Let’s Discuss Pain Medications for Dogs

Why pain meds for dogs?

Why do you reach for Tylenol® or Excedrin®, for example, if you have a headache? Do you take daily arthritis medications? Would you have been sent home with pain meds after a recent surgery? Our pets are no different. Though we all would love to prevent pain in all animals, sadly, they too experience pain. Failing to treat pain delays healing and negatively affects their quality of life. 

Dogs suffer from various painful conditions due to aging, trauma, health ailments, and more. Often, pain in animals goes untreated, remaining overlooked. Pets show a range of pain signs, from showing nothing and hiding discomfort all the way to growling or attempting to bite when handled to various things in between. For more on signs of pain in pets, check out our article “How do I determine if my pet has pain.” 

Alternative pain relief for dogs

Treating pain in dogs is a common necessity. While we can treat with painkillers for dogs, we also use several non-medication therapies. These include 

• Short-term exercise restriction (confinement)
• Physical therapy – including massage, laser therapy, underwater treadmill, and more
• Applying heat or ice
• Supplying extra padding for bedding and floors
• Supplements such as Glucosamine and Chondroitin sulfate – may not provide direct pain management but may help slow disease progression of conditions such as arthritis
• Weight management
• Use ramps and other measures to make it easier for pets to get around
• Provide traction with easy-to-grip surfaces 
• Slings and other assistive devices to help pets get around easier
• Prescription diets 

What can I give my dog for pain?

But when vets reach for medications to treat pain, we use a variety of options. We classify pain meds based on how they work in the body. You may be familiar with some of animal and people’s commonly used drug classes. These include

1. Non-steroidal anti-inflammatories (NSAIDs)   – This drug class includes human meds like Ibuprofen®, Asprin®, or Aleve®. However, these over-the-counter medications are not safe and potentially toxic to dogs. 
   Additionally, dog-specific drugs like Rimadyl®, Deramaxx®, and Galliprant® belong to this group. NSAIDs for dogs or any species are pain medications. People tend to think they are for inflammation, which is true, but that is how they provide pain relief by decreasing that inflammation. Side effects of NSAIDs vary with the drug, dose, and pet. 
2. Corticosteroids – AKA Steroids – medications like prednisone, prednisolone, and hydrocortisone. These drugs can be used for anti-inflammatory pain management as well as immunosuppression. Side effects are plentiful, and chronic use can lead to long-term problems. 
3. Neuroepileptics – Medications designed to prevent seizures can often be used for pain management. The most commonly used in veterinary medicine is gabapentin. Often used in combination with other medications or non-drug therapies, it provides a good adjunct for both neurologic and chronic pain.
4. Tramadol – You may be familiar with Tramadol, which is commonly used in people. However, its use in dogs continues to diminish, with more research showing a lack of effectiveness, especially when used as the sole pain medication. However, some veterinarians still use it in combination with other drugs.
5. Opioids – examples include codeine, hydromorphone, fentanyl, and methadone, most commonly used injectably in clinics for pain management but may be sent home in more severe pain cases. Veterinarians must use caution when prescribing this class of drugs to use for at-home pain meds in dogs. Vets need to ensure the safety of their pets and their owners and that these drugs are not misused. 
6. NMDA Receptor Antagonist such as Amantadine – This was originally developed as an antiviral for things like the flu. However, while it didn’t work very well for that purpose, researchers realized its benefit in pain management. The NMDA receptor generates pain, and drugs against that receptor alleviate it. This is most useful with chronic untreated pain and wind-up, where the brain becomes oversensitive to any sensation, and non-painful things start to seem painful. 
7. Polysulfated glycosaminoglycan(GAGS) – Adequan® …..Polysulfated GAGS constitute part of the normal building blocks of a joint. But they function beyond structure, providing anti-inflammatory benefits to decrease cartilage wear and tear over time. They aid in joint lubrication and various enzyme system functions to assist in joint repair. So, their use primarily for arthritis in dogs makes sense. Early on in the disease, it may be all that is necessary. However, it is often used with other meds or non-drug treatments
8. Local or topical anesthetics – Medications like lidocaine provide numbing of the area where applied; they are generally used as injectable medications, creams, or patches.

Pain medications come in various forms. We have injectable types, generally used in the clinic for outpatient and hospitalized pets. Additionally, we have topical anesthetics (e.g., lidocaine), oral medications (chewable, pills, capsules, liquids), and even pain patches (fentanyl or lidocaine). 

Pain medications provided in hospitals may not be the same as at-home pain meds for dogs. 

Dog pain medications

The development of dog-specific pain meds does provide some opportunity for veterinarians to reach for those first. However, some dog pain meds prescribed by veterinarians come from human medicine. These meds are not approved for use in dogs. Still, veterinarians reach for them (off-label use) based on scientific evidence and research showing their appropriate dose, safety range, and effectiveness. 

However, regardless of whether a medication is dog-specific, vets often prescribe dogs pain meds for many reasons. You should understand what you give to your pet, how it works, and any side effects or risks. 

Dog pain meds: One strategy in K9 pain therapy

Often veterinarians use a multi-modal approach to pain management. What does that mean? Simply put, we use a combination of treatments to provide overall pain management and improve our patient’s quality of life. 

Safe pain meds for dogs

Are there any safe pain meds? Safe is a relative term. All things we put into our bodies have the potential to cause harm. You can drink too much water, get too much oxygen, and ingest too much salt, yet all these things are also required to survive. So, safety is relative. 

When prescribing medications, veterinarians take into account various factors

• The age of the pet – Some drugs are not approved for use in dogs who are still growing
• Any underlying health conditions
• The type of pain being treated – a wound vs. a bone fracture vs. pancreatitis (inflammation of the pancreas) all warrant different pain management strategies
• The owner’s schedule
• Size and weight of the dog
• The willingness of the dog to take pills vs. liquids vs. capsules
• The cost of the drugs
• Any drug interactions with other medications the pet takes
• Side effects

What’s the best pain med for my dog?

What is the best pain medicine for my dog? Well, there isn’t one! Trial and error are sometimes required to achieve proper pain management. What works for your dog may not work for the dog next door. Some dogs are more likely to develop side effects from a drug than others. So, while we regularly use certain medications, we must consider the individual dog.

Another factor vets consider when selecting pain medications for your dog is the ease of administration. How often can you give your pet meds? If your pet doesn’t have someone to provide medicines at 7:00 am, 3:00 pm, and 10:00 pm daily, then giving meds that require three times a day dosing may not be right for your family. Finally, your pet may need a liquid because they are too small for other options or a chewable choice because they are hard to give pills. 

Remember

Not all drugs are created equal, and not all meds are right for your pet. Make certain for any pain med for your dog, you understand what your pet is prescribed, how to give it, when, and what side effects to expect. So, while there is no answer to the best pain medicine for dogs, pain relievers for dogs remain an important part of a veterinarian’s arsenal to aid in controlling pain and suffering in our 4-legged friends.