Dealing with a Pet in Pain

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Hi everyone,

Wow, it’s been quite a while since I posted on here.  It’s been great to see some new followers roll in, and I’m looking forward to getting to know you.

One of the reasons I haven’t had much time to write recently is that Ruby, my family’s 14-year-old Lab mix, has been having a rough time.  Old age has begun to set in.  She has a large, benign tumor growing over one of her hips, as well as arthritis in her joints.  She is in pain a lot of the time, and sometimes limps and has trouble going up and down stairs.

I’ve been feeling really guilty because it took us a long time to realize how much pain she was in.  Yes, even me—someone who’s lived with pain, read about it, and written on the subject for almost a year now.  Even I missed some of the signs.

In my defense, the first symptom she showed wasn’t exactly an obvious sign of pain.  Instead, she became restless and started asking for food all of the time.  Now, Ruby’s always been a little food-obsessed (what dog isn’t?) but this was just completely beyond the pale.  It was like she never got tired, never needed to sleep anymore.  Every thought in her head seemed to revolve around getting one of us to follow her over to the treat cabinet.

We took her to the vet, thinking that instead this might be some kind of age-related neurological change– perhaps the dog version of dementia.  But what the vet told us is that, although it’s not uncommon for older dogs to start acting strangely for no apparent reason, sometimes it’s because they are in pain.

He suggested we try giving her tramadol, which is a mild opiate pain medication.  And boy, what a difference it made.  Suddenly, we had our old dog back—the dog that actually slept from time to time.   And of course, she’s still food obsessed, but now when she’s medicated, she’s the old Ruby who would only ask for treats a few times in an evening (not once every five minutes).

Napping happily.
Napping happily.

I don’t know why her pain first manifested itself as a heightened desire for food.  Maybe she just wanted something to change the way she felt, and treats are the only thing she really knows how to ask us for.  Maybe the “reward chemicals” her brain released when she got a treat—that’s a big thing for dogs– helped to block out the pain signals, and all she could do was repeat that process.  Or maybe she literally felt less pain when she was standing in front of the cabinet, anticipating the treat.  I would really love to know.

Her physical symptoms have actually gotten more pronounced since this first started, and now there’s no mistaking the fact that this dog is in pain.  She limps from time to time, and has trouble climbing stairs and getting in and out of the car.  Sometimes she starts to lie down only to pop back up, as if the way she had distributed her weight was pressing on something sore.

Now that we understand how much pain she’s in, we’re being a lot more proactive.  The vet said she had some muscle loss around her hips, simply due to the fact that she has been in too much pain to actually use those muscles.  So she will be starting aquatic physical therapy in a few weeks (yes, they have that for dogs!).

In the meantime, I have been taking her swimming a few days a week at a river near our house, hoping some non-weight bearing exercise will help her feel better.  Of course, it is Massachusetts in November, but Ruby’s Labrador ancestors were specifically bred to deal with these temperatures and she doesn’t get cold.  It’s pretty amazing to watch!

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The river where Ruby swims is just behind those trees.

We’ve also talked to our vet about additional pain medications that won’t conflict with each other.  For now we are adding gabapentin, which is technically an anti-seizure medication that can also be used to slow the nerve impulses that signal pain.  In a few weeks, if she’s still in pain, we might also add a non-steroidal anti-inflammatory (basically, dog ibuprofen).

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Throughout this whole ordeal, I keep thinking about something I read recently, about how veterinary students receive five times more education on pain than medical students do.  (Technically speaking, this study was done in Canada, but I would bet this is a worldwide trend).

I have a lot of things to say about this disparity, but for now I will just say that I’m grateful that Ruby’s vet was able to see that she was in pain when we couldn’t.   I’m grateful that a medication like Tramadol exists, and that we were able to get it for her.

And that I wish it was always this easy for human pain sufferers.  No one asked Ruby about her mental health, or insisted she go to psychotherapy.   No one tried to give her an antidepressant instead of a painkiller.  The average human pain sufferer would be lucky to receive care that was this comprehensive and straightforward.

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Anyway, to end this post on a more cheerful note, Ruby still has plenty of good days (more so, now that her pain is being adequately treated).  As I write this, she is sacked out on the floor next to me.  We’re having some really warm weather this week, and tomorrow I will probably take her for a long walk and swim.

In the car on the way to her next adventure.
In the car on the way to her next adventure.

What do you guys think?  Have you ever had a pet in pain?

And are you surprised by the differences in the amount of training medical and veterinary students receive on the subject of pain?  What do you think the reason for that is?


