behavior issues

c a n i n e Is My Dog in Pain?

Robyn Lowe of PPG corporate partner Canine Arthritis Management discusses arthritis, how to identify the subtle signs of pain in dogs, and how we can help them enjoy a better quality of life

Did you know that arthritis is prevalent in around 35% of our canine population? And that of this 35%, we know that around 80% of dogs over 8 years old suffer from the condition? The numbers are quite staggering.

As every single dog is unique and every arthritis story is different, it’s imperative that, as their guardians, we learn to recognize the subtle signs of chronic pain. In doing so, it will ensure we are able to act swiftly and implement modifications if our dogs start showing signs of arthritic change. It is also of great importance that we take ac A change in behavior can be an indicator that a dog is experiencing some sort of discomfort or is in pain tion from a young age to prevent injury and repetitive strain, as well as consider other factors, are changes in the brain and spinal cord that can cause pain “windup” such as obesity, that can increase the risk of arthritic development. or central sensitization, causing an exaggerated pain response. The pain

Some dogs are stoic and will hide the symptoms of pain for a long outlasts the normal or usual time of healing and is associated with a distime, while others will show very early on that they are in pain. What ease or injury. Sadly, it serves no biological purpose and has no recogwe do know is that dogs all experience pain differently. By that, I mean nizable end point. Because of this, it is extremely important that we that Xrays may look horrendous on one dog, but clinically they are still manage it to the best of our ability. By doing so, we can still make our fairly mobile, whereas Xrays on another may show very mild changes – dogs’ quality of life as good as possible. yet the dog clinically is extremely painful! You may think that your dog isn’t in pain because he doesn’t limp all the time, or doesn’t yelp, or show any other obvious outward signs of discomfort. But this is where we need to consider the difference between acute and chronic pain: Dogs tend to tell us about chronic pain in a very different way to acute pain. Subtle Signs The take home message is that a dog suffering from chronic pain will not always cry, vocalize, or go completely nonweight bearing on a limb. The signs can be so subtle that we often miss them, or dismiss them as ‘slowing down’ or ‘old age.’ Acute Pain: Is an emergency strategy to help the dog move away from Chronic pain needs to be managed in a holistic and multimodal way. a noxious stimulus, literally run away (fight or flight) in order to protect Although holism is often confused – or misused – as the use of complethe body. Acute pain is selflimiting and is provoked by a specific disease mentary and alternative treatments, I mean it here in the true sense of or injury. It also serves as a useful biological purpose, which is, in the word. This means looking at your pet as a whole and assessing all essence to protect the individual experiencing it. his physical and mental requirements. These may include medication, preventing further injury, home adaptations, weight management (if reChronic Pain: In contrast, chronic pain may be considered a disease quired), the use of evidencebased supplements and additional therastate. It’s something that happens over time. With chronic pain there pies, and mental stimulation.

Some dogs are stoic and will hide the symptoms of pain for a long time, while others will show very early on that they are in pain. What we do know is that dogs all experience pain differently.

Identifying Chronic Pain

If you feel that your dog is showing any signs of chronic pain, at Canine Arthritis Management we always advise guardians to follow our pyramid (see Fig 1, below).

First of all, identify. You can do this by looking out for our pain indicators and identifying that there is an issue (see box, top right). Next, get the correct diagnosis. For this to happen, you will need to attend your veterinary surgery to work with your vet. A physical examination and history taking will occur. You may need to be open and financially prepared for the possibility of further investigations, such as Xrays and the possibility of longterm medication, as well as the idea of starting to implement a multimodal management plan, as discussed earlier.

Managing your expectations of the disease is important; this is now a lifelong, degenerative disease that will need to be managed. There will be waxes and wanes, which mean you will have good and bad days. Working with your veterinary surgeon and registered veterinary technicians to be in control of the pain is essential. This is exactly why pain control is at the center of our pyramid: because it is essential and central to all other interventions that we may want to implement.

Interventions

Once interventions are in place you may see a quick improvement in symptoms and behavior changes. Other changes require a bit longer to take effect as you work on rebuilding your dog’s muscle, core strength, and improve his gait. You will be happy to see that, in the months after diagnosis and starting a medication regime alongside other multimodal interventions, your dog becomes happier, livelier, wants to walk again, and asks to play with toys. You may also see that his sleep/wake cycle improves and that previous postural and physical changes will improve too.

Fig. 1

Tips/Signs of What to Look for When Examining Your Dog for Pain Indicators

1) Change in Behavior: Has your dog got grumpier? Less tolerant? Training going haywire? Fear reactive? This could be a defense mechanism to prevent pain. The dog may be anticipating that that big bouncy puppy is going to jump on him – and that HURTS. 2) Changes in Routine: Does your dog not want to get up in morning? Is he not asking to go for walks as much? Sleeping more than usual? 3) Mood State: Is your dog more withdrawn and depressed than usual? Not greeting you at the door with a wagging tail? 4) Sleeping: Has your dog’s wake/sleep cycle changed? Is he pacing at night? But is then depressed and sleepy during the day? 5) Comfort: Is your dog moving and shuffling around when trying to get comfy? 6) Joints: Is your dog licking his joints? Looking at a certain area? 7) Stiffness: Are the dog’s joints stiff or lame after walking, or after walking a certain length, or a certain terrain of walk? Are they stiff when he is getting up in the morning?

Optimal management includes the use of multiple interventions. Exercising your dog appropriately, not undertaking high impact games (such as the ‘ball thrower’ toy), implementing a suitable weight loss program (if your dog is overweight), and undertaking complementary therapies can all be considered in this plan.

From a personal perspective as guardian of a dog with arthritis, once we were following a medication regime, getting help from a physiotherapist, and adding complementary therapy, my dog was: • Less grumpy and reactive, and more tolerant. • Better at listening to cues. • Asking to play with toys much more. • Not asking to stop on walks. • Less fear reactive of other dogs while out for a walk.

All these factors add up to make for a much happier dog and guardian! n

Resources

Canine Arthritis Management. (2020). Chronic Pain Indicator Chart Canine Arthritis Management. (2020). Downloads and Resources Canine Arthritis Management. (2020). Has My Dog Definitely Got Osteoarthritis? Canine Arthritis Management. (2020). Identifying Signs of Arthritis

Robyn Lowe is a registered veterinary nurse who qualified at Myerscough School of Veterinary Nursing, England in 2016 and started her Royal College of Veterinary Surgeons diploma in advanced veterinary nursing in 2018. She has worked on a volunteer basis with animals since she was 4 years old. She spent several years at the Horse and Pony Protection Association and later at a local rescue and rehabilitation yard. Here, she met a veterinary surgeon who inspired her, and subsequently went for her first work experience in 2008 at their busy mixed practice. She has also travelled to Thailand to volunteer her knowledge and skills working with elephants, horses, goats, pigs, water buffalo, cats and dogs. She has supported the charity Street Paws, who help and provide preventative and medical care from homeless people’s dogs, and also volunteers for Canine Arthritis Management to help provide dog guardians with evidence-based advice.