Limping = Pain: Recognizing and Treating Discomfort in Animals

"Spot the Signs" is a brief YouTube video for cat
owners on how to identify feline pain symptoms.

Veterinarians hear variations on the following incongruous statement every day from clients so concerned about their pets' recent behavior they have brought them in for an examination: "He's been limping badly on that leg for two weeks," then as an afterthought, "but he's not in pain."

Not in pain? When you twist your ankle and hobble around awkwardly afterwards, isn't it because of pain? Animals are outwardly very stoic for a reason. Instinctively they know that whimpering and whining is an effective dinner bell for larger predators. It doesn't matter that your city pooch is in no real danger of being devoured by a pack of wild dogs. Instinct is a powerful motivator.

For many years even veterinary professional doubted whether animals experienced pain. The automatic use of pain relievers following routine elective procedures such as spays and neuters is a rather recent development. Veterinary schools spend a good deal of time nowadays instructing students on how to identify discomfort in different species of animals so they can prevent and treat it in future practice. It is widely accepted that pain relief leads to faster healing and happier patients.

Observing an animal from a distance often gives the best indication of how the animal is truly feeling. Rapid breathing (when inappropriate in the face of rest and cool temperature), restlessness or trembling are signs of discomfort in many species. Other signs your dog or cat is experiencing pain include:

• decreased to absent appetite
• reluctance to chew or play with toys (especially in the case of dental disease)
• unusually quiet behavior, hiding (especially cats), decreased sociability or increased sleeping
• repeated licking, chewing or looking at a certain area on the body
• decreased grooming and unkempt appearance in cats
• dilated pupils
• abnormal body position (e.g., hunched posture, tense abdomen)
• limping and changes in gait such "bunny hopping" while running
• difficulty climbing onto the bed/couch or into vehicles, inability of cat to jump onto counters, etc.
• vomiting
• urinating or defecating where they lie
• vocalizing or snapping when approached or handled

Purring in cats and tail wagging in dogs does not prove the absence of pain. In veterinary practice I have met cats horribly mangled in vehicular trauma purring like crazy. Purring can be a self-soothing technique similar  to Lamaze breathing used by women in childbirth to handle intense levels of pain.

Prey species such as rabbits, sheep, horses, cattle and birds are even more stoic than dogs and cats. The weakest member of a herd or flock is the most likely to be picked off by a predator, so these animals classically hide illness and discomfort until they absolutely can't stand it anymore. By the time caregivers  recognize a problem it may be too late, so the minute a problem is noted veterinary care should be sought.

Some owners fret that their pet will become "addicted" to pain medications or the medicine will falsely "cover up" pain prolonging the pet's life beyond quality. First, pets do not become addicted to pain medications because they do not have opposable thumbs! They cannot open vials and pop pills to get a high. Once the discomfort has been treated and the body has healed, dogs and cats are not dependent on the medicine and they do not seek it out inappropriately. (Unless it is a beef flavored anti-inflammatory. I've had more than one Labrador Retriever patient devour an entire bottle off the counter. But that was because it tasted good, not because the dog needed to feel good.)

As for "covering up" pain, I ask people to think of human arthritis sufferers. If Grandma can take an anti-inflammatory that allows her to get off the sofa and into her garden, shouldn't she use it as needed to lead a comfortable and enriched life? The same is true of our pets. Many of my canine patients are given anti-inflammatory medicine for years and enjoy very normal doggie lives. Yes, there often comes a day when osteoarthritis is so severe in these guys that we run out of effect pain relieving options (joint supplements, pharmaceuticals, physical therapy, acupuncture, etc.). This type of quality-of-life robbing pain cannot be "covered up" and pet owners can see the obvious difference.

Inability to recognize the subtle signs of pain in our pets does result in decreased quality of life. Animal lovers do not like to see other creatures in pain, so teaching them to recognize it allows them to better care for their animals. When a client worries they won't know when to give their pet its pain medicine my advice is "it is better to give a pain medication when it is not needed than to withhold it when it is needed." If in doubt, give the medicine.

A Veterinarian's Lesson to her Children: "Do Not Ever Pet Wild Animals"

We had just finished an impromptu cook-out with some college friends on their way home from visiting family for Father's Day. The men had taken the troupe of seven kids on a short walk around the farmland. I was in the kitchen chatting with my friend and packing lunches for my kids' first day of summer "enrichment" school. It had been a noisy evening. Seven children under age eleven bickering, whining, laughing, crying, and showing off with the adults' voices escalating to converse over the top of them. Suddenly, in the farmyard, a new sound met our trained mother-ears: shrill screams of excited fear overridden by the two dads' scolding in an oddly harsh, desperate tone. 

A cute but unhealthy and abnormal acting raccoon kit

We rushed to the window, our hearts in our throats. The little girls ran up to us chirping, "A baby raccoon! A baby raccoon!" Puzzled about the drama unfolding outside, we joined the raccoon's entourage. Kids ran pell-mell around the driveway, shouting and pointing, daring each other to get close to the wild creature hiding among the rocks and weeds in front of the playhouse. As I listened and watched, it became clear that the youngest of my brood, my fearless three-year-old, had been reaching out to pet the baby raccoon prompting the fathers' commanding shouts earlier.

With the kids at a safe distance, I approached the baby raccoon and evaluated it from afar. As the kids chanted "it's so cute" in the background, I listed off my concerns. First, it was barely moving. Paralyzed with fear? Fear can make dogs, for example, appear to move in slow motion as if they are sleepy. But this raccoon barely seemed aware of our presence, as loud as we were. Next, its third eyelids (nictitating membranes) were elevated from the inside corners of both eyes, practically obscuring its eyeballs. Elevated third eyelids in my dog and cat patients frequently indicate serious illness and discomfort. Finally, we've never seen a raccoon in the farmyard or even evidence of one since we've inhabited the buildings here. A wild animal hanging out in a high activity area crawling with people and dogs--even an inexperienced youngster--is probably sick, possibly rabid.

It being mid-June, this raccoon kit should still be living with his mother and littermates. The juveniles do not become independent until the fall. Was this kit's mother one of the countless roadkill raccoon that populate Wisconsin highways? Did she die of distemper virus, a frequent cause of death in North American raccoon that can reach epidemic proportions wiping out large numbers of animals? Perhaps this kit is likewise affected and showing the neurological symptoms. Incidentally, the distemper virus that kills raccoon is the same distemper virus that all puppies and dogs should be vaccinated against. It is the same virus, it is just as lethal in dogs as in the raccoon, and as long as it exists in the raccoon population it remains a threat to our canines.

After observing the creature and debating our options (by the way, as cute as it is, the raccoon is not commonly accepted for wildlife rehabilitation for a variety of reasons), I decided humane euthanasia was the kindest ending for the kit and the safest for my human and canine family (and friends). 

Once the raccoon had been put out of its misery, we had a fervent and frank discussion with the staring children. My eldest two had heard this speech many times before, but I had unfortunately never gotten around to telling my preschooler. "Never, never, ever touch a wild animal. If it lets you get close enough to touch it it is probably very sick and might bite or scratch you. It might have a terrible disease called rabies that can kill you." Grave nods all around. How much of this do they even understand, I wonder. "But if you forget," I add gently, "If you someday forget and do touch a wild animal, it is very important that you tell a grown up right away." Even though I regret I failed to prepare my youngest child for this unusual scenario, after tonight I guarantee there are seven Wisconsin kids who won't easily forget the lesson learned first-hand.