Pain Management

Identifying, preventing, and minimizing pain are essential in the senior patient. The 2022 AAHA Pain Management Guidelines for Dogs and Cats and the 2021 AAFP Feline Senior Care Guidelines outline specific, comprehensive recommendations for pain assessment and management.3,12

Clients often perceive changes in their geriatric pets as normal aging when it may be the result of clinical chronic pain. Clients may not perceive that changes in behavior or in vital signs can indicate pain, especially when chronic pain behavior changes may be subtle. Educating clients about how to recognize and monitor acute and chronic pain should be paramount for the veterinary team. Clients can take videos of their animal moving and interacting with their environment. Videos are useful for the client and the practitioner to evaluate changes in movement and can be used to monitor responses to medications and therapies. This may help large-breed dogs with degenerative joint disease and cats who, owing to subtle changes in behavior, may not have their chronic pain recognized.55

Treatment options for managing pain and mobility must be integrative and multimodal. Addressing these issues early in the course of the disease improves outcome. Pain management may include the use of pharmaceuticals, nutraceuticals, herbals, weight management, acupuncture, physical modalities, and environmental modifications. Senior pets with chronic musculoskeletal disease may also benefit from physical rehabilitation. Rehabilitation is an excellent option for assisting with pain management and increasing mobility and balance. Rehabilitation may use different therapies to reduce pain and increase the QOL, including exercise therapy, hydrotherapy, acupuncture, manual therapy, and modalities such as photobiomodulation therapy, extracorporeal shock wave therapy, and pulsed electromagnetic field therapy.55

Counseling clients on home modification and pet accessories to increase the mobility and QOL of the pet may include appropriate use of ramps, suitable placement and design of litter boxes, elevation of food and water bowls, use of rugs or yoga mats to provide better footing, fitted and padded harnesses to aid with lifting larger pets, toe grips, boots, and socks for foot stability, medical pet shirts for anxiety, and the use of appropriate beds. As senior pets may have limited vision or hearing, identifying potential hazards in the home and yard such as stairs or pools should be included when discussing senior care with clients.

The 2023 AAHA Senior Care Guidelines for Dogs and Cats are generously supported by Boehringer Ingelheim Animal Health, CareCredit, IDEXX, and Zoetis.

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