Chronic pain can significantly affect daily living activities in our pets. In a previous blog I posted photos and descriptions to determine pain in cats. Determining pain in dogs can be more difficult, as there can be wide variability between pet owner and veterinarian observations, as well as variability in how dogs express pain. Dogs may act differently at home and in the veterinary exam room.
Currently there are no biomarkers (biochemical or physiologic parameters) that reliably correlate to chronic pain. Physiologic biomarkers, such as blood pressure, heart rate, and cortisol levels, have very low specificity because circumstances other than pain such as fear, anxiety, and stress can also affect these markers.
Objective measurements are not widely used in veterinary practice. These might include force plate measurements, computerized gait analysis, and activity monitors. Unfortunately, even if these were utilized widely, they may only give insight into mobility parameters, with no measurement of internal pain. The most common chronic pain condition encountered in dogs and cats is osteoarthritis (OA); other conditions that can cause chronic pain include intervertebral disk disease, chronic pancreatitis, cancer, and other illnesses.
Things to consider when determining pain level in your dog include:
- Ability to play
- Appetite
- Gastrointestinal function
- Hygiene (ability to maintain cleanliness, urine or stool incontinence)
- Interaction with family members
- Presence of pain (flinching when touched, tension in the body, vocalizing)
- Sleep (increased, decreased, interrupted by pacing or wandering)
One owner assessment questionnaire that has been widely used was developed in Finland by the University of Helsinki researchers. By filling out the questionnaire weekly, a pet owner can determine whether their dog's mobility is improving or declining from week to week. Another assessment questionnaire has been developed by the canine arthritis association.
A more complete assessment of pain may be made using the BEAP Pain Scale created for pet hospice patients. By assessing appetite, ability and desire to move around, facial expressions, body weight, and vocalizations a pet owner can determine changes in pain scores from week to week.
Determining quality of life can be difficult for pet owners and veterinarians. By using these tools weekly it is possible to document changes in pet comfort that may help make decisions regarding improved pain management to improve quality of life.
There are many treatment options available for pain. Don't let your pets suffer in silence.
