Tag Archives: pain

Affection from a dog really is medicinal, according to a new study

Dogs may also be a doctor’s best friend.

For patients suffering from pain in the emergency room, just 10 minutes with a four-legged friend may help reduce pain, according to a study published Wednesday.

The results support what dog lovers everywhere have long suspected — canine affection cures all ills — as well as provides a bit of optimism for patients and health care providers frequently grappling with strapped hospital resources in the midst of the Covid-19 pandemic.

“There is research showing that pets are an important part of our health in different ways. They motivate us, they get us up, (give us) routines, the human-animal bond,” said lead study author Colleen Dell, the research chair in One Health and Wellness and professor at the University of Saskatchewan.

The study, published in the journal PLOS One, asked more than 200 patients in the emergency room to report their level of pain on a scale from 1 to 10 (with 10 as the highest level of pain). A control group had no intervention for their pain, while participants in the other group were given 10 minutes of time with a therapy dog, and patients rated their pain levels again, according to the study.

Those who got the visit from the dogs reported less pain.

The study has a strong methodology, said Jessica Chubak, senior investigator with the Kaiser Permanente Washington Health Research Institute. Chubak, who was not involved with the study, noted that there is still a lot to learn about therapy dogs.

“The results of the study are promising,” she said in an email. “Our current understanding of the effects of therapy dog visits in emergency department settings is fairly limited. So, it is particularly important to have more research in this area.”

Dell hopes that research like this study means we can stop asking if therapy dogs are helpful in a medical context and start asking how they help and how to integrate them better with health care teams.

In the hospital

The emergency room experience might actually contribute to patients’ pain.

The bright lights, long waits, anxiety and focus on immediate, acute conditions can make the feeling worse, said Erin Beckwell, a dog owner who has experienced chronic pain for much of her life.

“It’s not a place that you usually get escorted to a comfy room that’s quiet and gives us any sort of specific interventions,” she said. “It’s often suggestions of things you’ve already tried, and then they send you home after a long time of distressing and anxiety-provoking, pain-filled waiting.

You may not come out feeling like you were even really heard.”

Some people have a misperception that utilizing therapy dogs can transmit disease and risk hygiene in a hospital setting, but Dell said there are ways health care providers can utilize them in sanitary ways to make the whole system operate better.

Mike MacFadden, a nurse practitioner based in Canada, said he sees a lot of potential in incorporating therapy dogs as part of a holistic approach to pain treatment in the emergency room, and that it could help everyone involved.

“Emergency service teams can feel conflicted and experience moral distress resulting from their inability to meet their own expectations for optimal care. With people’s experience of pain being multifaceted, we know that a multifacetedapproach is most beneficial to meet the needs of patients,” McFadden said. “The presence of a therapy dog not only has the benefits of supporting the patient’s experience, but I think it also serves as a comfort to the care providers.”

Hunter, a therapy dog, and his handler, Amanda Woelk, sit with Tyler Regier, 2, and his mother, Tina Regier, both of Overland Park, Kan., on Oct. 2, 2015, at Children’s Mercy Hospital in Kansas City, Mo. (Allison Long/Kansas City Star/TNS)

In the home

Pain can be thought of as both a physical and social experience, said Michelle Gagnon, assistant professor of psychology and health studies at the University of Saskatchewan. Gagnon was not involved with the study.

Anxiety, depression, having support or being dismissed can all have an impact on how we experience pain, she said. It makes sense that spending time with a creature that brings you joy and doesn’t invalidate your feelings can help you feel better.

“The things that you can gain from pets and some of the positive emotions that could be elicited from having the pet around you I think could have an impact on the pain experience itself,” she said.

Beckwell said she has experienced it personally with her 10-year-old cocker spaniel, Reilly, as she has experienced arthritis and autoimmune disorders.

“I feel more in control of the situation and less panicked or anxious about the severity of my pain, the duration of my pain, those sorts of things when I have that unconditional support from my dog,” Beckwell said. “She will come in, and she has learned over the years when I’m in pain she can’t sit on my lap.

“I don’t need to tell her — she knows,” Beckwell said.

Source: CNN

Study Sets Baseline for Sleep Patterns in Healthy Adult Dogs

A new canine sleep study from North Carolina State University could serve as a baseline for research on chronic pain and cognitive dysfunction in dogs, potentially improving detection and treatment of these conditions.

