Over the past decade, treating pain in pets has gained more recognition in veterinary practice, but far too often I see pets at the end of their lives in horrible pain. These pets have been seen by a veterinarian, but the pain has not been treated; and, in some cases, for many years. These animals deserve better, so I think you should know how pain is treated in todayís modern veterinary practice.I often see dogs near the end of their lives and many of them are in horrible pain. The owners will tell me they know their dog is in pain, but they are giving the pain pills their veterinarian prescribed. Sometimes, I hear they are giving ìsome sort of supplementî or even a human medication. What is true in practically all of these cases is that these things are not working and the pet is still in pain. At this point, the pet needs drastic intervention or euthanasia.What could have been done years ago to give this pet some relief and ìmore good days, than bad onesî? The answer could be something called multi-modal pain management. The idea is simple and a new approach used in both human medicine and veterinary medicine. Multi-modal pain management means we use several medications and supplements that work at different parts of the pain pathway, which allows the veterinarian to decrease the overall amount of some of the drugs that can be harmful long term.What do we use besides the standard template of pain drugs? Letís take a look at a few of the drugs that can be used in a multi-modal approach.Gabapentin is a drug that has been used for many years in humans called ìNeurontin.î The newer form is Lyrica. Gabapentin works well in dogs. It must be dosed properly and started correctly in the first few weeks, but is often highly effective.Omega 3 fish oil is an outstanding way to help with the inflammation that accompanies most pain generators. You should find the highest quality medical grade fish oil so that it is pure and effective. I do not recommend an inexpensive brand on grocery store shelves. In researching this topic, Iíve found that Nordic Naturals Omega Pet is the best. It is hard to find in a store, but if you use ìNordic Naturals Petî in your search box, you will find it online.Duralactin is a milk protein that contains factors that reduce the movement of white blood cells into an inflamed area; thus, relieving pain. Results are seen in four to seven days, with peak effects in 10 to 14 days. It comes in a chewable tablet or a powder, and your veterinarian can get it for you.Amantadine is an antiviral drug that has been found to block very special receptors at nerve transmission sites and help with pain management. Some find it effective and others do not. It is something to try in long-term pain cases.AdequanÆ Injections are only used in selected cases where the pain is in the joints. The drug actually helps protect and rebuild the damaged cartilage in arthritic joints. Your veterinarian must give it by intramuscular injection only. It is used in horses and dogs, and can be highly effective in this type of pain.Class IV laser therapy is a relatively new physical modality used in veterinary medicine and many find it highly effective in all types of pain. It is called ìphoto-modulationî and is carefully dosed at the site of the suspected painful joint or tissue.Opioid analgesics are commonly used in human pain. Hydrocodone is the most common. This drug can help ease severe pain dramatically, but does make the dog sedate. These are controlled drugs, and your veterinarian will probably have you sign a form stating you will make sure the drug is used for its intended purpose.Steroids can be used short term and are given orally or by injection. They work on pain purely as a strong anti-inflammatory drug and are highly effective. The down side is that they should not be used long term; or, if necessary, then in lower doses.Physical therapy: Various forms of practical PT can be used in dogs ó swimming, heat, cold, range of motion, weight bearing controlled exercises , etc. The problem is finding a physical therapist who really knows their science and how it is applied to animal patients. So far in Colorado Springs, we do not have such a professional, but they can be found in Denver and at Colorado State University.Finally, Iím occasionally asked about ìedibles.î Medical marijuana can be used in pets to help with pain and improve appetite, especially in cancer patients. The problem is we donít have adequate research data to know dosage and predict reactions. So veterinarians are reluctant to prescribe it, especially considering the likelihood for abuse.Not all of these are used in a typical case, but this does show you there are many other things to try besides the standard ìpain pill and NSAID.î Your pets deserve a look at the multi-modal approach to pain treatment.Dr. Jim Humphries is a veterinarian and also serves as a visiting professor at the College of Veterinary Medicine at Texas A&M University. He provides hospice and end-of-life care for pets. He lives in Falcon with his wife, horses and Great Danes. www.MobilePetDocs.com
