Next to getting and staying well, you want your beloved friend to be comfortable. From our latest efforts to provide soft patient hospital beds to our latest discoveries, your pet’s comfort is a primary goal of ours, too. Whether or not you need to see a pain specialist at your next appointment at Foster Hospital, you can rest easy in knowing that behind the scenes, the physical and emotional comfort of your pet is a unifying goal of all of our technical staff.
Frequently asked questions about the PCRS:
of pain, the assessment of pain in animals, and advanced pain treatment modalities. Working with allied specialists, such as orthopedic surgeons, neurologists, internists, oncologists, radiologists, complementary medicine and rehabilitation practitioners, our goal is to achieve a diagnosis for the cause and type of pain, where possible, and formulate a treatment plan. Once a plan is in place, we follow the progress of our patients by phone contact with the owner or general practitioner, and in some cases by recheck visits.
Although all veterinarians care deeply about minimizing pain in their patients, sometimes the nature of a pain problem is so complex that referral to a specialist is necessary on the path to easing the pain our pets experience.
When a pain specialist at Foster Hospital sees your pet, we will check body weight and spend quite a bit of time taking a detailed history from you. We may ask you to walk and/or trot your dog (for cats, we allow them to explore the exam room), do various movements, and we will observe how your pet sits or lies down and rises. We observe such things as muscle tone, balance, tail position and other aspects of behavior. After making those observations, we do a physical exam of potential pain sources.
Once we have completed our examination and observations, we may be at a point where we can make specific recommendations for treatment—but oftentimes some diagnostic testing or other specialist consultation may be recommended.
A history is information that we gather by asking you specific questions that will guide diagnosis and treatment. In “sick patient” visits to the veterinarian, the questions asked are often limited to symptoms and recent events. During a pain consultation, we will ask about your pet’s daily activities, what they can and cannot do, type of exercise, play, food, treats, car rides, whether you can give medications, and financial limitations. This conversation takes longer than a usual veterinary visit, so allow extra time for it and the examination. We estimate that the average visit time is 1.5-2 hours for the initial pain consultation.
In some cases we may ask you to fill out a “comfort diary,” or to discuss your pet’s daily activities with other family members prior to the visit. It is very useful to bring any medications, including natural ones, to the appointment to show us, and to measure exactly how much food you are feeding your pet as well.
The treatment for pain varies tremendously depending on the underlying problem, how severe the pain is, how easy it is to medicate your pet, and whether options such as acupuncture, muscle/tendon therapy, rehabilitation, or surgery are indicated by the diagnosis. Regardless of the diagnosis, we can put you on the path to treating your animal’s pain right away.
In many chronic pain situations, achieving an optimal body weight is an important goal, and we offer nutritional consultations when necessary. Some cases involve dietary changes, such as use of nutraceuticals (i.e., foods that help with pain—fish oils, joint supplements, MSM, etc.) and/or eliminating certain foods.
Many pets are already on some type of pain medication, but we are able to skillfully assess whether this should be altered and if additional medications may help your pet.
We also integrate non-pharmacological interventions for pain in many cases. Acupuncture, low-level laser, shock wave therapy, heat and cold therapy, assistive devices (such as ramps, boots, harnesses), Reiki, massage, and rehabilitation measures are used. Owners are encouraged to learn some of these methods to use at home on a regular basis.
When needed, an orthopedist consultation is sought to decide whether a surgical procedure is recommended to stabilize joints, remove pieces of bone or cartilage that are causing pain, or remedy tendon or ligament problems. Injections of pain modifying drugs into the joint may be recommended.
Often a pet will have had some blood tests and X-rays done at their primary veterinarian clinic. If you are making an appointment with the PCRS, you should bring any previous X-rays and copies of medical records with you. Sometimes we will recommend another set of X-rays, which are usually performed under sedation, to look for specific problems or to examine a leg or the spine from a different angle. Sometimes, additional “imaging” techniques are needed: Ultrasound, computed tomography (CT), or MRI are useful ways to get a three-dimensional look at the problem. Our radiologists contribute their skill in interpreting these images. Some additional testing that may be indicated through the images includes: Neurodiagnostic tests (like EMG), nuclear scans, and biopsy of tissues. Your primary care veterinarian will do most follow-up blood testing so that you may continue to work with him or her.
A hands-on evaluation of your pet completed by a pain specialist is ideal. At the current time, there are relatively few veterinarians who specialize in pain medicine in the United States. If distance or difficulty with travel inhibits your ability to come to Foster Hospital, your primary care veterinarian also has the option to contact us for a detailed discussion of the case—from this conversation we will devise a diagnostic and treatment plan by fax or Internet. Such consultations may still involve a conversation between the client and a PCRS clinician so that we can get a detailed history. If your pet needs advanced diagnostics or surgery, we can also assist you, in collaboration with your primary care vet, in finding a nearby specialty hospital.
Note: PCRS clinicians must make all recommendations through the auspices of your primary care veterinarian, as we are not permitted to make diagnoses or to advise treatment for any patient we have not examined.