“The study was necessary because research on dogs and sleep has outpaced our basic knowledge about what a ‘normal’ sleep/wake cycle looks like,” says Margaret Gruen, assistant professor of behavioral medicine at NC State and corresponding author of the work. “The studies currently available are over 20 years old, only followed small numbers of dogs or dogs that were not in a home environment, and didn’t really capture data that is relevant to how dogs live (and sleep) now. We designed the study to update these findings and fill the knowledge gap.

“And for me, someone interested in how dogs develop and age, it’s a critically missing gap: we talk about a symptom of age-related cognitive dysfunction in dogs as being a disruption in the sleep/wake cycle without really understanding where the baseline is.”

The study followed 42 healthy adult dogs – 21 male and 21 female – ranging in age from 2 to 8 years old. The dogs wore activity monitors on their collars for a two-week period, and their owners filled out a questionnaire on the dogs’ sleep patterns. Functional linear modeling of the activity data showed that most dogs have two activity peaks during the day: a shorter window from 8 a.m. to 10 a.m., followed by a midday lull and a longer active period from about 5 p.m. to 11 p.m. All dogs were more active during weekends than weekdays.

“Since most of the participants were pets of people who work outside the home, we saw that the dogs were most active when human interaction happens,” Gruen says. “There were the occasional outliers – we did capture some midday ‘zoomies’ – but the pattern held true on average across 14 days for each dog. These findings aren’t surprising – they line up with many of the assumptions we’ve been making, but now the data are characterized and documented.”

The research revealed that weight and sex had an effect on the active periods; lighter dogs tended to be more active in a short period just after midnight, while female dogs seemed to be more active during the evening peak than males. Even in these healthy adult dogs, age had an effect; older dogs were less active during the peak activity times.

“Our hope is that this will serve as a foundational study for future work on the relationship between pain, cognitive dysfunction and sleep disruption, and as a study that is relevant to the way dogs live now,” Gruen says. “By establishing norms, we can better identify abnormalities and intervene earlier in the process. We can also use this as a baseline to evaluate development of adult sleep patterns in puppies.”

The research appears in Scientific Reports. NC State graduate student Hope Woods is first author. Duncan Lascelles, professor of translational pain research and management at NC State, also contributed to the work. Evolutionary anthropologist David Samson and his team, from the University of Toronto, Canada, created the functional linear models.

Source: North Caroline State University


Researchers find CBD improves arthritis symptoms in dogs

A team led by researchers at Baylor College of Medicine in collaboration with Medterra CBD conducted the first scientific studies to assess the potential therapeutic effects of cannabidiol (CBD) for arthritic pain in dogs, and the results could lead the way to studying its effect in humans. Researchers focused first on these animals because their condition closely mimics the characteristics of human arthritis, the leading cause of pain and disability in the U.S. for which there is no effective treatment.

Cannibus study

Credit: CC0 Public Domain

Published in the journal Pain, the study first showed both in laboratory tests and mouse models that CBD, a non-addictive product derived from hemp (cannabis), can significantly reduce the production of inflammatory molecules and immune cells associated with arthritis. Subsequently, the study showed that in dogs diagnosed with the condition, CBD treatment significantly improved quality of life as documented by both owner and veterinarian assessments. This work supports future scientific evaluation of CBD for human arthritis.

“CBD is rapidly increasing in popularity due to its anecdotal health benefits for a variety of conditions, from reducing anxiety to helping with movement disorders,” said corresponding author Dr. Matthew Halpert, research faculty in the Department of Pathology and Immunology at Baylor. “In 2019, Medterra CBD approached Baylor to conduct independent scientific studies to determine the biological capabilities of several of its products.”

In the current study, Halpert and his colleagues first measured the effect of CBD on immune responses associated with arthritis, both in human and murine cells grown in the lab and in mouse models. Using Medterra tinctures, they found that CBD treatment resulted in reduced production of both inflammatory molecules and immune cells linked to arthritis.

The researchers also determined that the effect was quicker and more effective when CBD was delivered encapsulated in liposomes than when it was administered ‘naked.’ Liposomes are artificially formed tiny spherical sacs that are used to deliver drugs and other substances into tissues at higher rates of absorption.

