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Dr. Wooten: Hi there, I’m Dr. Sarah Wooten. I am here with Dr. Robin Downing, and we are here to talk about pain in dogs. So why don’t you let our viewers know who you are and what’s your experience and education in this area?
Dr. Downing: Awesome. I’m Dr. Robin Downing. I have two veterinary practices. I have a primary care practice, in which I practice cradle to grave care and that’s the Windsor Veterinary Clinic. But I also have the Downing Center for Animal Pain Management. So I’m a veterinarian and a clinical bioethicist. As well, I’m a trained animal chiropractor. I practice medical acupuncture. I have two human pain management credentials, because pain management is such an important topic to me personally but also to me professionally as I work with my animal patients. And I’m a board certified specialist in the American College of Veterinary Sports Medicine Rehabilitation. Mostly what I do is I fix pain.
Dr. Wooten: Yeah. So she knows a lot, and she does a lot. Most importantly, she cares a lot about our little fur friends that live with us. So, Robin what I really want you to share with our viewers today is: What are some of the misconceptions surrounding pain in dogs?
Dr. Downing: So the most important misconception that I encounter when it comes to pain in dogs is the misconception that when an older dog slows down it’s just because they’re getting old. Old age is not a disease, and slowing down is actually a very important sign of pain, often the very first sign of pain and even more often a very subtle sign of pain. Which is why pet parents misinterpret slowing down and just think it’s a natural part of the aging process.
Dr. Wooten: If we’re thinking about trying to be more aware of how our dog friends are in pain sooner, what would be some of the signs that pet owners should be looking for?
Dr. Downing: Dogs in pain, things to think about: Difficulty getting up from a down position. Your dog used to meet you at the door when you came home from work, and now, well, she waits until you’re halfway across the living room, and then she might think about getting up. Dogs that used to get up on the furniture every day, and now you think, “Well, she’s not getting on the furniture anymore. No more dog hair.” That’s actually a very important sign of pain. A dog who used to sleep in the bed at night with you, and now he just doesn’t really want to jump up there. Dogs that used to love to go for a walk, used to walk three, four, five miles, and now you’re lucky if you get half a mile, so decreased stamina. Sometimes I’ll even have owners report to me that the dog used to have a really robust appetite, and now, you know, sometimes just a little bit off eating. Often these are dogs where the dishes are on the floor, and the dog is literally too painful to bend over all the way to the floor and eat, put stress on strain on the low back. They’d rather not eat than put themselves in pain. Those are all really very subtle things if you think about it. But when we add them all together, it paints a pretty important pain picture.
(Slowing down is a REAL problem. Here’s the bed specifically designed to keep dogs youthful for longer and bring older dogs back to their best)
Dr. Wooten: So when you do talk to your clients, and you notice maybe that a dog is in pain but the client’s not noticing it, how do you communicate that in a way that the pet parent can understand?
Dr. Downing: What a great question. When I’m speaking with a pet parent, particularly a dog parent, and I am going to assess for pain, which I do for every patient no matter how old or young they are, the very first thing I do is explain that I’m going to touch that dog in ways that are different from how the owner interacts with that dog at home. I’m going to touch very specific places and ask the question, Does it hurt when I touch you here? Before I actually lay my hands on the dog, I will actually show my client this is how much pressure I’m using when I do my palpation, because I don’t want them to misperceive that when I get a reaction from the dog that I’m somehow inducing that discomfort. So I will ask them if I can show them how much pressure I’m using on their forearm. Once I’ve done that, they visibly relax because they know I’m not going to torture their dog. But it alerts them that the pressure they just felt on their arm should be innocent or innocuous when I put that same pressure on their dog.
Dr. Downing: So when the dog cries out or tries to bite me or falls to the floor, their response is uniformly, “I had no idea.” Occasionally, their response is to burst into tears, because they had no idea and now they feel bad. I’m quick to reassure anyone who has a dog who is in pain, whom they did not realize was in pain, that you can’t know what you don’t know, and that I’m interacting with your dog in a way that’s quite different from how you interact with that same dog at home. But now we know something we didn’t know before, and we’re obligated to respond to that and to take care of it.
