Pain in pets.
The best doctor in the world is the veterinarian. He can't ask his patients what is the matter-he's got to just know. - Will Rogers
I spend a considerable amount of time trying to convince pet owners that their pet's conditions are painful. The disconnect is not in their understanding or their level of concern for their pet. The problem is usually in the way we are communicating about pain. Pain for us affects the way we act, feel and go about our daily business. Sort of. I think all of us have experienced pain that came on subtly and we adapted so well we didn't realize it was there until it was gone. Many headaches and sinus infections have pain like this.
The most common pain for me to be discussing with people is dental pain. At Riverside Veterinary Care we practice a lot of dentistry and we do it at the highest level possible. This includes paying close attention to pain management before, during and after the event. For those who see the need, understand the course of the disease or just take my word for it I will almost always (90% or better) hear from them at their one week check up that their pet is acting years younger or that they did not realize how much pain he or she was in before it was addressed. For those who have never had to endure my talk about why chronic or progressive pain often goes unnoticed, here it is.
Physiologically and anatomically speaking: All other mammals have exactly the same mechanisms feeling and reacting to pain as humans do. There is no reason to assume that something that is painful for us is not at least equally painful for them. Most of the really acute pain from fractures, lacerations or burns is fairly easy for people to relate to. The slower onset, chronic pain situations like arthritis or dental disease are a lot harder to understand.
Dogs are pack animals, they live in cooperative societies that also involve a fair amount of competition. A dog at the top of the heap, an alpha dog, is going to want to stay there. Dogs a little further down will want to at least maintain their position and may try to rise up and be alpha if the opportunity arises. Dogs at the bottom of the pack will be looking for any opportunity to make an advancement. Dogs at the bottom of the pack are also at risk for being removed from the pack if they are seen as a burden or a liability. For these reasons it is more advantageous to the dogs who have an endurable amount of pain to go on acting healthy and lively. That's why when they have dental pain they will continue to eat, continue to play and may even continue to chew on their chew toys. The changes that have occurred are going to have come on so subtly that you will most likely not notice that they are there until they have been treated.
Cats are certainly not pack animals. They may form friendships and may even develop a pride mentality if you have enough of them but it is not a pack. They are however, prey items for larger animals. Predators are going to look for the easiest possible meal and an animal that is showing weakness and vulnerability is going to be targeted over an animal that might put up a decent fight. Cats in pain have no incentive to show any pain, they don't know that you are going to help them. In many natural situations a predator that lives with you when you are healthy, read hyenas, jackals and piranhas,are likely to eat you as soon as you are weak. As far as Cuddles' instincts go she doesn't know you aren't going to eat her if she gets sick. It is for this reason that many cats are doing "just fine" until they fall down dead. Their instincts have been telling them that if they act weak they are going to die and then when they are going to die anyway there is no point in hiding their pain/sickness anymore.
I can explain this idea to people, even do a complete presentation with slides, illustrations and demonstrations and still hear at the end, "but he's still eating/running/chewing so I don't think it is painful." On the right day this can be infuriating for me, most days it just makes me smile. I have yet to find the magic bullet to getting this point across. If your dog or cat has a painful mouth or hips even if that pain is excruciating they still really only have one issue. If they then decide that they are not going to get up to go to the bathroom or they are not going to eat then they have two issues. Remembering that your pet does not know you are there to help them and take care of them when they are hurting, it is simply not in the pet's best interest to give themselves more problems. Keeping that in mind, this next thought is aimed at runners, skiers really anyone doing strenuous exercise or work. Do you run, ski or work when you're hurt? Chances are you do. Dogs are at least as fanatical about their running or chewing and are going to "play through the pain" just like you and I do.
The deal I would love to make with clients would be that if I recommend you treat something I consider painful and you don't see an improvement in your pet's attitude and activity then you get your money back. Unfortunately I am not now nor will I ever be in a position to offer such a gaurantee. I just can't control every variable. What I do offer and stand by one hundred percent is that if I tell you that something is painful and that your pet will do better if we address that painful condition and they dont; I don't ever expect you to take me at my word again. To me that's more important than money.
This week is another topic I would like you to share with as many people as you can. You can even email it to the one friend you have who is not on facebook.
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