veterinary pain

June Patient of the Month

Raji and mom

Raji's Story

Raji started coming to the VMC in the summer of 2013, when he was 12 years old. He had been showing some signs of arthritis, especially in his back legs and part of his back. Sometimes he was also reluctant to go out on walks and we started to wonder if he might be having some pain. We’d gotten him on some supplements that our veterinarian (Dr. Capparelli) recommended (which definitely helped). However, it seemed like he needed something else to help with the stiffness and increasing reluctance to walk for as long as he used to. Our vet thought acupuncture from Dr. Fleckenstein here at the VMC might help to reduce pain and increase mobility.

Raji started seeing Dr. Fleckenstein and right away we noticed a decrease in the amount of twitching in his back when we petted him in certain areas. He also seemed to have more energy, and he was more interested for his normal walks. He also liked coming to see Dr. Fleckenstein and Sue, who assists with most of our visits and also gives great massages and treats! There is always a calm atmosphere and I think Raj feels very cared for. Dr. Fleckenstein has definitely helped with keeping Raj comfortable in his own body as he ages. She has helped to keep down pain and inflammation from arthritis, and worked out trigger points with the laser and needle acupuncture. Dr. Fleckenstein also recommended a ramp for getting him in and out of the car. This ramp has been so helpful, and it is light and easy to set up; he couldn’t get in the car without it!

In the fall of 2014, Raj started seeing Lis for Physical Rehabilitation. Dr. Fleckenstein recommended her and said she could add another dimension to his care. Lis started doing laser therapy and massage to release the increasing number of trigger points he had, and also made exercise suggestions for home. He liked coming for the rehab sessions and was very comfortable with her and her caring, gentle and friendly demeanor. At first Raji had to get up a few times during the sessions to “shake out” after her manual trigger point release, but as Lis worked with him and the trigger points became fewer, he could sit for whole sessions quite often as she worked her trigger point release magic! Lis also shows me various exercises to do with him. She gave some simple exercises and massage techniques for us to do at home to keep his range of motion as good as possible. We also do the massage techniques she shows us so we can keep some of the trigger points at bay. With the sessions with Lis, we can see changes in Raji immediately: he seems brighter and moves better after she works out all the kinks!

Raji

Just a few days ago, unfortunately, Raji had a vestibular episode. Our vet and the folks at VMC were kind enough to lend a hand. The VMC lent us a special harness to help him get up and walk. So far, he hasn’t been successful, but we are working on bringing him back to his old self. It is nice to know everyone is concerned and willing to help Raji get better. We look forward to resuming his therapies soon!

~McCoy Family

Diagnosis:

  • Rhinitis & Sinusitis
  • Presumptive Hind End Osteoarthritis & Weakness
  • Compensating Muscle Pain
  • Myofascial Trigger Points
  • Vestibular Syndrome

Treatment:

  • Acupuncture
  • Lacer Acupuncture
  • Low Level Laser Therapy
  • Dry Needle Trigger Point Therapy
  • Soft Tissue Mobilization
  • Myofascial Trigger Point Release (Manual)
  • Home Exercise Program
  • Medications, Multiple Herbal Therapies, Supplements

 

What You Should Know About Pain and the Goals of Pain Management

acupuncture DEFINITION OF PAIN (according to The International Association for the Study of Pain):   An unpleasant and emotional experience associated with actual or potential tissue damage.

Pain is the most common reason humans seek medical attention.  Unfortunately most doctors are not specifically educated in the management of chronic pain.  This is also true of the veterinary profession.   To further complicate matters, we (pet owners and veterinarians) face a particularly challenging task in assessing our nonverbal pets and patients that evolutionarily have developed instincts to hide disease and pain.

FOOD FOR THOUGHT:  The inability to communicate in no way negates the possibility that an individual is experiencing pain and is in need of appropriate pain relieving treatment.

Here at the Veterinary Medical Center of CNY, our Pain Management team members have devoted hundreds of hours in advanced training to recognize and treat pain in our patients.  Our approach is to address pain by incorporating multiple “modalities” which may include medications, physical rehabilitation, acupuncture, myofascial trigger point therapy, and other treatments.  The primary professionals on our team, Dr. Michelle Burnett, Dr. Polly Fleckenstein, and Certified Physical Rehabilitation Provider Lis Conarton, LVT, are consistently receiving advanced formal training in veterinary pain management, making them uniquely qualified to assist your pet.

