Thursday, November 15, 2018

Pain Management: Types of Pain Medications for Dogs

The two main issues with pain in dogs are recognizing pain in your dog and what should be done about it. "What can I get over the counter to help my dog's pain," is one of the most frequent questions on dog forums. And yet, that's not what we'll be talking about today.

Pain Management: Types of Pain Medications for Dogs

Two main types of pain


Pain falls into two main groups. Pain from damaged tissues and neuropathic pain. Pain from tissue damage is self-explanatory. Neuropathic pain results from damage or dysfunction of the system that reports pain to the brain, the nervous system.

"This is the difference between engine trouble and trouble with that light on your dashboard that claims there’s engine trouble." ~PainScience

Isn't the above the best explanation ever? I wish I came up with it. If your dog is in pain, it is most likely the first type that is caused by damaged tissues or tissues in trouble. There can be a combination of the two.

There are other pain categorizations, but understanding that feeling pain is both a function of damage and communication is enough for our purpose. In other words, a pain source and pain perception.

Acute versus chronic pain

Dr. Huston explained the difference very well:
Chronic Versus Acute Pain In Dogs: What Is The Difference?

If you want to understand the difference, go check it out.

Purpose of [acute] pain


[Acute] pain has a very clear purpose--to alert to an injury and promote avoidance. If you put your hand on a hot stove, the pain will make you quickly pull away and, hopefully, not do that again. Without that, you could let your hand burn to coals without even noticing. If you broke a bone, without pain, you'd keep using the limb, and it would not get a chance to heal.

Inflammation


Where there is tissue damage, there will be inflammation. Inflammation is the body's response to damage. It recruits immune cells and repair crews. Tissues swell to allow easy access to the emergency teams and their equipment. Imagine a bad collision on a highway. You will see police, firetrucks, ambulances ... Everything else needs to get out of the way until the problem is taken care of.

Inflammation and the resulting pain remains until everything is repaired. Or it should. Conditions where damage is chronic, such as arthritis, or situations where the immune system keeps on bombarding perceived enemy forces, result in chronic inflammation and pain that no longer serves any purpose.

Anti-inflammatories


Anti-inflammatories work by reducing inflammation at the affected tissues. Those can include corticosteroids or nonsteroidal anti-inflammatory drugs (NSAIDs). These medications douse the pain-causing fire.

Corticosteroids are a synthetic version of a natural hormone, cortisol. They are extremely good at reducing inflammation and generally making anything feel better. Cortisol, however, is a stress hormone, facilitating the body's response to danger or crisis. Which means that while they reduce inflammation, they also generally turn off the immune system and maintenance. Since the goal through all that is healing, this can be quite counter-productive. The only time I agreed to use steroids for Jasmine was after her neck injury.

The downside of using steroids was the reason behind the development of nonsteroidal anti-inflammatory drugs (NSAIDs). The effect of NSAIDs is more selective; they don't take out the immune system and maintenance. They are not as targetted as one would wish but more so than steroids.

The way they work to manage pain is by reducing inflammation. With chronic inflammation that is absolutely what you want. With a fresh injury or trauma, you want the analgesic effect but how much do you want to knock down the inflammation? That is the question, and it is argued both ways.

Given enough pain, though, I can guarantee you, nobody cares about the potential downside of the resulting pain relief. Either way, the question remains how much inflammation is too little or too much. And whether a safe dose of NSAIDs would ever be able to stop the inflammation completely--not likely.

Turning off the pain perception


While opioids get a bad rep, they are the cornerstone of [acute] pain management in veterinary medicine. The way they work is by turning off the transmission and perception of pain. They don't affect the site of damage but make the brain not care. It's like when your smoke detector goes off, and you yank out the batteries. There is definitely a time and place for that, not exclusive to surgeries either.

There are many drugs in this class with various uses and applications. Some are only used by your veterinarian, say during surgery, some come as pain patches, some as pills.

The latest thinking is that a multiprong approach going after both inflammation and pain perception yield the best results.

That's why your arthritic dog might be prescribed both NSAIDs and say Tramadol or Gabapentin. Though recent research seems to prompt skepticism about how effective Tramadol for pain management in dogs really is.

Further reading:
Pain Management in Veterinary Patients

Related articles:
15 Tell-Tale Signs Of Pain
Chronic Versus Acute Pain In Dogs: What Is The Difference?
Veterinarians Answer: Do You Often Have Difficulties Getting Clients To Believe Their Dog Is In Pain?
Dog Knee Injuries: Should You Say Yes To Pain Management?

What is your dog telling you about their health?


Symptoms to Watch for in Your Dog now available in paperback and Kindle. Each chapter includes notes on when it is an emergency.

Symptoms to Watch for in Your Dog is an award-winning guide to help you better understand what your dog is telling you about their health and how to best advocate for them. 

Learn how to see and how to think about changes in your dog’s appearance, habits, and behavior. Some signs that might not trigger your concern can be important indicators that your dog needs to see a veterinarian right away. Other symptoms, while hard to miss, such as diarrhea, vomiting, or limping, are easy to spot but can have a laundry list of potential causes, some of them serious or even life-threatening. 

