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Recently, I received a concerning comment from a pet owner about their vet's reluctance to provide pain medication for their dog following a cruciate ligament rupture diagnosis.
The reasoning behind this being that pain would stop their dog from using her leg, so improving the speed of healing.
This raised an important question: Is withholding pain relief ever acceptable in veterinary care?
Is it even sometimes beneficial?
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My vet said no pain meds. Took my Aussie in today. Giving it about 3 weeks to see how she’s doing before we talk surgery. Said if they had no pain they would use it more and cause more damage instead of hopefully healing.
The Importance of Pain Relief for Pets
When a pet experiences a painful condition like cruciate ligament rupture, it's crucial to address their discomfort promptly. Just like humans, animals feel pain and it has a significant impact on their overall well-being.
This discomfort can impede their healing process, lead to stress, alter their gait, cause muscle wastage, and even contribute to behavioral changes.
It's our responsibility as pet parents and veterinary professionals to ensure that our furry companions receive the pain relief they need to alleviate their suffering and facilitate their recovery.
Outdated Beliefs in Veterinary Medicine
The comment I received, in which a vet advised against pain medication to wait and see how the dog fared without it, reflected an outdated and concerning belief in veterinary medicine.
This type of approach harkens back to a time when pain management was not given the importance it deserves.
It's essential that we recognize the negative impact of prolonged pain on our pets and understand the role of modern veterinary practices in addressing their pain effectively.
Rethinking Pain Management Strategies
The outdated thinking of allowing pets to endure pain with the hope of preventing further damage due to increased activity is flawed. As responsible pet owners, we have the ability to modify our pets' activities to minimize stress on the injured limb.
This can be achieved through confinement, controlled exercise, and mental enrichment activities that engage them without exacerbating their condition.
By taking a multimodal approach to pain relief, which may include the use of various painkilling options tailored to the pet's individual needs, we can ensure that they are comfortable while they heal.
The Impact of Pain Relief on Recovery and Well-Being
By prioritizing effective pain relief for our pets, we can positively impact their recovery, minimize the risk of postoperative complications, and maintain their overall well-being.
The absence of pain management not only prolongs their discomfort but also potentially strains the human-animal bond as the pet may exhibit challenging behaviors and experience a decline in their relationship with their caregivers.
Taking a Holistic Approach to Pain Relief
Recognizing that pain management is a multifaceted aspect of pet healthcare, it's crucial to adopt a holistic approach that addresses all aspects of the pet's comfort.
From pharmaceutical interventions to lifestyle modifications and environmental adaptations, there are numerous ways to support our pets through their pain and facilitate their recovery without subjecting them to unnecessary suffering.
Learn more about the holistic approach to long-term pain management.
Full Transcript →
The following is an AI generated transcription:
Dr. Alex: We're talking a long time ago that this hasn't really been acceptable thinking, you know, and it really needs to to kind of go the way of the dinosaurs.
voiceover: Welcome to the Call the Vet Show, the podcast that helps pet parents understand and optimize the health of their furry family so they can live the full and happy life you want for them. And here's your host, veterinarian doctor Alex Avery.
Dr. Alex: Hello, and welcome back to another episode of the show. And today, I'm bringing you a question, or more of a comment, I guess, that I got from one of my YouTube videos about ACL rupture or cruciate ligament rupture in dogs. It's a really common problems in in dogs especially our large breed dogs. It's probably the most common joint injury that we see. And the impact of that, and the treatment required can be pretty significant. And when I read this comment, I wasn't really sure how to feel, you know, whether to let my heart sink, whether, you know, I was just incredibly disappointed, or actually, I was also very angry that this is still a thing. Anyway, you'll see that it's something that I have a very strong opinion about, and I'd love to hear your thoughts on this as well. And so if you do have a question, if you've actually got an audio comment about any episode and you'd like to start a conversation, then you can record your question or your comment to our pets health dot com slash question.
Dr. Alex: You can find the links in the show notes as well. And, of course, if this episode resonates and you'd like to send it to anyone else who you think would benefit from hearing this message, then I'd love you to send it to 2 or 3 members of your pet owning circle, be that friends, families, relations, whatever that may be. But for now, here with the benefits of an AI voice, just to make things a little bit more interesting rather than me read out the comment, here's what we're going to be talking about today.
voiceover: And now on with the show.
April: My vet said no pain meds. Took my Aussie in today, giving it about 3 weeks to see how she's doing before we talk surgery. Said if they had no pain, they would use it more and cause more damage instead of hopefully healing.
Dr. Alex: Okay. So as I said, that came from a video about cruciate ligament rupture. So if you've ever done your ACL, you'll know that it's incredibly painful. Your knee joint is unstable, and a dog's knee joint is unstable. So very often in the early in the early stages of this rupture, kind of immediately after it happening or if we're dealing with a partial rupture that has suddenly deteriorated, a dog will be so painful. They're they're choosing not to use their leg at all. They're carrying their leg, and they're not doing that, to because they know that they need to to, put less weight through it, and that helps protect it and helps stabilize everything. They're doing that because it's painful.
Dr. Alex: It hurts. There's no two ways about that. And then as it heals, they will, use that leg, more and more, but they will be limping. They will still be painful. Because why do we limp? We limp because we're painful. We also, need to consider the fact that if a dog is lifting up its one of its back legs, it's changing the weight. It's changing its gait. In the other legs, it's putting stresses and strains on the other muscles, which are going to also result in pain.