Halpert and colleagues next assessed the effect of naked and liposome-encapsulated CBD on the quality of life of dogs diagnosed with arthritis.

“We studied dogs because experimental evidence shows that spontaneous models of arthritis, particularly in domesticated canine models, are more appropriate for assessing human arthritis pain treatments than other animal models. The biological characteristics of arthritis in dogs closely resemble those of the human condition,” Halpert said.

Arthritis is a common condition in dogs. According to the American Kennel Club, it affects one out of five dogs in the United States.

The 20 client-owned dogs enrolled in the study were seen at Sunset Animal Hospital in Houston. The dog owners were randomly provided with identical unidentified medication bottles that contained CBD, liposomal CBD, or a placebo. Neither the owners nor the veterinarian knew which treatment each dog received.

After four weeks of daily treatment, owners and veterinarians reported on the condition of the dogs, whether they observed changes in the animals’ level of pain, such as changes related to running or gait. The dogs’ cell blood count and blood indicators of liver and kidney function also were evaluated before and after the four weeks of treatment.

“We found encouraging results,” Halpert said. “Nine of the 10 dogs on CBD showed benefits, which remained for two weeks after the treatment stopped. We did not detect alterations in the blood markers we measured, suggesting that, under the conditions of our study, the treatment seems to be safe.”

Source:  Baylor College of Medicine via Phys.org

Beyond Izzy’s pram (managing dogs through to old age) Part 2

According to statistics, one in every five dogs is affected by arthritis, or more specifically osteoarthritis.  It’s a disease that is progressive and is associated with a number of factors which result in degeneration of the joints.

In my opinion, the stats are probably a lot higher.  More than one in five.  And that’s because too many dog parents see the symptoms of arthritis but classify it as ‘normal slowing down with age’ and they don’t seek professional help until much later – if at all.   Arthritis can develop in young dogs – I’ve seen it in dogs between the ages of 1 and 2 –  but the odds certainly increase with age.  If a dog reaches the age of 7, then they have a 65% chance of developing arthritis.

So in this post, I want to introduce you to the ladder concept for managing dogs with arthritis.  There are various rungs to the ladder and we’re going to cover each one.  Each rung is a step up in terms of effort (and potentially cost) and, just like in real life, you can go up and down the ladder based on circumstances which can include progression of the disease.

Ladder diagram

The first rung is about identifying pain and discomfort in your dog.   Many owners expect their dog to whimper or cry out as the primary indicator that they are uncomfortable.  But that just isn’t true.  By the time a dog vocalises, chances are they have been experiencing discomfort for some time and have become very painful.

There are degrees of difference between discomfort and pain

Discomfort is tolerable.  People describing discomfort use words like lingering, annoying, or aching.

Pain is much more than discomfort.  Pain is intense.  It changes the way you do things or enjoy your day.  When people describe pain they choose words like burning, sharp, or shooting.

Discomfort tells us something is wrong and often helps us manage before the situation becomes painful.

Our dogs are non-verbal communicators.  We have to become experts at their non-verbal communication by being keen observers.

In late 2017, for example, I noticed a behavioural change in Izzy.  Over the course of about 10 days, it seemed that almost every time I looked over at her, she was licking her left carpus (wrist).  And so I took her to the vet and asked for x-rays.  These confirmed ”very minor arthritic changes” – so minor that we agreed a regular rubdown with an animal liniment would likely be sufficient rather than requiring pain medication.  Izzy was experiencing discomfort and not pain.

Changes can be subtle.  My intake questionnaire for new clients is many pages long and I ask questions about mobility and behaviour as well as personally observing the dog’s gait.  A reluctance to get out of bed in the morning may not be a sign of laziness, for example.  It could be that the dog is stiff after resting all night.

Other signs can include:

  • difficulty getting comfortable in bed
  • withdrawal from normal activities
  • snapping when touched
  • pressure sores on the elbows or other joints
  • lameness or changes in gait
  • scuffing of toe nails
  • pacing

The list goes on…

When we see someone every day (and this includes our pets), we often don’t pick up on small changes.  This is a main reason why asking for a professional’s assessment is a good thing to do.  They come into your situation with a fresh set of eyes.

Got questions about this post?  Please feel free to post a message or contact me through my practice, The Balanced Dog.