Symptoms to Watch for in Your Dog is a dog health advocacy guide 101. It covers a variety of common symptoms, including when each of them might be an emergency. 

Symptoms to Watch for in Your Dog has won the following awards:

Tuesday, November 13, 2018

Brain Teaser: Why Does Cookie Eat Mice and not Moles?

Do you ever live under the impression you know something only to find out you’ve been oblivious?

Do you ever assume having knowledge because the subject seems so trivial that obviously everybody knows it?


Would you care to guess why Cookie eats the mice she catches but when she gets the occasional mole she will bury it and not eat it?

Saturday, November 10, 2018

Top Veterinary Articles of the Week; SAM-e for Dogs, Veterinary Specialists, and more ...

What Can SAM-e Do for Dogs?

Dr. Sarah Wooten

SAM-e is an antioxidant normally in the liver. When the liver is unhealthy or injured, it cannot keep up with the production. The supplement form is made to mimic the natural compound.

Top Veterinary Articles of the Week; SAM-e for Dogs, Veterinary Specialists, and more ...

SAM-e supplementation is used together with Milk Thistle as a liver supplement or it can be an adjunct therapy for other issues such as dementia.

SAM-e is quite safe; occasionally it can cause stomach upset. Jasmine was getting SAM-e supplement at one time and didn't have any problems with it in spite of her delicate system.

To learn more about SAM-e and its uses, read Dr. Wooten's article.


What’s a veterinary specialist?

Dr. Justine Lee

"I often get asked what that “alphabet soup” behind my name is. More importantly, as a pet owner, why should you care?"

Veterinary specialists are like human medical specialists. They receive a further education focused on a specific veterinary subject. Such as internal specialists, orthopedic specialists, dermatologists, oncologists ... The reason to see one is just that - they focus on a specific area and know way more about it than a general veterinarian could because that's all they deal with. When the problem is serious, complicated or mysterious, a veterinary specialist is whom you want to consult with. I'd say it particularly applies to oncologists. That, I believe is a must. But it can be extremely helpful with many other issues.


Food Measuring Math: Learn How Much to Feed a Dog

Dr. Jennifer Coates

Why measure your dog's food? Ask all the dog's whose quality of life is diminished due to obesity. Ask the dogs who suffer chronic issues or injuries because they are obese. Ask your dog whether they'd like to have two extra years of full life in exchange for not being over-fed.

The reasons are clear. Making sure you feed your dog just the right amount is more complicated.

Read Dr. Coates' article to learn about the science ant the art of feeding your dog just right.


Viruses and Bacteria: What's the Difference and Who Cares Anyway?

Else-Vet



This video is quite old but no less awesome for it. Else-Vet has a great way to make learning simple and fun.

Thursday, November 8, 2018

Symptoms to Watch for in Your Dog: Cloudy Eyes

Noticing cloudy appearance in your dog's eyes is scary. Is my dog losing their sight? Is it cataracts? I'd rather rush to a vet thinking my dog is having cataracts and find out it is nuclear sclerosis than figure it's nuclear sclerosis and leave my dog hanging. Well, I'd rather my dog not have cloudy eyes in the first place. But that's not always the option on the table.

Symptoms to Watch for in Your Dog: Cloudy Eyes

Jasmine once suddenly started squinting, and her eye looked as if it had a dark blue screen over it. We rushed her to a vet. All that because of a renegade eyelash which decided to grow inward, hurting the eye. Jasmine did need to have that eyelash removed but once treated, her eye was perfectly fine after that.

What can cause cloudy eyes?


The first thing most people's minds go when thinking cloudy eyes are cataracts. Cataracts are not, however, the only potential cause.

Mature cataract (left) vs nuclear sclerosis (right).
Photo: Animal Eye Care

Cataracts


A cataract is the loss of transparency of the lens. The impairment can range from minor to complete loss of sight. While typically thought to be associated with diabetes, the development of cataracts in dogs is often genetic in origin with some breeds more susceptible to the problem. As well as unlike in people, cataracts in dogs are most likely to develop between 1 and 5 years of age.

Cataracts that do develop due to diabetes can hit hard and fast. You should notice other signs of diabetes as well, though, such as increased drinking and urination ...

Nuclear Sclerosis


Nuclear sclerosis is cataracts' harmless cousin. What ends up with similar cloudy appearance is a result of hardening of the lens with age. Unlike a cataract, though, nuclear sclerosis only has a moderate impact on vision, particularly in low light conditions.

Uveitis


Uveitis is inflammation of the dark tissue at the front of the eye. Therefore it also hurts. It too can threaten your dog's vision.

Causes include the typical laundry list of potential culprits with any inflammation: infections, trauma, autoimmune diseases, or tumors. Just one that is different - lens protein seeping into the eye fluid. The last one sounds weird; it's usually a result of cataracts (just so we make a full circle, I guess).

And, don't forget, it hurts too.