Dr. Alex: A little bit like us, if we've got a problem with our, knee or with our hip, we might get back pain, and that's because it changes how we stand, and it changes how we use our bodies. And so we get pain in other areas, that are not immediately related to whatever injury or or the initiating condition. So, you know, my big take on this comment and what this vet told this pet parent was that this is incredibly old fashioned thinking. You know? This is I mean, even this is this is going back before I I qualified, probably before I even went to vet school, which was well, I've been a vet for 17 years, I think, 18 years now. I went to vet school at the the turn of the century. So, you know, we're talking a long time ago that this hasn't really been acceptable thinking, you know, and it really needs to to kind of go the way of the dinosaurs and and something that we should never be hearing ourselves thinking. We should never be hearing from a professional. So I was incredibly disappointed to read this.
Dr. Alex: We know that pain is detrimental in a number of different ways. So from the point of view of healing, it actually slows healing of a a long term problem. So it increases stress levels in the body that slows healing, and that causes prolonged pain. So it can be a bit of a vicious cycle there. We can increase risk of postoperative infection if we like to have a surgery, and surgical repair of cruciate ligament is generally the recommended most appropriate way to, the fastest recovery, so that becomes important. We can reduce GI mobility, which has an effect on the microbiome, which has an effect on the rest of the body as a whole. It alters gait. Like I said, it affects the rest of the musculoskeletal system, so we'll get pain elsewhere in the body.
Dr. Alex: We'll get wastage of muscle that can take an awful long time, if not be impossible, to recover, especially if we're dealing with an older animal who, yeah, is not going to be going back to full athletic ability, it impacts well-being. If you're in pain all the time, and it's no different from our dogs, you know, it really gets you down. You're miserable. You're grumpy. You're not happy. So why would we do that to our pets? That also leads to challenging behaviors. We can get increase in fear, anxiety, stress, especially with chronic pain. And when we're dealing with, an ACL, a ruptured cruciate ligament, then, absolutely, we're dealing with a chronic pain situation because regardless of how things go, we're going to be developing arthritis in that joint to in some way, shape, or form, so we're we're dealing with chronic pain.
Dr. Alex: A really big example of this actually is that it has I say recently in the last maybe 10 years or or so, become apparent that a dog in chronic pain is much more likely to develop a noise phobia. And, actually, an older dog who's suddenly become scared of loud noises, that can be an indicator that they are in pain which otherwise we are not aware of. It remains hidden. And, also, leaving them in in pain can result in a breakdown in that human animal bond. If they're grumpy, if they're, not interacting with you as much, if they are developing challenging behaviors, then our relationship with our pet can break down, and that is an incredibly important relationship that we have with our pets. It's it's possibly one of the most important relationships we have in our lives as I'm sure you'll recognize. So why would we want that to break down? And that's all this all comes through failing to treat pain, giving it 3 weeks. That's a long time to be in pain before we maybe reassess and before we talk about surgery and things like that.
Dr. Alex: That's just really not appropriate in my book. The thinking behind it is also flawed. So those are the negative effects of pain, but, you know, the thinking behind it is okay. So if we're not treating this dog's pain, they're not going to be using their leg as much so they are protecting it. So they're not going to be hurting as much because they're not using it. But also in the case of a cruciate ligament rupture, the joint is going to be moving less, and so the body has a better chance of stabilizing it naturally, without need for surgery. Now that's also flawed thinking because we are in charge of our pets' activity levels. We can confine them.
Dr. Alex: We can use a crate. We can keep them in a small room. We can make sure that they have nothing to jump onto. So we can restrict their exercise so that they're really not doing much anyway. If we're talking about a small dog, we can we can carry them, a lot to the way, carry them outside, upstairs, you know, wherever we need to be. We can use ramps, to to make sure that our dogs aren't having to jump up into backs of cars and things like that if we can't lift them. We can use a lead and harness. So, absolutely, it wouldn't be appropriate for this dog to have off lead exercise, but we can control their level of exercise and the speed at which they move by using, a lead and a hardness.
Dr. Alex: We can provide food puzzles and and, you know, various other mental enrichment opportunities so that they're not going stir crazy. We're not I'm not saying just stick them in a small room, stick them in a crate, and leave them there for 3 weeks doing nothing. Absolutely not. But there are things that we can do to take the place of leaving them in pain to make sure that they don't use that leg. You know? So so, really, we are in charge, and we can do all of the things anyway that this is this lack of pain relief is supposedly providing. And then when it comes to pain control, we do have lots of different options. We need to take, a multimodal approach, and you'll have heard me say this, recently and in plenty of other episodes, that multimodal approach, we need to be tackling pain from lots of different avenues. But, certainly, drug use is the most beneficial especially in the short term and especially in the case of an acute injury.
Dr. Alex: And it may be that your dog has got certain medical conditions that mean that one painkilling option is not the most ideal, but we're lucky. We have lots of different options in our arsenal that maybe wasn't the case, a few years ago. So, really, I hope that puts this thought to bed, and I hope it makes you appreciate how inappropriate it is. And if you hear someone saying this, if someone says it to you, if, you know, you're thinking it, if, someone writes it in a forum, you know, hopefully, you can nip that in the bud so that we can do the best for our pets to make sure that, yes, they have a great chance of recovery, but also they're comfortable while they're recovering.
voiceover: Helping your pet live the happy, healthy life they deserve.
Dr. Alex: Now if you have a thought on this topic or a comment on any other, episode, or a question that you'd like me to answer, that's a lot of oars there, you can, head over to our pets health dot com slash question, or there's a link in the show notes to this episode as well. And I'd love to hear from you. If you disagree with me, that's absolutely fine. I'd love to have a conversation about this as well. But, anyway, that's it for me for this episode. It's wonderful to be sharing, time with you again for another episode. But until the next one, I'm veterinarian doctor Alex. This is the Call the Vet Show because they're family.
voiceover: That's it for this episode of the Call the Vet Show. Be sure to visit call the vet.org to join the conversation. Access the show notes, and discover our fantastic bonus content. We'll see you next time.
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