Pain Management at Fairfax Veterinary Hospital

Pain identification and management is a major focus of the care we provide at Fairfax Veterinary Hospital.  For many of our beloved companions, pain is a silent struggle that negatively impacts the human-animal bond and quality of life.  Signs of pain are often extremely subtle, however over time, its effects compound.

How to tell if your pet may be in pain?  Here are some early and more subtle signs:

  • Loss of interest, avoidance or shortened engagement in activities that used to be easy and fun.  We often say it is what they are not doing as much as what they are doing in terms of routines and activities.
  • Changes in behavior: including irritability, reactivity toward and/or avoidance other pets.  Decreased social behaviors and interactions with people, even family members. Weariness around unfamiliar people and other pets.
  • Increased anxiety, restlessness, clingy or avoidant behaviors.
  • Inconsistent appetite.
  • Inconsistent bathroom routine, including house-soiling accidents, constipation and diarrhea.
  • Changes in gait appearance, body posture, and transitions.
  • Weakness, shaky legs, reluctance to stand long.
  • Scuffing of paws.
  • Obsessive licking at the same site(s).
  • Decreased grooming (cats)
  • Hesitating to jump
  • Not wanting to be petted
  • Inappropriate urination/defecation

Chronic pain leads to increased sensitization of nerve endings.  This is called “wind-up” which leads to significant discomfort, anxiety and diminished quality of life.  It is truly difficult to see animals in pain and heartbreaking to realize signs of pain are often subtle and go unrecognized until it has become advanced.  Fortunately, there are useful exam and assessment tools to identify and localize pain.  Once revealed, there are also many treatment options available.

Causes of pain

One of the most common sources of pain in pets is arthritis (osteoarthritis, or OA).  Arthritis pain starts at a surprisingly young age in both dogs and cats.  A 2024 study found that 40% of dogs had evidence of arthritis visible on x-rays by the age of 4!  Of these dogs only 40-60% had symptoms (abnormal posture or gait, lameness, activity avoidance/hesitancy, behavior changes).  By the age of 8 years-old, 80% of dogs have OA.  Osteoarthritis begins long before visible signs appear.  Arthritis is always a progressive disease without intervention and it often becomes debilitating.

Back pain, intervertebral disc disease is another common cause of pain from the musculoskeletal system.  Similar to humans, severity can range from episodes of severe pain up to paralysis.  Interestingly, joint disease from OA can increase the risk of intervertebral disc disease and many pets have both joint and back pain.  The musculoskeletal system is literally all connected!

Chronic systemic conditions are another categorical source of pain.  Chronic gastrointestinal upset (vomiting, diarrhea, inconsistent appetite, poor body condition) is very common in dogs and cats.   There are numerous causes of chronic gastrointestinal problems.  Urinary bladder cystitis is very common, particularly in cats. 

Tailored treatment

The good news is that all of these sources of pain are treatable.  The first step is always a thorough exam and detailed review of symptoms with extra attention given to those subtle signs of pain.  Our doctors and staff are trained to recognize these signals of discomfort, anxiety and avoidance.  Further diagnostics with specific lab tests, blood pressure monitoring and imaging are key to further localizing the origin.  This will allow therapies to have the greatest positive impact.

FVH has many pain management therapies and tools that are customized for each patient and condition.  These treatments include well-rounded pain medication of course, but also often involve nutritional supplementation, diet management, laser therapy, acupuncture, joint injections for cases of OA, VOM therapy, and specific prescribed at-home therapies that allow you hands-on involvement in supporting your friend.  Please see our page on OA management (hyperlink) for more details on this topic!  Our goal is always to minimize pain and maximize quality of life so your friend can stay by your side with ease and grace.