Pain in Dog

Cargo in her hobbles trying to chew a bully stick

I am coming out of two full years of injured dogs. Toad needed bilateral TPLO surgery to save his knees in 2022. Cargo was diagnosed with Medial Shoulder Instability in December of last year. My dog cabinet looks like a whole pharmacy. We have been to Physical Therapy, and worked with a Canine Fitness Trainer to help get their strength back to a point where they won’t hurt themselves and I have learned so much about pain management options!
There are two things I have learned through all this chaos. These are things I had put together while working with my behavior clients but this experience solidified my understanding. I am now going to be more vocal and determined to get General Practitioners on board with Pain management protocols in the future. So often my behavior modification plan does not include training. It definitely includes ways to make the dog feel better inside their skin.

Dogs hide pain really well.

Like really really well. This is an evolutionary advantage. If you look healthy you are less likely to be eaten. Also dogs like to do stuff with us. Adrenaline and the desire to go with us will always overshadow pain they are feeling. I mean, how many times have you done something you knew was going to hurt later. (Hi Its me!) Dogs do the same thing! Just because your dog will chase the squirrel doesn’t mean they should.
We knew Toad tore his cruciate when the “good knee” tore. He had probably been in pain since we got him in 2020 with the other knee but we had no idea. When we saw the specialist, she recommended fixing the worst knee first so that began many trips and many surgeries to get his back end fixed. Before that, he was chasing the frisbee and walking with Cargo like he was fine. Being with us was more important to him than the pain he was feeling. I feel terrible that I let him do all these things but I really had no idea.
Cargo was also “fine” when we saw the specialist. So fine in fact, he did not think she was as broken as she was. She did not come up lame, there was no head bobbing showing any sign of lameness or pain. The only thing that signaled to me that something was wrong, was she could not weave successfully in agility. After I pushed a bit to have the specialist check her shoulders and elbows while she was sedated we learned the extent of her injuries. And they were extensive.

Toad coming home after his first TPLO surgery

Pain management can be complicated

Cargo was bred to mask pain. It is a breed trait which makes Malinois so adept at working in high intensity, high impact environments. Not only did we have to work through the pain of her surgery, we had to teach her body to “break the pain cycle.” If your nervous system is continuously being told something is painful, it takes awhile for the body to realize that is old information and kind of recalculate what is actually happening. (that is a very simplified version of what actually happens) Cargo needed to be on specific pain medications much longer than her initial recovery. This helped her body realize she was not experiencing pain like before her surgery.
Veterinary guidelines on assessing pain are now recommending no less than 6 weeks for pain management trials. New studies have shown that it can take that long for chronic pain to subside in patients. If I am concerned there is a pain component to my clients training plan, 3 days of carprofen are not going to give the accurate information I need to determine if the behavior change could be pain related. I think many Veterinary professionals are hesitant to prescribe long term pain meds because of the damaging effects to liver and kidneys. I would counter that I would prefer a shorter pain free life where aggressive episodes are at a minimum to the alternative.

What to do if you suspect pain

Talk to your vet if you suspect your pet’s behavior change is due to pain. Behaviors do not have to be as severe as aggressive episodes. They can be minimal things like being short with housemates, or reluctance to go for a walk. Simple things like switching spots on the couch often or flopping down into a spot instead of controlled laying down could be a sign of pain somewhere. Don’t be afraid to push for a pain management trial, and a referral to a specialist. It might  give you answers to help your pet live their best lives. 15 years goes by so fast, I believe we owe it to our pets to keep them as healthy as we possibly can for the time they are with us.