pain itself is a complex issue...take the spine..you can be in excrutiating pain from mild to moderate spinal disease and no pain at all with some kinds of severe. your spinal pain could present in your back or it could present in your left arm or right hip.
true hereditary wobblers disease and progressive mylopathies are relatively painless...it is the destruction of the mylon sheaths and nerve endings that lead to progressive weakness and disability...dead nerves do not feel pain. but there still can be pain...as the body compensates for a deadening back end and hips...more pressure is put on surrounding structures like muscle groups and weight bearing joints which are moved, pulled and stressed in ways they were not meant to be by a progessive parathesia (numbness and weakness.)
so dogs like ozzie who felt no actual pain in her progressive paralysis and would bomb around like a maniac dragging her back end...did still feel discomfort because her back end was not supposed to flop around like it did so supporting muscles trying to carry the extra load, like her elbows and front end carried more stress and weight than they were actually designed to do.
mechanical wobblers caused by traumatic injury high in the cervical (neck) area and resulting arthritis are painful...the nerves are not so much silently dying, leading to paralysis...they are actually dying under pressure and further traumatized from arthritic changes, increased swelling and friction/inflammation...and that freaking well hurts.
pain is not something easily predictable on how or where it occurs...dogs with hip dysplagia have more pain in their elbows and spine than they do in their actual hips because the elbow joints/spinal muscles and joints have to take over a huge load in continuing mobility and again, they were not designed for this.
when we put sadie down because we could not control her pain from her massive neck and chest tumour..the pain that was the real problem was not in her neck and chest..it was in her head. that tumour was pressing on a nerve was somehow connected to her brain and gave that poor sweet dog an excrutiating headache that no pain medication could reach.
jewel, who has generalized spinal disease has three different types of pain to be managed. she has inflammation from inflamed nerves, muscles, discs...she has neuropathic pain from misfiring nerves, and she has muscle pain from muscle spasms that contract to try to protect the injured areas and leave her feeling overall really stiff and sore.
for jewel..managing just one type of her three types of pain, does not really help her because the other two still hurt a lot. and not all pain meds work for all of the different types of pain, hence the combo of three different pain meds to get her comfortable again.
and by the way, we are struggling again to manage jewels pain...the medications do not cure her spinal disease...they just allow her to live with it comfortably...for awhile, til the meds no longer work.
i know i am always on about pain..but here is the interesting thing.... it is not so much how severe a pain is that affects quality of life. severe pain can totally ruin anyones day. but even mild chronic pain eventually becomes unbearable simply because of its constancy and the progessive physical and mental and emotional exhaustion it causes relentlessly day after day.
moden day vet medicine is still in the dark ages regarding pain management...the light is just starting to flicker on in this area of animal care. and if you think it is hard to find a progressive and proative pain control program for aging dogs...try cats...try horses...try pigs, cows and sheep..it is beyond frustrating because the research just is not there yet to support that not only do sick or senior animals suffer pain daily, but they suffer different types of pain and need different types of medications to address this.
i have sent folks trying to unload their animals here to their vets for pain consultations, they walk out of the clinic with metacam and call me a month later because it did not work...well gee, too little, too late...they needed something alot more comprehensive than that. and even when we hold their hands and suggest adding something simple like tramadol to an existing metacam dose for progressive arthritis, the vets balk. if they do not really understand pain issues because it is a new and opening up to the light science, then they are not going to feel comfortable exploring other options that a few years ago, did not exist.
this is why i love colleen...when i put amitripyline on the table as an option for jewel, 2 yrs ago....she had never used that drug in vet medicine for anything except for anxiety..she was more than willing to give it a try..found it works and now uses it for her other neuropathic pain clients.
this is such a critical issue, this is the core of many seniors/palliative quality of life.....
omg!!! eddy just projectile vomitted a wet, slimy hairball right onto my keyboard...gross!
anyway..it is so central to their comfort and wellbeing that they do deserve a little more consideration from us then just a brush off from the vet or ourselves..."oh, i don't think he/she is in pain."...really? might want to think about that one again.
repeating the best rule..imagine your body and what you want considered for you with the same kind of issues....you don't want the brush off for what you might be feeling...do you?
later i will talk about balancing pain, meds etc gainst the risks of over sedation and other things (like GI bleeds, poor kidneys and livers)..now i have to get ready for work.