You’re a pain

Count me in as one of the lucky members of the migraine club. Now, I have it a lot better than many- mine hit infrequently, and usually last a day or less. I know for many it is so debilitating that they lose several days when one occurs, lost in a blinding sea of pain and nausea. I had one that bad in my adult life, when I was in New England for a family event. I had forgotten how bad they could be, unaware that something in the swampy Massachusetts air was a trigger.

My father- he’s the one to blame for that gene- and I both wound up holed up in a darkened, chilled bedroom like sides of beef left to cure, me pushing the limits of therapeutic index of Excedrin ingestion while he dialed his doctor back in California trying to score some Imitrex.

Much like the leprosy-afflicted were left to fend for themselves on the shores of Molokai, none ventured in to the clan of the hibernating cave bears. No one wanted to deal with us. When I could bear to stand long enough to crawl over to the door, I might find a glass of water left outside, a sandwich, some basic sustenance, but that was about it.

When at last I the wave had passed and I could walk outside without being blinded with pain, I practically oozed into a chair on the lawn, reveling in the relief that was simply not being in pain. I held my family members no ill will for abandoning me to my fate. There wasn’t much anyone could do, and to wander into my sphere was generally an invitation to be verbally abused as the simple act of opening a door might let in an errant beam of light or make a 50 decibel creaking noise that thundered into my orbits like the hammer of Thor.

My point is, pain is ugly. Headaches are ugly. When I have one coming on, my family tends to make themselves scarce, because- and I admit it- I’m not super pleasant to be around. It’s pretty obvious I am not in a good mood.

Now, we know pets also experience pain. They probably get headaches when their sinuses are all inflamed from allergies, just like we do. Since so many people leave them with mouths full of diseased teeth, a lot of dogs and cats are walking around with painful mouths, sometimes so bad that the infection can eat straight through the bone and cause an oronasal fistula. I can barely function when I get a brain freeze. I can’t imagine functioning with that kind of pain every day.

And yet the vast majority of animals suffer with pain quite stoically. A watchful owner will pick up on a listless pet, one whose appetite is diminished, maybe a dog a little slow on the stairs. Sometimes it’s translated as a pet that’s a little more grumpy than usual. In extreme situations- pets hit by cars, or those recovering from major surgeries- the signs of pain are clear and unmistakable. The rest of the time, though, it can be easier to miss.

This is important to remember. Pets, unlike people, aren’t wussies.

We tend to evaluate our pets as if they were people. “Eh, he’s just slowing down” is a refrain vets hear at least ten times a day from owners who don’t think their dog’s subtle signs of lameness are worth a workup. Many times, that workup will turn up arthritic changes that, if it were one of us experiencing them, would have us slugging down Joint Juice, slapping knee braces on our tired joints, and smoking out the house with Icy Hot.

Another example: a dog with a subtle limp presented for an exam. The owner thought maybe she had bumped her thigh on a piece of furniture because she seemed uncomfortable when it was touched. Unfortunately, she had a tumor on her femur that had almost eaten through the entire bone by the time we found it. Osteosarcomas are known to cause an excruciating pain, and here is this dog, who just winced a little.

I think about those pets often when I’m laid up with a headache, and I made myself promise to remind all of you the way my own body reminded me that pain stinks. We are so fortunate to be in a place and time where there are many good pain control options for pets, but you have to know to be looking for the pain to begin with and bring it up with the vet. Because god bless them, pets are much nicer than we are when pain is involved.

Pain management, not just the medications available but the recognition that we need to do a better job identifying and managing pain in pets, is one are of veterinary medicine that seems to have progressed with leaps and bounds since I graduated, and for that, I am so very grateful.

Have your pets ever surprised you with subtle signs of discomfort? Any surprising outcomes?

Pawcurious Vet Blog: With Pet Blogger and Veterinarian Dr. V

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