Hidden Pain: Relieving and Managing Pain In Both Dogs and Cats
Thu, October 21, 2021

Hidden Pain: Relieving and Managing Pain In Both Dogs and Cats


Many dogs will hide their pain as a survival mechanism, and this instinct led experts to think that canines don’t feel the same way as we do, said Ernest Ward, DVM, of VCA, an operator of over 1,000 animal hospitals in the US and Canada. Cats also have the same survival mechanism embedded in their DNA, said Robin Downing, DVM, CVPP, CCRP, DAAPM of VCA. Fortunately, in recent years, practitioners have taken significant steps in understanding how dogs and cats feel pain, as well as how to manage it.

Pain Knowledge and Analgesia In Dogs and Cats Among 131 Colombian Veterinarians (2019)

Carlos Morales-Vallecilla and colleagues of biomedical and life sciences journal portal PMC found that 52.7% of interviewed veterinarians showed a high level of concern about pain recognition and management (versus 38% of those who showed very high interest). Only 9.3% of veterinarians showed a moderate interest. 9.2% felt that their skills or knowledge in recognizing pain assessment responses was excellent, compared to those who said good (80.1%) and mediocre (10.7%). 3.8% answered “excellent” with regard to their skills or knowledge in quantifying pain assessment responses.

The most frequently mentioned pain indicators for dogs were abnormal postures or body position (tucked abdomen, arching, crouching postures, squinted eyes, sitting quietly seeking no attention) (68%), mobility (reluctance to move, lameness, slow pace) (53.4%), response to manipulation (52.7%), and unusual behavior/activity (45%). For cats, the most frequently cited pain indicators were unusual behavior/activity (64%), abnormal postures or body position (50%), mobility (45%), and response to manipulation/palpation (38%).

75% of veterinarians said that their analgesic use was good or excellent (10%) in dogs. 66% said their use of analgesics for cats was good while only a few veterinarians found it to be excellent (6.2%). 27% believed that their use of analgesics for cats was poor or mediocre unlike 15% in dogs. The most commonly prescribed NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) in canines included meloxicam (93.1%), dipyrone (85.5%), carprofen (78.6%), ketoprofen (75.6%), flunixin (53.4%), etodolac (37.4%), and ketorolac (13.7%). Non-recommended NSAIDs were mentioned by 10.6% and 3% of veterinarians, respectively.

The more recently “coxib” category of NSAIDs such as mavacoxib and firocoxib was used by 8.4% and 2.3% of veterinarians, respectively.  In felines, all NSAIDs were mentioned less frequently than dogs as only four of them were primarily used: meloxicam (89%), dipyrone (63.3%), ketoprofen (53.4%), and carprofen (24.4%). Only 7.6% of veterinarians selected etodolac in the list of prescribed NSAIDs. 58.7% of veterinarians knew about the term “Multimodal analgesia,” suggesting the respondents’ likelihood of using multiple simultaneous approaches to control pain. The remaining veterinarians typically used one medication either NSAIDs or opioids or an alternative approach to control pain.

Some of these alternatives to manage pain were homeopathy (92%), pulse electromagnetic therapy (55%), acupuncture (32%), neural therapy by local anesthetic injections (45%), chiropractics (28%), and the use of herbal remedies (28%).  Narrowing the type of analgesics used during the pre-and post-operative periods, the respondents enumerated the following drugs during the pre-operative period of surgical procedures for dogs: tramadol (58%), meloxicam (47.3%), acepromazine (35.8%), ketamine (17.5%), xylazine (17.5%) and dipyrone (16%). For post-operative periods, they used meloxicam (80%), tramadol (62.5%), ketoprofen (29%), and dipyrone (25%). 

For cats, the veterinarians used the drugs during the pre-operative period: tramadol (50%), meloxicam (40%), acepromazine (24%), ketamine (21%), and ketoprofen (14.5%). During the post-operative period, they used meloxicam (73%), tramadol (53%), ketoprofen (26%), dipyrone (15%), and morphine (13%).



How Do We Define Pain?

Pain manifests as injuries, conditions, and individuals, with pain experts defining it as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage." It is subjective and difficult to gauge. Outward demonstrations of pain may vary from pet to pet. Just because it does not cry, limp, or exhibit other signs of pain does not mean it’s not in pain. The rule of thumb is if it would hurt you, it would also probably hurt your pet.

How Do I Know If My Pet Is Hurting?

A careful observation of your pet’s behavior will help reveal the signs of pain. In dogs, they may not like going up the stairs, show decreased activity, or resist being touched or picked up. Arthritis pain is common among senior dogs, with signs of pain ranging from whimpering or vocalizing and stiffness or limping to personality changes and decreased appetite. In cats, they may be reluctant to “go vertical,” avoiding the back of the sofa or the windowsill. Cats in pain may be reluctant to climb a flight of stairs, preferring to stay on a single level of the house. Some sleep more than usual while other felines may be restless and unable to remain in a comfortable position. Other signs include unexpected reactions or aggression when touched, handled, or approached.



How Is Pain Treated?

Used to relieve mild to moderate pain and discomfort, NSAIDs hinder the production of inflammatory molecules that cause pain and swelling. However, these drugs should be used with caution since liver, kidney, stomach, and/or intestinal problems could arise. Opioids, a class of pain-relief medication, include morphine, codeine, and more that are used to treat severe surgical pain. Opioids are also used to treat advanced cases of cancer or manage severe arthritis pain. Cortisone and synthetic cortisone-like drugs like prednisolone are anti-inflammatory drugs that have a profound impact on your pet. Corticosteroids help reduce arthritic, allergic, or dermatologic discomfort. Apparently, these drugs have potential long-term side effects so they have to be used with caution.



Can I Give Human Pain Killers to My Pet?

No. Please don’t treat your pets with human medication, advised Willows, one of Europe’s leading specialist small animal referral centers. Keep human and household medication out of reach to avoid triggering a fatal reaction. Although it is common to assume that human medication is safe for pets, there have been cases of animal poisoning when owners attempt to give medications without speaking with their veterinarian. Don’t give your pet Ibuprofen or aspirin. Ibuprofen is toxic to dogs and cats as a single 200 mg tablet is enough to poison a cat or a small dog. When given in large doses, aspirin may be toxic to your pet. If taken without food, aspirin can lead to the development of stomach ulcers.


Pets may be resilient but it does not mean that they feel pain. Therefore, it is important for owners to carefully observe their dog or cat for any sign of pain like behavioral changes or decreased appetite. Medications should not be given unless owners receive a go-signal from their veterinarian.