Pain And Pain Relief

[poodle proud]

I have had Osca at the vet this past week having 4 teeth out. He has been so sooky and not himself since it was done. I made a point to ask about pain relief prior to him having it done and then again on the day. I was told he wouldnt need it and despite my gut feeling I didnt press the issue. In hindsight I wish he had had it as I really believe he was in pain.

Where I used to work humans got two types of pain relief with the same number of extractions and this was standard.

What I am wondering is what does everbody think? I have no doubt dogs can feel pain. Some people may not want to incur the cost but surely I am not the first person to want pain relief for their dog?

[SearchJane]

I have had Osca at the vet this past week having 4 teeth out. He has been so sooky and not himself since it was done. I made a point to ask about pain relief prior to him having it done and then again on the day. I was told he wouldnt need it and despite my gut feeling I didnt press the issue. In hindsight I wish he had had it as I really believe he was in pain.

Where I used to work humans got two types of pain relief with the same number of extractions and this was standard.

What I am wondering is what does everbody think? I have no doubt dogs can feel pain. Some people may not want to incur the cost but surely I am not the first person to want pain relief for their dog?

If it was my dog having teeth extracted I'd want him to have adequate pain relief. Stupid vets not to listen to what the client wants.

[julesluvscavs]

Joey has to have two molars removed soon (and a lump on one of his eyelid). I am wondering about this also, especially since he's having a couple of things done at the one time!

So I am interested in what other dolers have to say about it all

Hope Osca recovers quickly and is back to his normal self soon !

[puggy_puggy]

With any surgery dogs generally get a long acting pain relief injection before they go home. Dogs also have less pain receptors then humans.

My pug girl has had two lots of dental surgery. First time she had 4 teeth out and the second time 2 teeth out. She was fine without any take home pain relief and I do not believe it is common practice to provide it.

Much more major surgeries are performed on animals and they do not need take home pain relief.

Could it be that Osca is milking you for all it's worth.

Edited August 17, 2009 by puggy_puggy

[poodle proud]

Thanks for the replies and well wishes.

They probably would have given me something if I had pressed the issue but I felt like an overly worried parent and thought that if they didnt think it was necessary maybe I was wrong.

They had told me when I booked him in that if you give pain relief to a dog they might do stupid things because they feel ok and hurt themselves more. I understand this can happen but as I explained to them Osca is not like this. He doesnt really play with toys or chew anything other than food so the chances of him damaging where the teeth had been removed were remote.

puggy_puggy:

With regard to pain receptors, that is the kind of thing I was wondering about. If they have less pain receptors they wouldnt need pain relief as much which make sense and would justify him not having any. But I wonder even with less receptors whether in some cases it may still be appropriate for some dogs.

Could he be milking it for all its worth? Quite possibly . He is a sook at the best of times and I doubt his threshold for discomfort is very high. That said I have never seen him so miserable for so long since we got him. I had to really push him to go outside to the toilet, he wouldnt drink water, and he hardly moved for the first 48 hours.

I know the anaesthetic needed to wear off but after that he was still miserable. And as he is getting progressively better each day I am inclined to believe it is becoming less uncomfortable/painful which is what happens after any surgery major or minor.

It may not be standard practice to offer it but if it is enquired about the option should be to take it of you want and if you don't use it then great. Its too late after the surgery has shut to suddenly decide you want it without footing a massive after hours bill.

JulesLuvsCavs: Hope Joey goes okay!

[Janba]

When Moss had a canine removed (it was growing parrallel with the roof of his mouth) the vet told me they had to burr away a lot of bone to be able to extract it so not a simple pull the tooth out and he had a row of stitches in the gum as where they had had to cut it to get to the bone. He was given a long acting pain killing injection and I was given additional pain relief to give him if needed. He was fine and didn't require the extra pain killers and he has a low pain thresh hold. He was also castrated at the same time.

I suspect Osca is milking it for what its worth especially if you are giving him extra attention and some tasty soft foods.

[Staff'n'Toller]

We give routine pain relief for dentals with extractions. Specialists even advise that nerve blocks are not difficult and can make post-op recovery nicer for the dog. Although it's not something we've adopted yet.

We actually will give a small dose to small breeds who've had a scale and polish only because they tend to take it very personally. They go home happier for it.

We will send dogs home with 3-4 rimadyl tabs but having had personal experience with wisdom teeth removal in the chair the first 24hrs (the bone pain) is the worst then you're usually aok.

[westiemum]

I always ask about pain relief after surgery for my guys - and usually they have an injection and then I start a short course of pain relief for 4-6 days afterwards.

