Wednesday, October 27, 2010

Guest Post: Dr James St Clair - Is Your Dog In Pain? Are you listening closely enough?

As we continue Orthopedic Issues Month at Embrace Pet Insurance, Dr James St Clair discusses signs of pain in dogs in relation to arthritis, a leading causes of pain in dogs and one that often goes unnoticed by pet owners.


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Pet owners and even many veterinarians are still in the dark when it comes to recognizing signs of pain in pets. For the sake of illustration let’s discuss this with relation to arthritis in dogs.


Lula with her bum lifter Canine Osteoarthritis is by far the most common orthopedic disease in dogs. It is said that 1 in every 5 dogs suffers from some degree of Osteoarthritis. Yet most pet owners never recognize the early warning signs. On top of that most veterinarians do not take a strong enough, pro-active approach in educating their clients and catching this disease process in its early stages; therefore, millions of dogs continue to suffer in chronic pain every day without anyone even knowing.


Becoming aware of the signs of arthritis in your dog is only half of the battle. The other half is becoming cognizant and understanding that most likely your dog is in some degree of pain.


As a veterinarian who prides himself in being in-tune with this, when I know a dog is in pain due to Osteoarthritis, I always ask the owner the question, “Do you think your dog is in pain?” 95% of the time the response is NO. And when I ask why do they think that? The most common responses are, well he/she does not cry, whimper, or “seem” to be in pain. Mind you, when I list the 12 signs of arthritis they will always answer yes to one or more the signs.


Wake up everyone!


The lack of pain in a dog is by far the biggest misconception by pet owners about their pets and it is about time that we change this.


Ask yourself this.


Are people who have Osteoarthritis suffering or in pain?


Obviously, the answer is yes. Though there are many different degrees of pain depending on the severity of the arthritis, the sum and substance is that they are experiencing pain.


Well, the same holds true for our pets.


We first need to understand and acknowledge that both dogs and cats do not show the same signs of pain as people do. People who are in pain either cry or verbally express that they are in pain, often times looking for sympathy or comfort recognition.


Dogs and cats on the other hand show their pain in much more subtle and humble ways. 99.9% of the time dogs and cats are SILENT when it comes to pain. But if you learn to recognize the signs and listen closely you will distinctly hear them telling you that they are in pain and need your help.


Lets quickly review the 12 Subtle Signs of Arthritis in Dogs. Note: It is common for dogs to show more than one clinical sign.

1. Slowing Down:
Don't Mistake 'Just Getting Older' with signs of Dog Arthritis. Many times people mistake that their dog slowing down is just a sign of getting older. This is not true. Most likely if you dog is slowing down they are suffering with some degree of chronic pain.

2. Sleeping More & Sleeping Longer:
Many times people will notice that their dog seems to be sleeping more, especially in the morning. Often they will often be reluctant to get out of bed to start their day.


3. Closed Hind Leg Stance:
If your dogs hips or knees are arthritic and therefore painful, often times you will appreciate that while standing at rest their back legs will be closer together. This can be very subtle in the early stages. They do this in order to take weight off of their hind legs and shift some of their weight to their more comfortable front end.


4. Wide Front Legs Stance:
What you will see is that the elbows are pushed out and not kept under the dogs body giving the dog a wide stance in the front. Again this can be very subtle and also sometimes only seen on one side.


5. Bunny Hopping:
Many times pet owners will notice that when their dog runs they use their hind legs together as one. This is commonly referred to as “bunny hopping” because the dog looks like a rabbit in its hind end. This is often a tell tale sign in a young dogs that they have hip dysplasia.

6. Joint Licking:
Sometimes if one particular joint is bothering your dog, they may begin to lick at it, to pacify the discomfort. You may notice a color change in the fur around this joint, from saliva staining.

7. Slow to get up:
This is pretty self-explanatory and probably the most common clinical sign noted by pet owners.

8. Reluctance to go on walks & walk less than normal:
Often pet owners will notice that their dog is reluctant to go the usual distance. Of course most pet owners notice a trend and not just a one-day, one time episode.

9. Avoiding Stairs or slow to go up stairs. Avoiding jumping in car, or on beds, couches.

10. Stiffness:
Sometimes you can see that your dogs gait may be a little more stiff than usual.

11. Limping:
Of course this is an obviously one. If you notice that your dog is limping on just one limb, before you decide yourself that it is arthritis, it would be definitely be a good idea to contact you veterinarian for an evaluation.

12. Muscle loss (Muscle Atrophy):
It is always a good idea to every once in a while feel your dog’s muscles. Make sure that you always compare one side to the other while feeling overall muscle size and tone.


Just today, I had a new client come into my facility with their 11.5yr old golden retriever for an evaluation. The dog had severe Hip Dysplasia and severe Spondylosis (i.e. Arthritis involving the spine.) He also had a history of a torn ACL a few years back. The only medication he was receiving on a daily basis was Previcox, a non-steroidal anti-inflammatory. He was grossly obese and almost to the point that he was unable to get up and walk on is own. When I asked why he was not on any other pain medications, they replied that he was not in pain. What? Are you Serious?


The moral of the story is this, ask yourself the question, “If I where to have the same medical problems that my dog currently has, would I be in pain?”


If the answer is YES, then discuss this with your veterinarian. In veterinary medicine today there are a ton of very safe and effective pain medications that are available, especially medications beyond the scope of the commonly prescribed non-steroidal anti-inflammatories (NSAIDs).


Many times if there is any question whether or not a pet is in pain, I run what I commonly refer to as a “Pain Trial”. I prescribe comprehensive pain management for the pet for a total of 1 week and then I ask the owner to pay close attention to the dogs disposition, as well as physical function, during that 7-day period of time. If it seems that the pet is happier or moves better, then it is safe to say that they were in pain all along. We then make a comprehensive plan with a more holistic approach addressing weight management, nutritional supplementation, strengthening exercises and long term pain management.

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James st clair Dr. James St.Clair is one of the nations leading veterinarians and expert in the fields of dog arthritis and canine rehabilitation. He is also the founder of TopDog Rehabilitation and TopDog Animal Health. Dr. James is also the author of the Home Rehabilitation Guide series. These booklets provide step-by-step instruction to pet owners to help their pets heal after major orthopedic surgery.