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).
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!
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).
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.
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.
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?