shocked me: my dog had almost no hip sockets and severe bilateral arthritis. By all rights, he said, she was born with severe hip dysplasia and had learned to live with it - but how she ever walked normally was anyone's guess. I went home in tears, wondering how I could have overlooked her painful condition for all those years.

Animals act better than they feel

According to Dr. Lisa Powell, associate clinical professor of Emergency and Critical Care at the University of Minnesota's Veterinary Medical Center, stories like this are not unusual because animals often look (and act) better than they feel. Animals seem to be much more tolerant of pain than their human companions and, as such, are capable of concealing injury and disease.

Behavior change indicative of pain

A recent article published in the Journal of Feline Medicine and Surgery provides some direction for veterinarians and pet parents navigating the tricky territory of pain assessment. While humans and animals have the same brain structures responsible for pain development and modulation, animals are less likely to display what most of us consider outward signs of painful (the most obvious sign being vocalization). Instead, the number-one cue indicative of pain is behavior change. If your animal starts behaving in a way that is unusual for him, consider yourself the recipient of a hint.

Understanding what is normal behavior for your animal (not most animals) will help you judge when something is awry. The loss of normal behavior (a lack of energy, enthusiasm and vigor for daily activities), or even the development of abnormal behaviors (such as aggression, hiding, pacing, social withdrawal or inappropriate elimination) may indicate that your animal is hurting.

Physical signs of pain

Additionally, there are some concrete, physical signs of pain that serve as benchmarks of discomfort. These signs include:

• Increased heart rate (more than 80-100 beats per minute in large dogs, 100-140 beats per minute in small to medium dogs, and 180-200 beats per minute in cats).

• Increased respiratory rate (more than 20-40 breaths per minute for dogs and cats who are at rest/not panting).

• Increased body temperature (normal range is 100F-102F for both dogs and cats).

• Increased blood pressure.

• Dilated pupils.

Other physical signs of pain include muscle tension, flinching or other reactions to being touched, and altered posture such as "hunching." Dr. Powell notes that a potent example of altered posture is the "prayer position" in which animals stand with their forelimbs and chest down while their rear end stretches upward. This position, a slower, more deliberate pose than the canine "play bow," is often a sign of severe abdominal pain, especially in dogs.

Manage chronic pain

Anyone who has lived with chronic pain will say that it is a heavy burden - a burden that wears on emotional health as well as physical health, impacting motivation, movement and overall capacity for enjoyment. The same can be said for our animals, for whom untreated pain can reduce quality of life and even interfere with the ability to heal from other illnesses or injuries. While a little bit of pain can be an "adaptive" response, signaling to our animals that they have run too far, jumped too high, or ingested something wholly inappropriate, that pain can become "maladaptive" when it persists without relief. Maladaptive pain stems from physical changes in brain structure that make the body even more sensitive to stimuli and therefore more painful overall. So the longer your animal's pain goes unmanaged, the more difficult it will be for you and your veterinary team to control it.

The best advice is to keep a close eye on your critters. Dr. Powell has two tips: first, take careful note of what is "normal" behavior for your animal and then respond swiftly to any change in that norm. While the changed behavior may not be indicative of significant disease, it may point to the development of pain that requires support. Second, if you sense that something is wrong with your animal - even if the signs are subtle - trust yourself and seek veterinary care. You know your animal and your animal's special language better than anyone else.

Jeannine Moga, MA, MSW, LICSW is a social worker and human-animal bond specialist at the University of Minnesota Veterinary Medical Center, and an editorial advisory board member for Star Tribune Pet Central. www.cvm.umn.edu/vmc/aboutvmc /clientsupport.html