Cat in Bed
If your pet were in pain, would you know? If you’re like most of my clients, you’d say, “Absolutely!” But studies show that pet owners — and even veterinarians — aren’t always good at detecting discomfort in dogs and cats. What’s more, my experience confirms it.

It’s true. Most of my clients seem to assume their pet’s outward calm (or, in some cases, their persistent exuberance) is a sure sign of painlessness. But we’ve learned this isn’t necessarily so.

Over the past couple of decades, veterinary medicine has made great strides in anesthesia and pain control. In large part, this has come about as the result of the recognition that those who can’t communicate with us and don’t necessarily behave as we do may still be feeling the very same pain we do under similar circumstances.

Learning From Human Medicine

The most notable example of this oh-so-obvious leap in our understanding of other creatures came, surprisingly, from lessons learned in human medicine. Turns out that as recently as the mid-’80s we used to assume that human infants didn’t feel pain the same way we do.

Indeed, it was only when studies demonstrated an increase in survival rates among infants who received anesthesia and pain control during and after surgery that we came to understand the egregious consequences of our misperception: Our babies were literally dying of pain.

Since then, pain-scoring systems have been devised, modified and continually refined to help us better identify not just pain in infants, but also in pets. We’re not so different after all. In this, in particular, it seems we’re quite alike.

What Gets Lost in Translation

But there’s still the philosophical question to grapple with: While pets can't verbalize when they're in pain, they have other ways of showing it. But can we, with our human limitations and biases, ever correctly interpret what we see?

It’s true that we veterinarians have a tough job of determining how best to assess a patient’s pain, even with our fancy-schmancy scoring systems adapted from human pediatrics. After all, so much of it is subjective.

What's more, all animals are given to hiding their pain and distress to some degree. This is an effective evolutionary adaptation designed to help them avoid predators when they’re sick or injured. Even our pets, divorced from their wild cousins though they’ve been, have never lost that natural skill, despite their many thousands of years of domestication.

That's why cats are notorious for cloaking their pain in a cloud of quiet determination. Dogs, too, may silently slink into their beds and appear to slumber peacefully.

Despite these common adaptive abilities, how an animal responds to pain can differ significantly between cats and dogs, different breeds, individual pets or even the circumstances. Most veterinarians have witnessed a dog with a pelvis shattered in half a dozen pieces get up and walk when the owner enters the room, despite X-rays that say he should be in too much pain to do so. And one look at a pet who’s running around just after having her uterus and ovaries scooped out should be enough to make you assume they can’t possibly feel pain the same way we do. Nonetheless, I’m here to tell you that regardless of how they may act, our pets do experience pain.

Their evolutionary advantage — combined with their desire to please their human family, their excitement in our immediate presence and their inability to communicate verbally — means our pets don’t display pain in ways we humans always recognize.

Watch for Obvious and Subtle Signs

As with any invisible issue, acceptance of the problem is the biggest hurdle. Already, veterinarians try to anticipate when a medical procedure may cause an animal pain and provide pre-emptive analgesia, so hopefully the pet doesn't experience pain in the first place.

But unless a veterinarian or a pet owner recognizes the signs of pain as such, nothing can be done about it. This is the conundrum we confront daily in our profession, one every owner needs to be made aware of. And since pets often hide these signs when in the proximity of the veterinary white coat, we depend on you to tell us when you suspect something's amiss, even when you're not quite sure what it is.

Never a day goes by that I don’t advise an owner to think hard on the slowness, hunched back, unwillingness to jump and decreased appetite of their pet. “It’s probably an indication of discomfort, perhaps even severe pain,” I tell them, trying to impress on them the importance of these symptoms. While the limp and the painful cry may be obvious, it's also important to watch for the more subtle signs: the loss of social interaction, the decrease (or increase) in grooming, the restless pacing, to name just a few. 

And yet a surprising percentage of my clients will argue their dissent — vehemently in many cases — even when the possibility of pain clearly exists and cannot be definitively ruled out. “I would know” is their final rejoinder.

Would you?

Perhaps they do. Perhaps you would. But it’s nonetheless possible that our human-centric brains can’t always grasp what our pets' animal bodies are telling us.

Pain is the one thing we all say we can’t abide in our pets. But it won’t go away just because we don’t see it or believe in it. It takes trust in medicine and an open mind to accept that they may feel what we feel — without all the wincing, complaining and whining that we humans tend to do.

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