When your pet is suffering, it can be more frustrating than when a person is in pain. At least your daughter or son can TELL you “where it hurts, Mommy.” But think about the infant or toddler who can’t communicate yet.

Does that finger in the ear mean something, or is Jake just pretending his thumb is a Q-Tip?

Is Fifi standing funny because she’s scared, or does her tummy hurt?

Why is Jo-jo following me around with his head down? Is he depressed or in some kind of pain?

Pain Assessment — Not an Easy Thing

Gauging an animal’s pain can be extremely difficult.

Pain varies greatly among species and from animal to animal. A rabbit can “mask” pain up to a few moments before death. A Border Terrier can undergo an abdominal surgery and be running around two hours after surgery.

But say your next patient is a Greyhound with an infected canine tooth. Touch it and she screams for five minutes.

Does the Greyhound have intense pain or intense fear — or a little of both? Has she been in chronic pain for so long that the thought of you touching the tooth sends her reeling?

How about the terrier? Is he actually feeling pretty good, or is this dog driven by instinct to act normally while experiencing considerable pain?

We now know that a dog may even wag his tail and seem okay when he is actually in a great deal of discomfort.

And cats! Oh, boy, they exhibit pain in very subtle ways. You need your cat-whispering hat on your head front and center when trying to figure out what Puffers is trying to tell you when she’s ADR (ain’t doin’ right).

Recognizing Pain Matters

Most pets admitted to a vet clinic are out of their comfort zone (and fearful). And these patients may well be due for surgery.

The thing is, vets care a lot about whether their patient is in pain or not. Now, more than ever, we have an armory of drugs that can give effective pain relief, so there’s no need for dogs or cats to suffer discomfort.

However, all drugs have side effects, some more than others. In an ideal world, we want to control pain but avoid unnecessary medication. So with the right tools for the job, vets can control pain in cats — but first you have to recognize there’s a problem.

Vocalization

When your buddy cries out, you take notice.

If the sound of their whimpering or purr has changed, if it’s a frightening yelp or a dull moan, it’s time for action.

Same goes for no sounds. Where is the happy yip or any purr at all? Your may need your veterinarian to determine the meaning of the vocalization, but don’t ignore it.

Let’s start with our incredible canines. Many owners bring a dog in because “he has yelped in pain.” In my opinion, yelps that come intermittently from a dog, with normal behavior between the yelps, is frequently caused by neck or back pain.

Think of it as an acute spasm.

Many clients think this is abdominal pain, but that’s not usually the case. Rarely does a dog in abdominal pain scream out and then go back to what they were doing, like eating.

Cats do not give us as many clues as dogs do when it comes to vocalizing. Lack of happy purring and meowing is an obvious clue, but cats purr for many reasons, even stress or pain.

Low growls are usually significant and mean something is wrong. Excessive vocalization, as I’ve mentioned before, is not always pain but needs to be addressed with your vet.

Posture

How your dog or cat is standing, sitting or resting can give you subtle hints that they may be experiencing pain. If their stance is off, they probably ARE “off”!

Dogs

So many sources of pain are obvious in a dog, it’s simply common sense.

A limp, licking a particular paw, scratching an ear: It’s almost as if your dog can talk to you in these instances.

But if your dog is standing in one position without moving, tucking in his abdomen, hunched, holding his head down, walking gingerly, these are all signs that should not be ignored.

If they could talk to you, they would be saying they are in pain.

Cats

Changes in posture are so subtle in cats, but this may be one of the only ways you get a clue that something is wrong.

When cats are in pain, they tend to be reclusive and stay in one position for extended periods of time.

Paws tucked, hunched, eyes half closed: They may not be telling you what it is, but they are telling you to get them help.

When cats are in pain, they frequently retreat. It’s upsetting when I hear clients say they let their cat “stay under the bed, not moving for two days.” This is not cool!

Cats don’t hang out under the bed because they’re playing “hide and seek.” They’re hiding because they feel like crap. Getting them from under the bed and out to the vet may save their liver, stop pancreatitis from becoming life-threatening, or relieve their dehydration — whatever the reason.

In the comfort of your own home, a cat in pain will act differently. They may:

• Hide away
• Not come to greet you
• Refuse to eat
• Be unusually grouchy

The list of what may be wrong when a cat is hiding is extensive. You need to find out what’s up with a downer cat.

Reducing Stress for Cats

No one wants to cause unnecessary stress to their patients, so vet staffs go to great lengths to make their inpatients as stress-free as possible. To reduce a cat’s stress, the vet tech may give the cat a box to hide in. This gives the cat a vital coping strategy, which is to conceal themselves.

Clinics use strategies to reduce stress such as:

• Keeping cat and dog inpatients in different wards
• Using reassuring cat pheromones (Feliway)
• Playing soothing music
• Providing boxes for cats to hide in

1. The Cat in Their Bed

• Meow or growl: When a cat is left alone, then “stress” noises such as growling, crying or groaning can indicate pain.
• Relaxed or hunched: If the cat is hunched and miserable, then this can reflect discomfort.
• Ignoring the wound or licking: Paying attention to a surgical wound may mean something has drawn the cat’s attention to it, such as pain.
• Pricked or flat ears: Agitated cats flattened their ears. So what caused the agitation? Is it pain?
• Muzzle shape: A squishy, tense muzzle reflects inner tension — caused by pain, perhaps?

2. Response to a Fuss

Does the cat enjoy a fuss and press in for a rub (good), freeze (not so good) or become aggressive (pain)?

What is the overall impression of the cat on a scale from friendly to depressed and grumpy?

3. Assessing the Sore Place

Is the surgical incision causing the cat pain? This is tested by gently touching the area around the incision and comparing their reaction with touching a non-sore place.

A Cat Is Not a Small Dog

Differences in species make pain control difficult for the small animal veterinarian.

Never assume anything.

What works in a dog could be bad in a cat, for instance. Morphine and similar drugs are very effective in dogs, much as in humans. Not necessarily so in the cat. And wouldn’t you think you would treat a rabbit like a tiny pup or kitten? You would be wrong.

Of the few pain meds that are safe and effective in bunnies and other small mammals, you often need to use much more of the drug than you would in a dog or a cat to achieve proper analgesia.

Never, ever give your own pain meds or OTC meds to your pet without checking with your vet first. It’s hard enough for us to have the right answers, because many drugs have not been properly tested in dogs, cats, rabbits, etc.

And dose ranges are not the same. A dog is not a small human. A cat is not a small dog.

Don’t listen to your pharmacist either. They may be great resources for humans, but many pharmacists give out wrong advice about pets.

Proper pain control does not have to be expensive. Many newer pain drugs are already generic and can be very helpful in chronic or acute pain conditions. Combinations of drugs may be warranted, and veterinarians need to be thinking outside the old-fashioned pain box, both in how we assess pain and in how we treat it.

This article did not touch on many other advances in pain control such as acupuncture, laser therapy, local analgesia and anesthesia, and physical therapy, to name a few. Lifestyle, weight management, nutrition…

The answers are not just in the pillbox.