Thursday, April 18, 2013

OUCH! That Hurts - Identifying Pain

By Amanda Brown, Certified Veterinary Technician
Sick puppy - OUCH!
A newly diagnosed illness can be very traumatic for both the family involved and the animal.  Pain management is key in the success of healing and well being for the ill or dying.  Often times we are not aware that our beloved pet is in any amount of pain until they begin exhibiting signs of abnormal behaviors or signs of discomfort.   Instinctively, animals will disguise pain to avoid becoming prey in the wild, so it is not until the pain has become so severe to the animal that we notice changes in their behavior. You, as the pet owner, are most equipped in determining whether noticeable routines and functioning of the animal are related to pain or social manners.

Pain triggers a series of physiological changes that increase stress.  These changes can affect all major body functions and may trigger abnormal body responses.  These modifications to normal body function can decrease the body’s immune system and its ability to work effectively.  For example, potential side effects of stress in animals include loss of appetite; increased heart rate; delayed wound healing; and/or a sudden onset of infection.

According to the AAHA Pain Management Guidelines for Dogs and Cats these are common signs of pain:
Loss of normal behavior
Decreased appetite, decreased activity, lethargic, decreased grooming (cats)
Expression of abnormal behaviors
Inappropriate elimination, vocalization, aggression, decreased interaction with other pets or family members, altered posture, restlessness, hiding (especially in cats)
Reaction to touch
Increased body tension or flinching, injured area and touch of regions may illicit reaction
Physiologic parameters
Elevations in heart rate, respiratory rate, body temperature, and blood pressure; pupil dilation
No animal should need to prove that they are in pain, which is why we as veterinary professionals have developed what we call a Multimodal approach to pain management. Multimodal Pain Management (MPM) is a tactic that takes advantage of the synergistic affects obtained by combining two or more classes of drugs to alter more than one phase of the pain pathway.

MPM is the best way to approach pain management, and provides comfort not only to the animal, but the pet owner as well.  Observation, touch, and knowledge of how pain can be displayed combined with how to defeat pain, will now make dealing with an otherwise disheartening situation easier.

The AAHA Pain Management Guidelines also note the following overlooked causes of pain:
Frequently overlooked causes of pain from AAHA
Learning to recognize pain in your pet is one of the most important things you can do for him or her. Pain indicates injury, illness, and decline. Picking up on it early can make a very big difference in your pet's comfort and prognosis.

If you think your pet may be in pain, talk to your vet about options for treating it.  Sometimes the only way we can determine if an animal is in pain is to treat for pain and see what happens. You may be surprised! Your couch potato may become more active, your grumpy old man may become more friendly, and that occasional hitch in her giddy-up may lessen or disappear.
WANT TO USE THIS ARTICLE IN YOUR EZINE OR WEB SITE? You can, as long as you include this complete blurb with it: “New England Pet Hospice & Home Care supports those caring for ill, elderly and special needs animals at home following the human hospice and palliative care models of interdisciplinary care. Learn more and get your FREE subscription to Wag & Purr: Your Guide to Comfort Care for Pets at"

Wednesday, April 3, 2013

Diagnosis Cancer: Now What?

By Michelle Spencer, Veterinary Technician

Cat researching optionsWelcome to our series on companion animal cancer. In this article, we address what normally happens after your pet has been diagnosed. In future articles, we will address the ins-and-outs of conventional treatments, alternative treatments and palliative care.

A diagnosis of cancer in your pet can be terrifying. But remember, you are not alone. Your veterinary team and New England Pet Hospice & Home Care are here to support you every step of the way.

Step One: Staging

Staging is the act of running a series of medical tests to obtain additional information.  Staging allows your veterinarian to see the extent of cancer spread throughout your pet’s body and to assess your pet’s ability to handle certain treatments.

 Three types of medical tests are typically run during the staging process:

Imaging: The mode of imaging chosen will depend upon the type and location of the cancer. It may include x-rays, an ultrasound, an MRI or a CT scan. Imaging  shows not only the Getting imagingspread of cancer, but also the integrity of internal organs. For instance, while an echocardiogram may not show spread of cancer to the heart, it may show an abnormality in the heart muscle, which may affect the your pet’s tolerance for treatment. In that case, special precautions may need to be taken or another treatment option chosen.

Blood Work/Urinalysis: Typically, a Complete Blood Count (“CBC”), Serum Chemistry and Urinalysis will be run. These tests are not used to diagnose cancer (except certain blood cancers) but provide information about the cancer’s behavior, any infection and how well your pet’s organs are functioning. For instance, while a pet’s liver may look healthy on an ultrasound, an abnormal blood test measuring liver function may reveal an issue.

Additional Cytology (cell investigation): Your veterinarian may need to look at additional cells under the microscope to get more information about your pet’s disease. This may involve a needle aspirate (a quick and simple procedure under local anesthesia), a biopsy or even surgery.

Step Two: Treatment Options

After gathering further information about your pet’s disease, your veterinarian will present you with treatment options.

Some cancers respond very well to conventional treatments, such as chemotherapy and/or radiation therapy, while others simply do not. Your veterinary medical oncologist and veterinary radiation oncologist are the best sources of information about treatment options, but always keep in mind:

1. The goal of cancer treatment in pets is to control or eradicate the cancer cells while preserving a good quality of life. Your veterinary oncologist relies on you to assess your pet’s daily quality of life at home and communicate that information often. Remember, quality of life is the driving force behind veterinary oncology, and you are your pet’s voice.
Getting treatment  
2. You and your pet are not trapped. Cancer treatment is fluid and there is room for assessment at each step in the road. If, for instance, you begin treatment and your pet experiences side effects, you, along with your veterinarian, may decide that you will no longer use that type of medicine or even that you no longer wish to proceed with that form of treatment. On the flip side, you may cautiously begin treatment and, after seeing a positive reaction, decide that it’s appropriate for your pet to continue or pursue more aggressive treatment.   Remember, you always have choices.

Making decisions about whether and what type of treatment to pursue can seem overwhelming.  In  the next issue of Wag & Purr, we will talk about how to make decisions in times of crisis and confusion that will feel right to you both in the moment and when you look back on them.

Michelle Spencer is a Veterinary Technician with New England Pet Hospice & Home Care.  Michelle has been a Veterinary Technician for 12 years, much of it devoted to the field of oncology, including more than five years at New England Veterinary Oncology Group as a Medical Oncology Technician, at Dana-Farber Cancer Institute as a Clinical Research Coordinator, and more than 5 years at Massachusetts Veterinary Referral Hospital as a Critical Care Technician. 

WANT TO USE THIS ARTICLE IN YOUR EZINE OR WEB SITE? You can, as long as you include this complete blurb with it: “New England Pet Hospice & Home Care supports those caring for ill, elderly and special needs animals at home following the human hospice and palliative care models of interdisciplinary care. Learn more and get your FREE subscription to Wag & Purr: Your Guide to Comfort Care for Pets at"