Pets can’t tell us when something hurts—in fact, they can be experts at hiding pain. Cats are particularly adept at masking injury and illness because they instinctively hide signs of weakness from potential predators. Too often, “bad behavior” in both dogs and cats—like urinary or fecal “accidents,” aggression when handled, or refusing to follow commands to climb the stairs—actually has an underlying medical cause.

Because pain management is central to veterinary medical practice—and because there have been rapid advances in the field—AAHA collaborated with the American Association of Feline Practitioners (AAFP) to create the AAHA/AAFP Pain Management Guidelines for Dogs and Cats.

What you need to know

1. Behavioral changes are the principal indicator of pain. Pay close attention to any changes in your pet’s normal behavior. For instance, what we sometimes attribute to “old age” could actually be arthritis. A cat eliminating outside the litter box might simply be because he’s unable to climb into it.
2. Know the warning signs. Your dog or cat might be in pain if you notice decreased activity or appetite, lethargy, vocalization, restlessness, aggression, less interaction with pets and people, dilated pupils, or reacting with a flinch to touch in a sensitive area. Signs of pain in cats may also include flattened ears, an elongated muzzle, decreased grooming, or hiding. If you see any signs of pain, call your veterinarian.
3. Reduce risk factors. You can help prevent pain with regular visits to the veterinarian for dental care and by helping them maintain a healthy weight, since decaying or otherwise damaged teeth can cause a serious toothache and obesity can lead to aching joints. Nutrition and exercise will go a long way to a healthier pet.
4. If your pet is in pain, keep everyone calm. Unfortunately, pain can cause a pet to lash out at even the most well-meaning caregiver because fear and anxiety can amplify pain. Be as gentle as possible when handling your pet and speak soothingly, but also be careful not to get hurt in the process.
5. Your pet may be experiencing several pathways of pain. Your veterinarian may recommend multiple pain medications to be given at the same time. That’s because pain can be controlled in many ways to decrease soft tissue, bone/joint, and nerve pain.
6. There’s more to pain relief than medication. Modern veterinary medicine involves an integrated approach to pain management, not just prescribing analgesics (painkillers). Cold compression, therapy lasers, acupuncture, physical therapy, weight optimization, and adjustments to the home environment can be complementary options for alleviating pain.
7. Lifestyle changes can have a huge effect on chronic pain. When a cat or dog suffers from chronic pain, changes in your home can make life easier for everyone. Soft bedding, easy access to food bowls and litter boxes, gates to limit access to stairs, and nonslip rugs can make a big difference in your pet’s day-to-day wellness.
8. Your veterinary team will routinely evaluate pain at every appointment. Recording a pet’s pain score is considered the “fourth vital sign” after the standard temperature, pulse, and respiration measurements. Be sure to mention any unusual or concerning behavior.
9. Pain management is a team effort. At home, you are the eyes and ears of your veterinarian, and you’re always the voice for your pet. Never overstep your role by administering pain medications meant for people or another pet, as there can be life-threatening consequences. By recognizing pain quickly and seeking treatment as soon as possible, you’ll alleviate your pet’s suffering and strengthen the bond you share.

Questions to ask about managing your pet’s pain

• My pet yelped/hissed when I tried to pick her up. Does this mean she’s mad at me or in pain?
• How do my pet’s teeth look? Do you see any signs of dental disease?
• Is my pet at a healthy weight?
• My dog is hesitant to walk upstairs or jump into the car. Is this just aging?
• Why won’t my cat use her litter box?
• Now that my pet is a senior, is there anything I can do to increase her mobility?
• If my pet is injured, can I give her over-the-counter medications or do I need drugs specifically for animals?
• Can I give my pet leftover pain medications from another pet since they’re both the same species?
• Can laser therapy treatments, acupuncture, or physical therapy help ease my pet’s chronic pain?
• Should we schedule more frequent exams since my pet has chronic pain?
• What do you think of animal chiropractors?
• I take glucosamine/chondroitin supplements for my arthritis. Do they work for pets?
• Can my pet get “addicted” to pain meds?
• What kind of pain medications will you offer my pet before, during, and after a surgical procedure?
• Can I give my pet medicinal marijuana to treat pain?
• What side effects should I watch for when administering prescribed pain medication? Do these side effects outweigh the benefits of the medication?
• Should I give this pain medication every day or just on “stiff” days?
• I know my pet has a terminal, painful disease, but I’m not ready to euthanize her yet. What are my options for keeping her comfortable?

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