Clean Run - May 2014 - 28

Non-Drug Therapies for Pain
By Bonnie Wright, DVM, DACVAA, photos by iStock photography except where noted

Courtesy Bella's Pain relief

We will all experience pain to
some degree, and so will our dogs.
Active individuals know the difference between tolerable and intolerable pain, and how to balance
these with activities that bring joy
and physical fitness. In working
dogs, the balance between some
discomfort and the type of pain
that causes suffering is a challenging puzzle for handlers. Keeping working dogs in their activity is
important for their quality of life,
yet intervening in nonverbal animal pain is an ethical imperative.
To further complicate the issue,
physical activity is a double-edged
sword-more pain may be generated by subsequent injury, muscle
soreness, etc., but exercise has
also been shown to reduce pain
globally.1, 2, 3
Diagnosing pain, evaluating the
severity and reversibility of painful
conditions, and navigating the dilemmas around a dog continuing
to perform or retiring are beyond
the scope of this article. I would
like to say these resources are
available elsewhere, but the truth
is that each case must be evaluated individually. There are no rules
or protocols, only individual performance dogs and their human
advocates. It's worth searching
for a practitioner who makes decisions based on what their hands
find on gentle palpation, what
28

their eyes see in the dog's movement, and whose spirit recognizes
the complex pull between comfort
and life mission. Protocols really
don't have a place in this kind of
medicine, but some basic principles can provide a framework. One
is to combine drugs and non-drug
therapies in every case.

A Word About Pharmaceuticals,
Herbs, and Supplements
There are a number of pharmaceuticals for treating pain in dogs.
Some of these treat short-term
pain (such as tramadol) but can
become less effective over time.
Others treat long-duration pain
and help reduce the amplification
of pain in the nervous system (gabapentin, amantadine). While others reduce inflammation and may
help lessen accumulated damage over time (NSAIDs). All drugs
have side effects, some of which
are common and affect every dog
treated (usually in a dose-dependent manner), while others affect
only some dogs (but we can seldom predict which dogs will react).
Likewise, there are a number of
non-drug compounds for treating
dogs in pain, though these impact
the body in ways that are not as
well described or studied as pharmaceuticals. These include herbal
compounds, complex combina-

tions of herbal compounds, and
dietary supplements that may be
directed at reducing pain or inflammation. Some of the herbal
compounds have been better researched than others and there is
a level of comfort associated with
their use (such as omega-3 fatty
acids derived from fish, greenlipped mussels, avocado-soy unsaponifiables, glucosamine, and
chondroitin). Others have less evidence, but a long history of use
(bioflavanoids, ginger, curcumin,
boswellia serrate, devil's claw,
bromelain). Most herbals are considered relatively safe compared
to manufactured drugs, but this
is not always true. It is important
to verify the origin of the supplements (US made?) and purity.
Finally, a number of Chinese medicine herbal compounds are available. These depart even further
from the realm of evidence-based
medicine. Often there is no list of
ingredients available. This does
not necessarily mean they don't
work, but both the risks and benefits are unknown. Because there
are many treatment choices for
pain with much more supporting
evidence than these compounds,
taking chances with them is seldom necessary.
I am not addressing homeopathy
as a modality because it is too far
removed from measurable, eviClean Run | May 14

Clean Run - May 2014

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