Kathleen Crisley, Fear-Free certified professional and specialist in dog massage, rehabilitation and nutrition/food therapy, The Balanced Dog, Christchurch, New Zealand

Continuing education in pain management

In some professions (like mine) unless you choose to belong to a professional association that requires it, there is no requirement for continuing education (“CE”) or lifelong learning.

Long before I became Fear Free certified, I pledged that I would invest time and resources each year to additional study and I list everything I’ve done on my website to give my clients transparency and assurance.

This weekend has been a study weekend for me.  I’ve just finished a course in the Effects and Management of Chronic Pain in dogs and cats.  Chronic pain presents challenges for a number of reasons including:

  • recognition by the owner that their animal may be in pain
  • scoring of pain and tracking of improvements – a communication challenge across practitioners (owner, vet, massage/rehab therapist)
  • trigger points, myofascial pain syndrome, and compensation in movement which must be resolved to manage the pain (this is where my skills, in particular, are important)
  • setting realistic goals for the dog’s future activity

I was pleased to see the course endorse things I already do in my practice, such as having owners keep a journal of their dog’s movement and pain.

What I particularly liked is the description that arthritis is not an old dog’s disease – it’s a young dog’s disease because development of osteoarthritis is typically secondary to a conformational issue.   For those of you who wonder why I insist on gait analysis, this is why!

I cannot emphasise enough that we need to use our observational skills with our dogs because they are non-verbal communicators.  This video from Canine Arthritis Management ‘In Silence’ puts this important issue into perspective.

So in signing off, I use the words of basketball coach John Wooden, “It’s what you learn after you know it all that counts.”

Kathleen Crisley, Fear-Free certified professional and specialist in dog massage, rehabilitation and nutrition/food therapy, The Balanced Dog, Christchurch, New Zealand

Pain in dogs with noise sensitivity

Dogs which show fear or anxiety when faced with loud or sudden noises should be routinely assessed for pain by veterinarians, a new study has found.

Animal behavioural scientists from the UK and Brazil examined cases of dogs which had developed a sensitivity to either loudness, different pitches, or sudden noises, and found that those which also had associated musculoskeletal pain formed a greater sensitivity to noise.

The study suggested that that fear or anxiety about noise could be association between a fear of noises and underlying pain.

dogs and noise

Credit: CC0 Public Domain

The researchers believe that pain, which could be undiagnosed, could be exacerbated when a noise makes the dogs tense up or ‘start’, putting extra stress on muscles or joints which are already enflamed, causing further pain. That pain is then associated with a loud or startling noise, leading to a sensitivity to noise and avoidance of situations where they had previously had a bad experience—for example a local park, or a louder room in the house.

Researchers say that veterinarians should ensure that all dogs with behaviour problems associated with noise receive a thorough physical examination to see if pain could be a factor in their fear or anxiety, so that undiagnosed pain could be treated, and the behavioural issue tackled. All the dogs that had pain which were treated showed an improvement of their behaviour. This is the first study to explore this phenomenon.

Professor Daniel Mills from the University of Lincoln’s School of Life Sciences, said: “Although the average ages of the dogs were similar, the average age of onset of the problem was nearly four years later in the ‘clinical cases’. This strong theme of an older age of onset suggests that the pain may develop later in life and that owners seek treatment more readily, perhaps because the appearance of the problem is out of character in the subject.

“These results are consistent with the suggestion that whenever there is a late age onset to a behaviour problem, medical issues including those related to pain, should be carefully evaluated. It is worth owners being aware that once pain is successfully managed, the previously learned associations with noise may persist and require their own targeted behaviour modification programme.”

Researchers assessed two groups of dogs which presented with noise sensitivity: those which had already been diagnosed with underlying musculoskeletal pain and those which hadn’t.

In both cases, the presenting signs of the dogs’ behavioural issue included shaking, trembling and hiding, but those with a diagnosed pain issue also showed a higher level of avoidance when it came to places they had a bad experience with noise – for example attempting to avoid a certain area at a park altogether compared with those without pain.

The dogs with the musculoskeletal pain also started to show signs of fear of noises much later in life than the control cases, and were on average four years older than their pain-free counterparts. Noise triggers ranged from fireworks, thunderstorms and aeroplanes, to gunshots, cars and motorbikes.

