Charlie, a 5-year-old orange-and-white cat, was in acute pain from a back injury. But when his owner took him to the veterinarian, surprisingly simple relief was at hand. No struggling to cram a pill down his throat, no trying to coax him to swallow a liquid.
“My veterinarian had been looking for an opportunity to try out a new ‘cocktail’ of drugs that goes into a needleless syringe and is applied to the gums,” says Charlie's owner, Marion Lane of New York City. Absorbed directly into the bloodstream, the medicine took effect within seconds. Charlie relaxed and soon fell asleep right where he was lying. He enjoyed sweet, soothing sleep for the next six to eight hours.
Charlie was lucky that his veterinarian was able to offer such quick, effective pain relief. A little more than a decade ago, pain management wasn’t an issue for many veterinarians. They didn’t have a clear understanding of how animals experienced pain, and few drugs were available that could help.
Managing pain in animals has always been a challenge because cats and dogs can’t say where or how much it hurts. Beyond that communication gap, animals — especially cats — often try to hide their pain, an instinctive behavior dictated by the premise that the weak don’t survive.
Owners are demanding it
In the past 10 years, however, veterinarians have focused on pain relief for pets, and managing pain in companion animals will be one of the two or three defining issues of veterinary medicine in the first half of the 21st century, says William Tranquilli, a professor of veterinary clinical medicine at the University of Illinois in Urbana.
What changed? Part of the answer lies in increased demand by pet owners. “Many of the questions we as anesthesiologists are asked on a daily basis are about pain and anxiety,” says Alicia Karas, an assistant professor of anesthesiology at Tufts University School of Veterinary Medicine in North Grafton, Mass., and a diplomate of the American College of Veterinary Anesthesia.
Owner concern, plus their own interest in animals, led anesthesiologists, surgeons and intensive-care veterinarians to look more closely at animals in pain and try to do a better job of recognizing and treating it. Dogs and cats have been the main beneficiaries of this interest. Not enough is known yet about treating pain in birds, reptiles and other pets such as ferrets, Karas says, adding "we are using some pain meds in birds, and we are studying how best to treat them, so progress is being made."
The treatment Lane’s veterinarian used for Charlie includes a morphine derivative that’s usually injected. What’s new is the idea of placing it in a medication syringe and applying it to the gums. This makes it easy for owners to give it at home as needed, a relief for people with cats, which are often reluctant if not downright unwilling to swallow pills or liquids. Lane keeps a filled syringe on hand in case Charlie has another episode.
What’s also different is using this type of drug with a cat. Veterinarians once believed that opioids such as morphine couldn’t be used in cats because they metabolized the drugs differently than dogs and humans. “We can and do treat cats with these drugs quite effectively,” Karas says.
Better medicine
Veterinarians also have access to safer, more effective drugs now. A few years ago, Gabriel’s veterinarian might have chalked up the 11-year-old Belgian Tervuren’s pain and stiffness to old age and recommended a small dose of aspirin. Instead, Gabriel takes a two-week course of a nonsteroidal anti-inflammatory drug (NSAID) as needed.
“My veterinarian wants to use it as needed, rather than all the time, because typically dogs have ups and downs,” says Gabriel’s owner, Kathy Diamond Davis of Oklahoma City, Okla. “The same medication works when he has a flare-up of his bulging cervical disk. We’ve learned by trial and error that he needs a two-week course of medication to avoid a quick recurrence.”
Surgery is another common cause of pain in pets. Whether it’s a spay or a fracture repair, the aftermath of surgery is pain. Imagine not getting anything to relieve that pain. When Karas graduated from veterinary school in 1989, that was often the case with dogs and cats. Now veterinarians can provide pain relief that starts before surgery and continues throughout recovery.
New anesthesia techniques include using local anesthetics to block nerves to the area being operated on and combinations of drugs that can be put in IV fluids and continued postoperatively to give pain relief for hours or even days, if necessary, says John Hamil, a veterinarian at Canyon Animal Hospital in Laguna Beach, Calif.
When 12-year-old Diamond, a poodle mix owned by Cheryl Smith of Port Angeles, Wash., somehow twisted the wrong way and dislocated her hip, her veterinarian wasn’t available to operate that day. Instead, Diamond was X-rayed and then anesthetized so the hip could be put back in place temporarily. She was sent home with a liquid NSAID that kept her comfortable until surgery was performed. Afterward, she wore a patch that dispensed pain medication through the skin for the next three days.
“She never seemed to be in serious pain once we got her on the Metacam [the liquid NSAID], and the pain patch also seemed to work very well,” Smith says.
Diamond is expected to make a full recovery. She didn’t fuss at the surgery site while on the pain meds and continued to ignore it even after the controlled-release patch was removed.
“Maybe actual recovery time wasn’t affected,” Smith says, “but ease of recovery was.”
Kim Campbell Thornton is an award-winning author who has written many articles and more than a dozen books about dogs and cats. She belongs to the Dog Writers Association of America and is past president of the Cat Writers Association. She shares her home in California with three Cavalier King Charles Spaniels and one African ringneck parakeet.