I don't think it hurts to errr on the side of providing our guys with pain relief - particularly as they get older. And if your dog is miserable I think I'd be ringing the vet, telling them about his symptoms and pain behaviour and asking when I can collect further pain relief... owners generally know thier dogs well and when it comes to pain they know their animals better than anyone else so, I I were you, I'd follow your gut and discuss further with your vet as what you are describing sounds like a dog in pain to me....

Hope that helps.

Cheers,

Weastiemum

[Erny]

I'm one of those unfortunates who wasn't born with great teeth and I'd class myself as reasonably experienced in tooth extractions. I've never had nor never felt I needed pain relief after an extraction. I guess it depends on the extraction and any complications.

I am presuming you are talking about pain relief post extraction???

[Tru Borders]

After Asher had one of his premolars removed, we did not go home with any pain killers. The extraction was not an easy one as the tooth had been a little bit broken up. Asher was not a happy fella coming out of the anesthetic, but I dont believe he was in much if any pain.

I have had a few teeth out as well with no after op pain relief ..... but my dentist is amazing!!

[poodle proud]

I think what everyone's responses are highlighting is that everyone is different and this can apply to our dogs. I have recovered hundreds and hundreds of people having wisdom teeth out and other oral surgery under a general and the differences in pain tolerance for them were astounding. Most needed some pain releif, a rare few didnt. And as you said Erny this is affected by the complexity of cases and any complications.

When we brought Osca home we put him on the bed and there he stayed for 95% of the next couple of days (And the bed is where he sleeps anyway so not a novelty worth exploiting). If he was milking it he would have come and pawed at me for attention like he does every other day of the week . He was offered some chicken mince but wasnt even interested in that for a couple of days. I'm sure as Staff'n'Toller said he did take it very personally but I don't doubt he was also in pain.

I guess what I was wanting to know from the post was whether it was totally unreasonable to want pain relief for him and I know now it wasn't. I understand a lot of dogs may be fine without it but looking back I think he would have been a lot more comfortable with it. I love my vet and can't fault them in his care but I will trust my gut about it next time. If it's only me being a bit out of pocket then I don't see the harm in getting it.

Has he coped without it? yes. But all the posts on DOL are evidence that we don't just give our furry friends the bare minimum. If we did there wouldnt be so many debates about the 'best' dog food

[Erny]

When we brought Osca home we put him on the bed and there he stayed for 95% of the next couple of days

A bit of this could be contributed to the affects of GA in his system.

Has he coped without it? yes. But all the posts on DOL are evidence that we don't just give our furry friends the bare minimum.

The difference being that with us, we can take pain relief but still be aware (because we're told) that we need to be careful with what we do/eat etc. etc. Animals can't have that explained to them, so for them some pain or discomfort is necessary. Can you imagine dogs who are into (eg) stick chewing or even having a good munch on bones (which they might retrieve from some forgotten hole that's been buried over) with an open wound in their mouth?

I agree with pain relief in more extreme cases, but in those cases the pain relief is not as likely to completely remove the pain - just take the edge off. More milder pain - pain relief may have the animal completely forgetting there is anything there it needs to protect.

[poodle proud]

A bit of this could be contributed to the affects of GA in his system.

Totally understand this concept and so I wasnt too concerned about him for the first day as I knew this was normal.

The difference being that with us, we can take pain relief but still be aware (because we're told) that we need to be careful with what we do/eat etc. etc. Animals can't have that explained to them, so for them some pain or discomfort is necessary. Can you imagine dogs who are into (eg) stick chewing or even having a good munch on bones (which they might retrieve from some forgotten hole that's been buried over) with an open wound in their mouth?

This was the reasoning of the vet nurse when I inquired about it initially which I understand but as I said in a previous post Osca is not like this. He doesnt play with toys. He doesnt eat anything random like sticks rocks etc, he doesnt mouthe me and so I wasn't worried about him not protecting the area as I was present and controlling what he ate.

I realise this is unusual behaviour for a dog but he has been this way since we got him from his previous owners. That's where I thought my knowledge of him could have made some difference to the plan of care. Had it been midnight having had the op I would have totally agreed. It was so hard keeping her quiet after she was spayed. Osca has keeping quiet down to a fine art

[Rappie]

There is quite a wide spectrum of opinions regarding the what / how / why of pain relief amongst members of the veterinary profession, let alone dog owners.

I try to be quite pro-active about providing pain relief and managing post op pain. I work on the principle that if I think it is likely to hurt, then my patient gets whatever pain relief I feel is appropriate while it is under my care. I don't agree with using pain as means of preventing movement or activity, others might but I don't feel that it is productive. Pain is stress, stress is not beneficial.

If one of my patients had 4 surgical extractions (as opposed to very loose teeth that fall out when the tartar gets scaled off) they would get pre-emptive pain relief in their premedication, local nerve blocks prior to the extractions, post op pain relief and likely some take home pain relief as well. Wherever possible, I try to create gingival flaps before removing teeth so that the holes can be closed with suture material - reduces the number of sockets to fill up with food and the gums heal very quickly and patients will eat a meal on the night of the surgery.