Veterinary Medicine student Ana Luisa Lopes Fagundes, from Centro Universitário de Belo Horizonte in Brazil, led the research at Lincoln as part of Brazil’s Science without Borders scheme.

She said: “The aim of the study was to explore the presenting signs of dogs with generalised noise sensitivity with and without pain in their muscles or joints. We think that dogs with this sort of chronic pain may experience the noise quite differently, because if the noise makes them startle it may cause them to tense their muscles and as consequence they feel pain associated with the noise.

“We found that these dogs which had pain do indeed show different signs, in particular they seem to form much wider associations with the noise, for example they would often tend to avoid not just the place where they had the bad experience but much larger areas too. These dogs also tended to avoid other dogs as well. The findings of this study are really important because they contribute to the dog’s welfare and improved behaviour as pain could be identified and subsequently treated.”

Common signs of pain in dogs

How do I know my dog is in pain?

(It’s a question I get fairly frequently)….

Here’s a list of things to look out for:

  • Decreased social interaction
  • Anxious expression
  • Submissive behavior
  • Refusal to move
  • Whimpering
  • Howling
  • Growling
  • Guarding behavior
  • Aggression, biting
  • Decreased appetite
  • Self-mutilation
  • Changes in posture

If you think your dog is in pain, then a visit to your vet is the first priority.  Once we have a working diagnosis, then consider what complementary therapies can do to manage your dog’s quality of life – often with reduced or no drugs.

Kathleen Crisley, specialist in dog massage, rehabilitation and nutrition/food therapy, The Balanced Dog, Christchurch, New Zealand

Is my dog in pain?

One of the questions I get asked fairly often by clients is ‘how do I know if my dog is in pain?’

The month of September is Animal Pain Awareness Month.  The International Veterinary Academy of Pain Management has created this one-page poster to help pet owners.

The only thing I would add is that once you have a veterinary diagnosis of your pet’s condition, then it is useful to seek out complementary therapies like massage and laser that can help with pain management.

Kathleen Crisley, specialist in dog massage, rehabilitation and nutrition/food therapy, The Balanced Dog, Christchurch, New Zealand

IVAPM-Pet-Pain-Awareness-Month-Poster-2016

Source:  International Veterinary Academy of Pain Management

Teddy’s journey: pain and anxiety come to the fore

The past week has been a tough one for Teddy and for Jill.

When Teddy first came home from the hospital, he seemed to be adjusting quickly.  He’s always been an independent boy and so he has rejected any support such as a strap or harness when taken out for toileting.

However, this week, Teddy became noticeably withdrawn.  For much of the time, he was restless and would whimper frequently.  We were sure he was in pain.  Because he was so out of sorts, we also felt that he was suffering from anxiety.

When I saw Teddy on Monday, Jill was stressed and Teddy was clearly not himself.  We introduced a hot water bottle (or ‘hottie’ as they are known here) on his back which seemed to provide relief and comfort.  I also gave Jill a CD from the Through a Dog’s Ear range.  This music is designed specifically for dogs to help calm and treat anxiety.  These seemed to assist Teddy in the short term to relax and rest.

But Teddy needed better pain management…

Teddy and his 'hottie'

Teddy and his ‘hottie’

Jill took Teddy back to his vet several times this week to discuss pain relief.  She freely admits, “I didn’t feel that I was being listened to as the owner.  I knew Teddy better than anyone.  Persistence, in my case, finally paid off.”

We seemed to agree on Monday that he was taken off his pain medication too quickly – he was taking only Previcox at the time –  and his body had been left vulnerable.  A Fentanyl patch was re-introduced on Monday and replaced again on Thursday.  Jill also started Teddy on Tramadol on Thursday and Teddy received a ketamine injection, too.

Meanwhile, I could tell that Teddy’s back muscles were stiff; his top line did not seem normal, and he was clearly distressed at being handled along the withers and the back.  Thankfully, since Teddy was too uncomfortable for deep massage, I was able to use the low level laser along his spine and muscles to help with blood flow and pain relief.  I know I want to passively stretch Teddy’s spine but we agreed to wait until Teddy was more comfortable before attempting this.  I was able to do passive range of motion stretching on Teddy’s legs.