Other signs can include redness, tearing, eye discharge, swelling, small or oddly-shaped pupils, and squinting because it hurts.

Glaucoma


The first thing you need to know about glaucoma is that it hurts. A lot. A lot a lot. Did I mention that it hurts?

Glaucoma is increased pressure within the eye. This can happen because of an anatomical abnormality in the drainage angle, or as a result of an injury or disease of the eye. And it hurts. It is likely to eventually lead to blindness. Oh, and before I forget to say it, it hurts.

Beside cloudy appearance in the eye, your dog will likely act miserable, blinking or squinting. Pupils might not respond to light, and the whites of the eyes might look red due to dilated blood vessels.


Other things that can cause cloudy eyes include a variety of corneal diseases and disorders. These will cause a change in color on the surface of the eye rather than within the eye.

Learn how to detect and interpret the signs of a potential problem.


Symptoms to Watch for in Your Dog now available in paperback and Kindle. Each chapter includes notes on when it is an emergency.

Symptoms to Watch for in Your Dog is an award-winning guide to help you better understand what your dog is telling you about their health and how to best advocate for them. 

Learn how to see and how to think about changes in your dog’s appearance, habits, and behavior. Some signs that might not trigger your concern can be important indicators that your dog needs to see a veterinarian right away. Other symptoms, while hard to miss, such as diarrhea, vomiting, or limping, are easy to spot but can have a laundry list of potential causes, some of them serious or even life-threatening. 

Symptoms to Watch for in Your Dog is a dog health advocacy guide 101. It covers a variety of common symptoms, including when each of them might be an emergency. 

Symptoms to Watch for in Your Dog has won the following awards:

Tuesday, November 6, 2018

How Obscure Is Babesiosis Really? Mika's Story

When I was writing about Ted's Babesiosis, I kept wondering how obscure this tick-borne disease really is.

Dog Conditions - Real-Life Stories: How Obscure Is Babesiosis Really? Mika's Story

Mika was treated right around the corner, at a specialty hospital we used to go to.


Mika is a 6-year-old Great Dane. Beautiful, lovable, energetic. She was adopted from the US several years ago and only brought her family love and joy.

She ended up at the hospital because of lethargy and high fever.

Blood work showed low levels of all red blood cells, white blood cells, and platelets. Mika's bone marrow was doing its job, though, and the blood cell levels evened out relatively quickly on their own.

Mika's liver and spleen were enlarged. Given her enlarged spleen, was she bleeding internally?

Mika was scheduled to have her spleen removed and liver biopsied.


However, neither the spleen or liver tissues showed any disease. Good news that Mika didn't have nether hemangiosarcoma, hemangioma, or anything wrong with her liver. Perhaps it was just some bug she came down with and her immune system dealt with it?

Mika was in good shape and could return home.

A month later, however, Mika was back at the hospital with the same symptoms - fever and lethargy.


Mika was anemic and her bilirubin was elevated. What has been destroying Mika's blood cells?

And there it reared its ugly head--Babesia gibsoni.


"Canine babesiosis is a tick borne disease caused by a protozoan blood parasite. Babesiosis is characterized by a hemolytic anemia, fever and splenomegaly. Some infections are subclinical while others are life threatening." 


Finding the little buggers under the microscope is mostly sheer luck and not a good idea to rely on that for diagnosis. There are tests that are much more likely to be successful in diagnosing this, such as PCR assays.

Once she received the treatment, Mika recovered quickly and is doing well. She might have lost a perfectly good spleen but kept her life.

Perhaps Babesia should be higher on the differential diagnoses list.

Original story:
Well, now You Have Ticked Me Off

Further reading:
Babesia gibsoni: An Emerging Pathogen in Dogs



Do you have a story to share?
Your story can help others, maybe even save a life!


What were the first signs you noticed? How did your dog get diagnosed? What treatment did/didn't work for you? What was your experience with your vet(s)? How did you cope with the challenges?

Email me, I'll be happy to hear from you.

Do you know what your dog is telling you about their health?

Do you know what your dog is telling you about their health?

Learn how to detect and interpret the signs of a potential problem.


Symptoms to Watch for in Your Dog

Symptoms to Watch for in Your Dog now available in paperback and Kindle. Each chapter includes notes on when it is an emergency.

Symptoms to Watch for in Your Dog is an award-winning guide to help you better understand what your dog is telling you about their health and how to best advocate for them. 

Learn how to see and how to think about changes in your dog’s appearance, habits, and behavior. Some signs that might not trigger your concern can be important indicators that your dog needs to see a veterinarian right away. Other symptoms, while hard to miss, such as diarrhea, vomiting, or limping, are easy to spot but can have a laundry list of potential causes, some of them serious or even life-threatening. 

Symptoms to Watch for in Your Dog is a dog health advocacy guide 101. It covers a variety of common symptoms, including when each of them might be an emergency. 

Symptoms to Watch for in Your Dog has won the following awards:
MINIMAL BLOGGER TEMPLATES BY pipdig