Greenbriar Animal Hospital
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Pain Managment

Greenbriar Animal Hospital Pain managment Handout

Pain MANAGEMENT 

When we think about pain, we consider layers of medicines and therapies to help our patients, regardless of whether we are looking at surgical, cancer or arthritic pain.

Non-Medication Therapies

1. WEIGHT LOSS- if your pet is overweight, fat magnifies inflammation by producing hormones that worsen and speed up arthritis. This is the NUMBER ONE preventative you can use to improve your pet's pain.

2. Fish oil (a.k.a. omega 3s) acts as anti-oxidant and helps with inflammation (skin, cancer, joint, heart). Plant based omega 3's do not work in pets.  Dosage: under 20lbs use liquid products or 300U krill oil, 20-60 lbs  500-600U, 60-100lb, 1,200 U, over 100lbs 3,000U per day

3. Physical Therapy for joint pain is invaluable. There are now veterinarians trained to do physical therapy and that will come to your home to teach you the exercises.

4. Glucosamine/Chondroitin/MSM- is a nice addition for joint pain. The science supporting its effect is not as strong. It should not have any side effects. You will want to invest in an approved veterinary product to assure that it will work.  Dose by the bottle, or approx10-20mg/kg/day

5. Adequan is a joint protectant/ increases lubrication in affected joints (so only for arthritic pain). It is only available as an injectable. It can be given at home by the owner.

10. K-Laser is a "cold" laser treatment that is used to penetrate into the tissue and stimulate the body's own immune system to reduce pain and inflammation. It cannot be used in cancer patients.

Medical Therapies

1. NSAIDs- non-steroidal anti-inflammatory medicines are carprofen (Rimadyl), Previcox, Deramaxx, Meloxicam, Galliprant and others. These medicines reduce inflammation at the site of the problems and thereby pain.  They also slow the progression of arthritis. They can have negative effects on the liver and kidneys and require some monitoring, but provide good long term relief.

2. Steroidal anti-inflammatories (prednisone) work best for spinal pain or some cancers. It has many side-effects so is not ideal for long-term therapy. IT CANNOT BE USED WITH NSAIDs.

3. Gabapentin works on pain receptors in the brain. It does nothing for inflammation, so is usually used in chronic pain in conjunction with NSAIDs. Gabapentin must be started at a lower dose and gradually increased. It cannot be stopped "cold turkey" but must be weaned if used longer than 5-7 days.

4. Tramadol is broken down into an opiod-like drug in the body but also acts as a "happy brain" drug.  It is believed that in dogs, the enzyme necessary to break it down is limited and that mostly it acts to make the dog happier and helps them to sleep.  It may cause sedation or loss of appetite.

5. Hydrocodone with Acetaminophen-(Tylenol-3)- can be used with prednisone as an additional level of pain relief. It doesn't help inflammation, and is usually used short term.

6. Amantadine works similarly to Gabapentin and is used for chronic pain. It has a narrower safety margin, and can often cause appetite supression, but is a good addition as pain managament escelates