Originally written by Dr. Cornelius for September 2013 Houston PetTalk.

Pete’s beloved Irish Setter, Sasha, was first diagnosed with osteoarthritis of her hips and lower spine four years ago. Despite being on medications for her condition, Pete noticed a couple of months ago that Sasha started having trouble getting up and down on her own. Now, Sasha can barely rise without assistance, she refuses to go up the stairs, and she no longer gets excited when Pete grabs the leash to take her for a walk. Pete adores Sasha and doesn’t want to lose her, but he also doesn’t want her to suffer. He is confused as to whether or not her suffering is significantly affecting her quality of life to the extent that he should consider ending her life to relieve the pain he perceives Sasha to be experiencing.

The words “pain” and “suffering” are often used synonymously, but they are actually two different experiences. Pain is the sensory experience, while suffering is the emotional experience that is often associated with the sensation of pain. We assume that those things that cause pain in humans probably also cause pain in animals. If a pet is in pain, it is generally considered that it should be given the benefit of the doubt that it is also suffering. Some of the consequences of pain include distress, anxiety, depression, sleep disturbance, increased blood pressure and heart rate, nausea, vomiting, changes in breathing pattern, and urinary retention. It is important to realize that in critically ill animals, the expression of pain may be limited.

Chronic pain in dogs causes changes in exercise tolerance, play, owner interaction (clingy or distant), greeting the owner when they arrive home, attitude toward other dogs and people (including children), sensitivity to noises, appetite, sleeping position, general activity, and general demeanor. Behaviors that are strongly suggestive of pain include: panting or pacing for no apparent reason, excessive licking of or gnawing at an area of the body, and restlessness.

Assessing cats for pain can be difficult because the signs can be very subtle. Signs of pain in cats (from minimal to maximal pain) include: decreased interaction, avoidance of eye contact, unkempt appearance, hunched or retracted posture, withdrawal when approached, salivation, dilated pupils, incessant licking, vocalization, attacking when approached, and appearing rigid or non-responsive. Chronic pain in cats causes changes in climbing/jumping on to high areas, grooming/hygiene, activity, play, interaction with owners, demeanor and mood, and inappropriate urination or defecation. Jumping or attacking areas of the body is strongly suggestive of pain.

Chronic pain causes a reduction in sleep and sleep quality, which causes more chronic pain. It causes a reduction in posture, which puts strain on musculoskeletal structures, thereby causing more chronic pain. It also alters mood and alters the mechanisms by which the individual copes with pain, again leading to more chronic pain and more suffering. Just as it is so in humans, chronic pain in animals causes the same changes in the body as chronic stress does.

A pet owner’s input is crucial in determining whether or not an abnormal behavior is linked to pain. Constant and effective communication between an owner and their veterinarian is the best way to minimize suffering. Veterinarians are more frequently using a multi-modal approach to control pain in their patients. Common pain remedies in veterinary medicine include narcotics, anti-inflammatory drugs, nutraceuticals, acupuncture, cold laser therapy, chiropractic care, and physical rehabilitation.

With that said, there often comes a point in a pet’s life where pain management for a chronic condition is no longer effectively keeping the pet from experiencing pain and suffering. As a result, the pet’s quality of life becomes noticeably and significantly compromised, and because it is legal to end an ailing animal’s life, euthanasia is considered the most humane way to cease the pet’s suffering. If you feel your pet is exhibiting a pain-related behavior, please call and schedule a consultation with your veterinarian. You are your pet’s advocate in the prevention and treatment of their pain.