Armed with this information Jill took Teddy for acupuncture on Tuesday and an osteopathic adjustment on Friday.  Both his acupuncture vet and his osteopath agreed that Teddy was in pain and that support with traditional veterinary medicines were needed.  The osteopath used gentle traction on Teddy’s back since she found his spine has become compressed.

With his pain properly managed, we can do more to help Teddy’s muscles, tendons and ligaments to adjust to his new gait.  And then true rehabilitation and exercise can begin including a greater focus on core muscle strength.

During this stressful week, Jill took to the Internet for help with Teddy’s condition.  She found a wonderful site – Tripawds Blogs – for owners of amputee dogs.  Owners soon responded with news that helped to assure Jill she had made the right decision for Teddy and gave her information to help her discuss pain management with her vet.

Owners who have been through similar adjustments with their dogs said:

  • Amputees go through an initial ‘good’ period after coming home, only to suffer because they do too much, too soon
  • The muscles of the body are under incredible strain because the body’s mechanics have changed rapidly
  • In Teddy’s case, his amputation was not preceded by a period of pain or dysfunction in the front leg – so his body had no time to adjust (such as would be the case for an osteosarcoma patient, for example)
  • Pain management medication is critical; the switch from Fentanyl to Tramadol was recommended
  • Teddy’s size is a big advantage – he’s a lot smaller than, say, a Labrador with the same conditions
  • Every dog is different and it takes a little time to find the right balance of therapies

Jill says, “In hindsight, we really took things too quickly and allowed Teddy to move around the garden area with enthusiasm.  I wish I had thought of this sooner and we may have avoided him seizing up so badly.  The Tripawds site has been a fabulous resource for me  knowing that there are others who have been through this before us.

I do feel that vets should listen to owners when it comes to understanding their animal.  And if you are not happy with your vet, you need to find someone who you are more comfortable with.  The vet can’t have all the answers when they are not with the dog as often as the owner is.  This proves that vets are not the final word in recovery – and I’m grateful that complementary practitioners are part of Teddy’s healthcare team”

It’s a new week – and we are all hopeful that Teddy is back on track to recovery.  He’s booked for massage and acupuncture this week.

Kathleen Crisley, specialist in dog massage, rehabilitation and nutrition/food therapy, Canine Catering Ltd, Christchurch, New Zealand

The importance of pain management

Whenever I take on a new client, I use a health questionnaire that covers current conditions as well as the dog’s health history.  One of the issues I address is any recent changes to the dog’s behaviour or living conditions.

What I am trying to ascertain is if a dog is in pain or having adjustment difficulties. There is a clear link between pain and aggression and this has been supported in a recent study by researchers at the Autonomous University of Barcelona in Spain.

In the Spanish study, which has been published in the Journal of Veterinary Behavior, 12 dogs that were brought in by their owners for ‘aggression problems’ were studied.  All were found to have pain-induced aggression with eight diagnosed as having hip dysplasia.

The breeds in the study were:  a Giant Schnauzer, Irish Setter, Pit Bull, Dalmatian, two German shepherds, Neapolitan Mastiff, Shih-tzu, Bobtail, Catalan Sheepdog, Chow Chow and Doberman.

The researchers concluded “if the pet is handled when in pain, it will quickly act aggressively to avoid more discomfort without the owner being able to prevent it.”

So, when a dog is behaving differently or is “out-of-sorts”, a visit to the vet is recommended.  Behaviour changes can be the first indicator that something is wrong and your vet can help to run appropriate tests to see if there is an underlying health problem.

Dogs have a way of not telling us they are in pain until a problem is more pronounced because their natural instinct is to protect themselves by not exhibiting any noticeable vulnerabilities.  Therapies such as massage and low level laser (which I employ in my canine rehabilitation practice) are useful in helping to manage pain through appropriate stimulation of acupressure points and managing muscle, tendon and ligament condition.  I’m also a strong supporter of acupuncture and refer clients to a local vet who is trained in veterinary acupuncture.

These complementary therapies can be employed alongside traditional pain medications such as NSAIDs to support your dog’s quality of life.  When pain is managed, quality of life improves for everyone in the household.

Source:  Plataforma SINC. “If your dog is aggressive, maybe it is in pain.” ScienceDaily, 13 Jun. 2012. Web. 15 Jun. 2012.