Jan 16 2017

Don’t Poke The Bear – How to Avoid Pain Wind Up

If you are dealing with any pet that may have any chronic pain or discomfort, say due to arthritis, the next couple paragraphs will give you some important insight and knowledge that you need to know for the long term comfort of your pet. Now the next sentence is a little technical but if you stick with me I promise the entire article is not dry and medical. Pain Wind Up, also known as central sensitization, occurs when there is chronic pain that over stimulates the dorsal horn of the spinal cord resulting in an increased perception of pain. Phew ok that was a long sentence, but basically means if you keep poking the bear you are going to hurt!

The issue with wind up is that once it occurs, pain becomes more difficult to control. I have heard this term used both with my mother and best friend when they were diagnosed with cancer. Neither wanted to start on pain medication early on as they did not feel they were in a lot of pain. They both got the same response… “If we do not treat the low level pain, wind up will occur, and then we will have trouble control the pain later.” This also happens in our pets with cancer but also with pain associated with benign chronic conditions such as osteoarthritis. This is why we want to start treating arthritis early and why it is important to treat multimodal.

Now this doesn’t mean one has to put their dog or cat on a pharmacy full of medication early on – nope – it depends on severity. In fact my cat Brandon Muller hasn’t shown me signs of arthritis but since he is 14 and has about a 70% chance of having some form of arthritis I have him on a glucosamine treat – Therabites. I also watch him closely for any possible signs of discomfort and in cats a common sign (but not seen in every cat) is a decrease in jump height – ie if he used to jump to the table from the floor but now does it in two jumps by adding a chair mid jump … well that sets of warning bells. (Other signs in cats include increase or decrease in grooming (a little indecisive) increase in sleeping (maybe hard to tell with a cat) not liking having their back petted, urinating or defecating outside the litter box – just to name a few)

Winston, our clinic greeter, is only 6 now, but as a puppy I took radiographs to check out his hips, as pugs are known to have hip dysplasia, and yup Winston has it. So I am proactive and keep his weight down, which is a serious challenge in a pug – but this is so important as this can delay the onset of arthritis by as much as 6 year! I treat him multimodal with having him eat Royal Canin Mobility Diet and give him high levels of Omega 3. As well I make him do physio exercises to strengthen his hind legs to help support his hips.

Many of you know Brutus, our 3-legged Rottweiler. Well he is now 10 and for a year now pulls himself to a stand rather than pushing with his hind legs. (This is a common subtle sign of being sore in the hind quarters) He has arthritis so once again I am going to treat multimodal. Brutus has food allergies so we chose not to give Mobility Diet but since he shows pain (the subtle pulling himself to a stand) he gets a NSAID – Rimadyl was our choice for Brutus as the first NSAID upset his tummy, he is also on very high levels of Omega 3, Gabapentin and laser therapy as well we keep his weight down as well.

As you can see we must tailor treatment plans to each pet depending on their stage of disease and level of discomfort or pain, as well as taking other medical conditions into consideration. The goal though is to start early, adjust as needed, used multimodal and don’t allow the pain to over stimulate the spinal cord (don’t keep poking the bear) and create pain wind up as it can be very difficult to control pain once wind up occurs.

Please email us at FVAH@live.ca

ntaylor | Life behind the exam room doors

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