“Ouch!” The typical response when you stub your toe, but when you have muscle pain the day after a pickup soccer game, you might just groan, move slower, or simply pop an ibuprofen to get on with your day. Cats and dogs have similar reactions to pain. Acute, sudden pain will often cause them to vocalize, but when pain is low grade and chronic, it can be hard to know they’re uncomfortable.
Many cats and dogs have arthritis—even at a young age—and their owners don’t know it. I often hear owners say their dog is a little slower getting up in the morning or needs help getting into the car, but that the dog couldn’t possibly be in pain since it runs after a squirrel. I recently fell and chipped a bone in my wrist. While it hurt, it didn’t stop me from doing the things I needed or wanted to do, even if meant discomfort afterward.
Cats are very good at hiding pain. They tend to sleep the majority of the day, so determining if inactivity is normal or due to pain is difficult. The majority of cats over age 12 have some degree of arthritis. Since they live on average 16 to 18 years, that can be a long time to live with pain. Subtle signs include not jumping up on the bed or counters anymore and sleeping on the floor or low surfaces.
Have you ever tried to pet or brush your cat on the lower back only to have it swat or try to bite you? It’s telling you its lower back hurts. Older cats may also get mats or dandruff on their lower back. This is due to pain—it hurts to turn and groom those areas. Has your cat started pooping outside the litter box? Hip, knee, and lower-back arthritis make it painful to get into a tall litter box, squat, and have a bowel movement. A decrease in appetite is a sure sign a cat doesn’t feel well, and discomfort going to a food bowl or crunching on hard kibble can be a painful if the cat has joint or dental pain.
While dogs sleep a lot during the day, most are ready to jump up to greet you or go on a walk. But if they have pain when they move, it’s easier to just lie quietly and wag their tail when they see you. Dogs with arthritis move more slowly, especially in the morning. They start to lag behind on a walk or sit and watch the activity at the dog park instead of joining in. They will be more reluctant to go up or down stairs. Their legs may tremble or they will pant excessively at rest.
When I went to urgent care about my wrist, the nurse asked me to grade my pain on a scale from 1 to 10. I’ve tried this with my furry patients, but mostly I get blank looks. Dr. Dorothy Cimino Brown at the University of Pennsylvania developed a “Canine Brief Pain Inventory” to help owners put a number to their dog’s pain. There are 11 questions to answer with a number from 1 to 10. I think the most useful is the description of the dog’s function. Is pain interfering with the dog’s general activity or enjoyment of life? Does it prevent the dog from running, walking, getting up, or climbing stairs? Your veterinarian should be able to provide you with this form and help determine if your dog needs relief from pain.
What if your dog seems a little stiff? Does that mean they need daily treatment for pain? Yes! In arthritis, there is a vicious cycle at work. As cartilage in the joint starts to break down, it causes inflammation and pain. Inflammation causes more deterioration of the cartilage. Pain keeps dogs from being active. Inactivity leads to muscle atrophy, which leads to more stiffness. Activity is actually very good for arthritic joints, so being inactive makes things worse.
Because inflammation does so much damage to a joint, it’s important to keep that inflammation to a minimum every day. Just giving an anti-inflammatory when your dog is obviously in pain isn’t as helpful as giving a daily dose. Giving it daily helps prevent wind-up pain and helps dogs stay more comfortable all the time. I took ibuprofen daily for a week after I hurt my wrist to help with swelling and inflammation, which in turn kept me relatively pain free.
There are a number of medications and therapies to help dogs with arthritis. For an overweight dog, losing 10 percent of body weight is considered equivalent to taking a daily nonsteroidal anti-inflammatory pill (NSAID). But for a dog in pain, getting up to exercise for weight loss is challenging. Daily anti-inflammatory medication is necessary to keep your dog active.
There are several brands of NSAIDS available, and your veterinarian will have a favorite to recommend. There is a new pain medication called piprant. It isn’t an NSAID, but a new class of drug called a piprant. According to Elanco, it blocks the specific receptor for pain, which is the primary cause of pain and inflammation, without potentially affecting the liver or stomach lining as some NSAIDS can do. As the degeneration in the joints progress, stronger pain medication, like gabapentin or opioids, may be necessary.
If you don’t think pain is interfering much with your dog’s enjoyment of life, then starting a nutraceutical, like glucosamine, might be enough. Because nutraceuticals aren’t regulated by the FDA, it’s best to start with the brand recommended by your veterinarian. Not all dogs respond to these medications, so if you don’t see any change, then you’ll know it’s your dog and not the medication.
Physical rehabilitation, including an underwater treadmill, can help build muscles and help with weight loss. Acupuncture and chiropractic treatments can also provide short-term relief from arthritis pain. I took my dog for treatment when he was having difficulty going up and down stairs. After treatment, he slept soundly and jumped into the car to go home. He hadn’t done that in a long time.
Cats with arthritis are more challenging to treat. Weight loss is very important. Acupuncture can be worthwhile, if your cat will tolerate the procedure. Glucosamine supplements are available, if your cat will eat them. Cats don’t metabolize NSAIDS as quickly as dogs, so care must be taken in the dosing and administration of anti-inflammatory medications. But there are options available—just talk to your cat-friendly veterinarian.
The important thing is to recognize your pet is having chronic pain. Don’t be fooled if you don’t see a limp. There could be multiple joints involved on both sides of the body. Don’t assume that a pet in pain will whine. And please talk to your veterinarian sooner rather than later about ways to keep your pet comfortable and active into old age.
Lori Scarlett, DVM, is the owner and veterinarian at Four Lakes Veterinary Clinic. For more information, visit fourlakesvet.com .