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Pain and function are connected.  Changes in activity, behavior, and physical ability may all be indicators of pain in pets.  Pain can negatively affect muscle function, and muscle (myofascial) disease, in turn, can be a major cause of pain.  This connection means that medications alone rarely allow a chronic pain patient to recover.  Our pain-specific nerve pathways and our muscles are no different than our joints, our hearts, or our eyes – they are all susceptible to major breakdown in their form and function.  Medications alone may alleviate some symptoms, but often will not address the source of the pain.

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To achieve the best possible results we apply a coordinated strategy, bringing together a broad range of therapeutic options available to us.  This strategy is based on the individual needs of the patient and integrates all available therapeutic options to obtain the best possible patient outcome.  Once we have the patient stabilized at their optimal level, we then gradually decrease the therapies (both physical and medicine based) until we find the minimum required to maintain patient comfort and quality of life.

Advanced pain medications help “reset” the pain pathways to a less sensitized state.  This can have an immediate effect on patient comfort and function.   Concentration on rehabilitation and strengthening, however, is crucial to the restoration of long standing comfort and return to function.

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The general approach that many veterinarians take in treating pain is by prescribing, almost exclusively, a nonsteroidal anti-inflammatory drug (NSAID) such as Deramaxx, Rimadyl or Metacam.  Interestingly, NSAIDs are the most commonly used pain medication in veterinary practice but also have the greatest potential for causing damage to the kidneys, liver and/or the gastrointestinal (GI) system.   Aging pets are the most likely to be chronically painful, and are also most likely to have some compromise of kidney, liver or GI function.  Regardless of  age, any pet on an NSAID drug should be closely monitored (bloodwork and possibly urinalysis) on a regular basis.

Fortunately, we have other options.  If you are concerned and want more answers now, contact us at 315-446-7933 and ask to speak with our Pain Management Service. More information is also available on our website www.vmccny.com

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Written by Dr. Michelle Burnett, Director of VMC's Pain Management Service

Is Your Pet in Pain?

Recognizing Pain in our Pets

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How do we know our pet is experiencing pain?

Pets feel pain for many of the same reasons as humans: dental problems, infections, arthritis, disease and cancer as well as discomfort after surgical procedures. There are certain signs and changes in behavior that can indicate when a pet is suffering. As a pet owner, you are in the best position to notice those often subtle changes. The sooner your dog's pain is diagnosed and treated, the sooner he or she can heal and resume a normal, happy life.

Out of instinct, many animals will hide their pain. This is most common in our cats. In the wild, animals that appear sick or injured are vulnerable to predators. For this reason, our pets often disguise the fact they are in pain.

Also true is that our pets do not simply slow down because they are aging. Age is not a disease. If your senior dog or cat is less active, it is likely because there is something wrong and may very well be that he is suffering from arthritis pain or some other type of pain.

The most obvious signs of pain are crying, whimpering, growling and limping. A common misconception is that a pet that is limping is not painful because he/she is not vocal or is still willing to play and chase the ball. The fact is, an animal that is not painful does not limp (assuming that there are no anatomical abnormalities that result in an abnormal gait). If your dog or cat is limping, it is because his/her leg hurts. There are many reasons the leg may hurt but the bottom line is that your pet is in pain!

Behaviors that may indicate pain: 

  • pacing
  • restlessness
  • reluctance to move or reluctance to lie down
  • trembling
  • facial expression frequently vacant stare, wide eyed, and/or  grimacing
  • posture rigid, hunched back
  • decreased appetite or not eating at all
  • hiding or avoiding contact versus interactive and asking for attention
  • aggression
  • generally “grumpy"
  • “accidents” in the house/soiling outside litterbox
  • doesn’t want to be picked up
  • guarding a body part
  • focused on one part of their body – licking, biting, scratching or staring at a body part
  • panting excessively
  • excessive grooming/not grooming at all
  • some animals will “talk” more when they are in pain where others may “talk” less than they normally do
  • unable to sleep/rest for long a period of time
  • circling, getting up and down on bedding
  • Sleeping excessively
  • withdrawn for long periods of time

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Treating pain Please do not try to treat your pet’s pain yourself. Many forms of human pain relief can be dangerous (even fatal) to our pets. Pain occurs for many different reasons and so treatments will depend on the diagnosis.   Pain relief options for our pets is a rapidly expanding field, and there are many safe therapies available.  We will explore some options for pain control in our next post. If you are concerned and want more answers now, contact us at 315-446-7933 and ask to speak with our Pain Management Service. More information is also available on our website www.vmccny.com  

Written by Dr. Michelle Burnett, Director of VMC's Pain Management Service