19 thoughts on “Dealing with a Pet in Pain

  1. I have had a pet in pain and it was agonizing, but I was very lucky to find support and wanted to share it. Gail Pope is founder of Bright Haven, a sanctuary for animals and she is a phenomenal woman, one of the most loving I have ever met. She has written a small book (quite affordable) on Animal Hospice, which of course includes dealing with animals in pain. For any who are interested:

    http://www.amazon.com/gp/product/B00OEMOIIA?ref_=sr_1_1&qid=1413581832&sr=8-1&keywords=the%20brighthaven%20guide&pldnSite=1

    You can also look up their organization — a wonderful resource for those who love animals, dedicated to healing and their care:

    http://brighthaven.org/

    Jessica

  2. Hi, I found what you wrote so interesting. No, I didn’t know that Vets are much more knowledgeable about pain management issues than regular docs. I am wondering if it because they are not able to communicate if they are in pain or if it is because we are all animal lovers or both. I think that most people don’t view animals as being psychotic, depressed, or a hypochondriac but I think many people do wonder that of those of us who suffer from chronic pain. I don’t think people view animals as exaggerating their symptoms or drug side effects. I loved how you are able to consider the reasons your dog kept going to the treat cabinet- really very interesting – I never would have thought those things, but in reading them they are so logical and fitting , but I wouldn’t have been able to think of it on my own. Then I thought of myself as I have a tendency to overeat, but I can open the treat cabinet myself – that’s my problem lol.. I tend to overeat when stressed, anxious, in fear, sad, and in physical pain – all looking to escape those feelings. But, I especially liked what you wrote about she looks at it as a reward and the possible endorphins that are released during that process and maybe that reduces her pain. Thank you for sharing that.
    I had a rabbit that lived in the house with me. He was amazing/ He died a very painful death, but it is sad what rabbits do when they are hurt they don’t say anything and are perfectly still so they are not discovered by a predator and eaten. It amazes me that they are able to go through so much pain and do so quietly and alone it give new meaning to courageous and then I question, gee why cant I do that

    1. Thanks for your comment, Irene. That’s so sad about the rabbit. My family babysat a rabbit for one summer when I was young and it blew my mind how smart he was. I even taught him to use the cat door to go outside (we didn’t have any cats at that point).

      I obviously can’t say this about your rabbit specifically, but it does help me to know that some animals (and people) go into shock in traumatic situations and don’t always feel the pain of what they’re going through. (If you’re curious about this, I first learned about it in Robert Sapolsky’s book Why Zebras Don’t Get Ulcers).

  3. What a beautiful dog, so glad she’s feeling better. We have a big guy named Mishka who is 10. A couple years ago we got him a 4″ memory foam type bed covered with microfiber and it has made a huge difference.

  4. It’s both surprising and not-that-surprising that there is such a difference between human care & pet care. I thought what you said about no one suggesting she needs psychological help was spot on. As humans, we always have to justify/explain/validate every pain.

  5. I’m angered but not surprised. Human pain management is so taboo. And we gave it a reason to be, though that doesn’t make the generalizations fair. When my childhood doggie friend starting getting on in years, it was so hard to watch her suffer. We gave her medicine and a special diet, but towards the end she wouldn’t even walk. My parents carried around that big black lab. Up the stairs, outside, vet appointments. There was no other way, and it was a labor of love. Always worth the strain to see her smile when the sun warmed her up. There wasn’t much to do but try to make her happy. I think we all did our best, and when her time did come I think she probably didn’t feel great physically, but she felt loved.

  6. My lab mix is 17 yrs old. He doesn’t have a pain issue but we are watching as old age is gradually taking it’s toll, he’s become confused and sluggish. A far cry from the OCD dog who would play ball all day if you let him. It’s hard but I’m grateful he doesn’t have a pain problem on top of it.

    And no, I’m not surprised by the difference in the amount of training vet students receive regarding pain. Sad isn’t it?

    1. Yup. I wasn’t exactly surprised either. Imagine what life would be like if our doctors had even *half* the pain knowledge of vetrinarians!

      And I have to say, I’m pretty impressed that your dog has made it to 17, although I’m sure it is hard to watch as he slows down. I’m glad we haven’t really gotten to that point with Ruby yet. Wishing you the best of luck with him!

  7. My older dog Chaos is in a lot of pain, he takes tramadol, nuerontin and a could of others that I can’t recall right now. It has helped but as he gets older and time passes he spends most of his days following me around and can’t settle until I do. Then he just sits next to me or near me and sleeps. It breaks my heart but I too was surprised that the vet is really tuned in to his pain and yet when I try to talk pain with my Dr it gets a passing glance at best sometimes. It is almost as if we, as humans, are expected to just deal with it as part of having a “normal” experience.

    I love that you’re doing water therapy with your dog. I think I may have to try that with mine and see how he does. He has arthritis and a condition where the patella does not stay in place, he has it in both hind legs. It is funny because he has been my constant companion for the past 13 years and is even more tuned in to my pain than his own some days. I think that is why he follows me around and waits for me to settle before he will relax.

    Animals are amazing aren’t they? Good luck with your sweet pup!

    1. Thanks Stina!
      I’m glad Chaos also has a vet who understands how much pain he is in. (Love that name, by the way).

      And I think you totally hit the nail on the head, in terms of doctors looking at human pain as part of a “normal experience.” With some of them, it’s like they imagine that for every one patient who comes in to their office and complains of pain, there are ten others who deal with it on their own and don’t ask for help.

      And yes, definitely check out aquatic therapy for Chaos. One thing I’ve found for my own achy knees is that swimming in cold water helps a lot more than warm water, because it’s just like a giant ice pack– everything gets numbed. (Not sure if Chaos can handle the cold, but I just thought I’d throw that out there).

      Good luck to the two of you as well!

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