Assessing pain in animals can be tricky business. Animals have evolved to hide pain well in order to survive in the wild. While our pets need not fear losing 
their place in their pack these days, they still mask pain. First we should observe our pets at home, have them evaluated by a veterinary professional, discuss our findings together, and come up with a plan to manage their pain effectively.
As loving caregivers of older pets or pets with chronic disease, we must be watchful for the subtle cues they give us. It is often not one clue, but a collection of clues that tip us off to their potential discomfort or underlying pain. Some of these clues or symptoms may be more evident during certain activities, certain times of day or types of weather.
Each animal should be assessed by their caregiver(s) and their veterinary professional to fully evaluate their pain status. There are instances where pets hide their pain from their owners at home, but a veterinarian or veterinary professional may get a better sense of it when in the office. On the contrary, many of us have had the experience of bringing in a limping dog to the veterinary office only to have them run right in as if they have not a care in the world! This can be due to a handy surge of adrenaline that masks the pain during that moment.
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Pain Symptoms
Pain is reflected in physical and emotional symptoms, both are essential in our evaluations. Physical symptoms include panting, limping, groaning / vocalizing, licking excessively, pacing, changes in appetite, changes in facial expression, difficulty rising, difficulty sitting / laying down, difficulty with stairs or inclines. Emotional symptoms include changes in sleeping patterns, inability to settle, changes in levels of displayed affection, changes in energy level, confusion or hiding behavior.
In my practice, I have found using a diary or journal can be very helpful in tracking comfort and pain levels in pets. It can sometimes help to use a subjective scale or just a few words each day to better see trends over time. It can also help us by having a time that we are assessing our pet for pain, and time that is spent “putting that away” and enjoying one another’s company.
A variety of pain scales have been developed to help us in the veterinary profession standardize our evaluations and know when to modify pain management. Colorado State has some nice ones:
Feline
http://csuanimalcancercenter.org/assets/files/csu_acute_pain_scale_feline.pdf
Canine
http://www.csuanimalcancercenter.org/assets/files/csu_acute_pain_scale_canine.pdf
And of course, if we observe and find symptoms of pain, then what do we do? First, we find the cause. This may be found through a physical exam or diagnostic tests, such as lab work or imaging. It may be done with our general veterinarian or in some cases require veterinary specialists.
Pain Treatment
Once we know the cause, it is time to treat that pain! We can do this with household modifications (putting in a ramp to the backyard or the couch, elevating food bowls, for instance), physical therapy, acupuncture, herbal supplements, and many medicines. Just like in human medicine, a multi-modal pain management approach is popular these days – and for good reason! Why not use a little bit of everything modern and traditional medicine has to offer to help our little guys out?
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So for an older beagle with arthritis…. it may be appropriate to lay down some extra carpets for easier walking, use a ramp to get into the car, have regular acupuncture and swimming therapy, in addition to using some non-steroidal pain medicines or general pain killers when needed.
Or for a cat with kidney cancer… it may be helpful make his/her access to the litter box a little easier by cutting a larger and lower entrance, make sure the food bowls are near by and freshened up often, introduce a little self-heated bed in the winter months, have regular physical exams and acupuncture treatments, use some herbal supplements and have some stronger pain medicines on hand if needed.
We love our pets dearly and want to make their moments all peaceful and comfortable. If you find yourself questioning whether your pet is struggling or hiding pain, go with your instincts; make some notes of your observations, set up an appointment with your veterinarian, and know that you are your pet’s best advocate and are taking a wonderful, proactive role in your pet’s well-being.
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