Dogs and Pain Medications

The Full Story

It is very upsetting to see your dog in pain. You want to help, right? Pain can affect your dog's ability to function normally and enjoy life. You might see a reduced ability to exercise, difficulty standing and walking, decreased appetite, and licking or biting at the site of pain. Fortunately, there is good information about what works best to treat canine pain. The sooner a dog's pain is treated the less likely it is to worsen.

There are two common types of pain that your dog might experience. The first kind is acute pain, which can result from injuries such as surgery or trauma. Chronic pain lasts longer than acute pain and can be associated with progressive diseases like arthritis or cancer. The origin and type of pain help determine what type of treatment is best.

How to read your dog's body language

Watching your dog's behavior and movements can give you clues about the severity of his pain. The International Veterinary Academy of Pain Management has published a pain scale that ranges from 0 to 4, with 4 being the worst level of pain.

0  No pain: Happy and normal. Interested in surroundings

1  Mild pain: Happy, but somewhat unsettled or restless. Reacts to pressure application at the site of pain

2  Mild to moderate pain: Uncomfortable, may whine or cry. Flinches or pulls away when touched at the site of pain

3  Moderate pain: Limping, or shifting body position to protect the site of injury. The dog might resist moving or might react to pressure at the site of injury with a harsh cry or growl.

4  Moderate to severe pain: Unresponsive to surroundings; difficult to distract the dog from its pain. The dog cries without being touched and can react aggressively to application of pressure at the site.

If your dog exhibits pain symptoms resulting in a score of 2, 3 or 4, you should contact a veterinarian for further evaluation and treatment. All FDA-approved medications for canine pain are available by prescription only. Your veterinarian might recommend an over-the-counter (OTC) supplement such as glucosamine, an herbal remedy such as cannabidiol (CBD), or a non-drug therapy like acupuncture or therapeutic exercise.

Medications used to treat pain in dogs

With numerous effective pain medications available for your best friend, it is vital to know about their safety and best uses. Some might be prescribed for home administration to your dog. Others are likely to be given in a veterinary hospital or office. The table below lists information on commonly used pain medications for dogs.

Can you give your dog OTC pain relievers made for humans?

Human medications for pain are usually not a safe choice for treating canine pain. Because each dog's pain is unique, a veterinarian should always diagnose and treat your best friend. Your veterinarian might recommend a doggie-dose of acetaminophen or aspirin under very special circumstances. However, keep in mind that these medications are not approved for use in animals and can be dangerous if not administered correctly. (As an important note, cats must never be given acetaminophen.)

Acetaminophen is an analgesic (treats pain), but it does not reduce inflammation. A veterinarian might use it in combination with other analgesics or anti-inflammatory drugs to treat a dog with chronic pain. Acetaminophen has the advantage of not causing as many GI side effects as anti-inflammatory drugs. To avoid toxicity, a veterinarian must always be consulted about the appropriate dose of acetaminophen for a dog. Symptoms of too much acetaminophen include vomiting, diarrhea, swelling of face and paws, and difficulty breathing. Liver damage is a serious complication of excessive acetaminophen doses in dogs and can usually be seen within 24-36 hours after ingestion. If you suspect your dog has gotten too much acetaminophen, it is important to get treatment immediately.

Aspirin, ibuprofen, and naproxen are NSAIDs found in many homes. A veterinarian might rarely okay the short-term use of coated aspirin, but aspirin carries a much greater risk of side effects (such as GI bleeding) than NSAIDs that are developed specifically for dogs. The same warning applies for ibuprofen and naproxen. As little as a half tablet might cause significant toxicity. Symptoms such as vomiting, diarrhea, and even GI bleeding and kidney injury can occur. NSAIDs developed for humans can reach higher levels and last longer in animals, so the best rule is to give only the safer veterinary products to your furry friend.

Are there alternatives to medications?

Evidence-based research justifies an important role for non-pharmacologic approaches in canine pain management. Several of these are considered mainstream options and are important in a pain treatment plan. An example would be applying an ice pack or heating pad to the painful area. Assuring that your dog gets plenty of rest and avoids too much jumping or running is also essential. If necessary, keep him in a confined space to permit healing to occur. Gently massaging the painful area might help increase circulation and ease pain.

CBD: another option for canine pain management?

Cannabidiol, or CBD oil, is extracted from cannabis and hemp plants. It lacks THC, the psychoactive chemical that produces the "high" of marijuana. Anecdotal evidence, such as owner testimonials, has claimed that CBD might have anti-inflammatory and analgesic actions in dogs. A small scientific study has shown reduced pain and greater mobility for some dogs with osteoarthritis that received CBD for a month. Dogs that received a placebo showed no improvement. These results are only preliminary, so much more information is needed to assess the benefits and precautions for using CBD in dogs. Side effects such as drowsiness, stomach upset, and abnormal liver enzyme tests have been reported. CBD can also interfere with the breakdown of certain medications leading to drug interactions. There aren't a lot of answers right now, but CBD could offer another option for pain relief down the road.

Leslie A. McCament-Mann, PhD, RPh
Clinical Toxicologist

(Dr. McCament-Mann acknowledges the substantial contributions of pharmacy students Rochanda Chee, Alex Ho, Adan Magallanes, Neha Parmar, Hien Pham, and Kimberly Yeh)