[Staranais]

There is quite a wide spectrum of opinions regarding the what / how / why of pain relief amongst members of the veterinary profession, let alone dog owners.

At uni they showed us a survey someone had done, where different vets had been asked to estimate the amount of pain an animal would typically be in after certain surgical operations (laparotomy, castration, spay, etc). The study found that female veterinarians, as well as more recent graduates/younger vets, tended to estimate the animal's pain as higher for almost every procedure, and were more likely to give the animal pain relief after surgical procedures, than male or older vets were.

I though it was interesting.

[Teebs]

I'm one of those unfortunates who wasn't born with great teeth and I'd class myself as reasonably experienced in tooth extractions. I've never had nor never felt I needed pain relief after an extraction. I guess it depends on the extraction and any complications.

I am presuming you are talking about pain relief post extraction???

I just want to comment, i had 4 teeth removed when i was about 15, they gave me an injection to numb me, pulled the teeth out, and sent me home, i didnt take any pain killers either.. kaos has a tooth due to come out very soon, so not sure what i would do with her... I know no matter what she will milk it for all it is worth

Atlas did have pain killers when he had his dew claws removed

[Do No Harm]

What I am wondering is what does everbody think? I have no doubt dogs can feel pain. Some people may not want to incur the cost but surely I am not the first person to want pain relief for their dog?

I used homeopathic arnica when my dog had surgery (to her eye). See http://www.dolforums.com.au/index.php?showtopic=174636

The tumor had been removed twice before and regrown because the vets had 'leveled' it instead of excising it properly, so the latest surgery involved trauma at a deeper level of tissue.

Both vets referred to in my earlier post felt some pain relief would be needed. The local vet proposed using Tramadol and the (specialist) vet who ended up doing the surgery was going to use Rimadyl. My dog didn't have either.

All she had for pain relief was homeopathic arnica given twice daily from the day before surgery to the day afterwards (both days inclusive). Had there been any indication at all that she needed something stronger then it was easy enough to quickly obtain it for her, but she didn't.

Edited August 18, 2009 by Do No Harm

[Do No Harm]

The study found that female veterinarians, as well as more recent graduates/younger vets, tended to estimate the animal's pain as higher for almost every procedure, and were more likely to give the animal pain relief after surgical procedures, than male or older vets were.

I though it was interesting.

My first dog had a carnasial tooth root abcess at the age of 15. That required extraction of the offending tooth. He had no pain relief. It was an older male vet in 1985 who did that surgery!!!

[poodle proud]

I try to be quite pro-active about providing pain relief and managing post op pain. I work on the principle that if I think it is likely to hurt, then my patient gets whatever pain relief I feel is appropriate while it is under my care. I don't agree with using pain as means of preventing movement or activity, others might but I don't feel that it is productive. Pain is stress, stress is not beneficial.

Such a shame you arent in Brisbane Rappie

At uni they showed us a survey someone had done, where different vets had been asked to estimate the amount of pain an animal would typically be in after certain surgical operations (laparotomy, castration, spay, etc). The study found that female veterinarians, as well as more recent graduates/younger vets, tended to estimate the animal's pain as higher for almost every procedure, and were more likely to give the animal pain relief after surgical procedures, than male or older vets were.

I though it was interesting.

Me too. I think there is that stereotype that women are more empathetic which in some cases is probably true. OH loves the dogs but would usually err on the side of "she'll be right" when it comes to their level of comfort. But when I brought Osca home OH said "why didnt he get any pain relief? They should try having 4 teeth out with no pain relief" He then proceeded to fuss over him and talk to him in a baby voice. I almost fell off my chair from shock

I just want to comment, i had 4 teeth removed when i was about 15, they gave me an injection to numb me, pulled the teeth out, and sent me home, i didnt take any pain killers either..

The younger a person is when they have extractions the easier the teeth are to remove, less swelling, bleeding, potential complications and the less pain relief they need. The most amazing patient I looked after was a 12 year old kid who had 4 teeth out and was back at school the next day :D

[poodle proud]

All she had for pain relief was homeopathic arnica given twice daily from the day before surgery to the day afterwards (both days inclusive). Had there been any indication at all that she needed something stronger then it was easy enough to quickly obtain it for her, but she didn't.

I have had a lot of patients ask if they could use this after extractions and the surgeons always said yes. While I am not against homeopathic remedies I probably wouldnt choose them over pharmaceuticals and I wouldn't be game to give them to my dog. Simply because I don't know enough about them. I know Arnica is ok but there are quite a few natural remedies that can actually increase bleeding post-op. How do you know what doseage to give?