Dr. Wooten: That is so profound. I feel like I just learned something. If a pet parent is noticing some of the subtle signs that you mentioned earlier, what should they do?
Dr. Downing: The first thing that should happen is that you should make an appointment with your veterinarian and voice your concerns. The second part of that is if for some reason you happen to be seeing a veterinarian who’s not as enlightened about looking for and finding pain, identifying it, and then making a plan to manage it, please trust your intuition, because your intuition is best. You know your dog better than anyone else knows your dog. If your intuition is telling you that, my dog is slowing down and I have learned that this is not normal and so I want an answer, please trust that intuition.
Dr. Downing: Once that assessment is made, then and only then can we make a reasonable plan for how to do we manage that pain. It could be as simple as a nutritional supplement that acts in a way that helps to relieve pain and support the body’s immune system and to support the joints that are often painful when we have osteoarthritis. It could be far more complex than that. It may be that we need to actually use a specific nutritional profile that’s been proven in clinical studies to assist dogs who are painful from osteoarthritis in their joints. It may be complex enough that we need to use more than one medication. This is what we call multimodal pain management, where we actually approach the pain problem from several different perspectives. Finally, as someone who practices physical medicine, you may find that chiropractic acupuncture and physical therapy are all things that will help that dog regain, reestablish, its normal activity and to be restored to the kind of lifestyle it’s been used to for all of these years until now that they’re older and painful and they can’t do the things they’re used to doing.
Dr. Wooten: That’s so hopeful. That’s so encouraging. What are one or two of the most exciting advances in pain management for dogs in your world?
Dr. Downing: That’s a really challenging question because there have been so many things that have changed over the last even five or six years. First is this idea that we know we have to approach pain from more than one perspective. The other is that we have more and more tools available, so we have different medications, we have now nutritional supplements that have been actually proven in clinical studies to help dogs that have pain.
Dr. Downing: But we also have environmental adaptors for the house. So for instance, I mentioned earlier that some dogs who have back pain don’t eat very well, because it doesn’t feel so good to reach to the floor and get their food out of the dish. But we have raised feeders of every design you could possibly imagine that put the food and water dishes up around the height of the elbow. That really helps them not have back pain. We have mats that are easy to lay down and pick up to cover slippery floor surfaces to make sure that the dog has a good, solid surface to stand on without having to worry about putting wall to wall carpeting in your house.
Dr. Downing: We also now know that we can help them sleep better if we use an orthopedic bed. There are some just excellent, excellent orthopedic beds that have good, functional, closed cell foam. You know, we used to throw a blanket on the floor and call it good. That’s how my dogs slept when I was in my twenties. Not anymore. So to take the time to think through how can I help my dog sleep comfortably so that when they do get up, they’re not stiff and sore because they’ve been laying on the hard floor, and now it’s really a struggle for them to move.
Dr. Wooten: Thank you. Those are all amazing recommendations. So we know you’re an amazing animal doctor, right, but are you also a pet parent?
Dr. Downing: I am a pet parent. Actually, our population of pets is lower than it’s been in many years. We only have two dogs now, and we only have eight cats now. But my oldest cat is going to be 24 this year.
Dr. Wooten: Oh, my goodness.
Dr. Downing: My youngest cat is three, so quite an age span. We only have young dogs now. I have a five-year-old and a three-year-old. But my last big dog was a Great Dane who lived to be 12, which for a Great Dane is really, really ancient. She had pain issues. She had things that I had to take care of as a pet parent, not just as a veterinarian.
(This is the special bed that Dr. Downing is recommending to help dogs with hip dysplasia)
Dr. Wooten: So you have some experience with the Big Barker beds, right?
Dr. Downing: I do.
Dr. Wooten: What is your experience, and would you recommend them to any pet owners with dogs that are suffering with joint pain?
Dr. Downing: I can assure you that I already recommend Big Barker beds for my patients, my big patients in particular, but not just my big patients, any of the dog patients that I see who are dealing with pain issues. My own dogs have the privilege of sleeping on the Big Barker bed, and they are big dogs. They have a big enough Big Barker bed that they share it, and they love it. In fact, when I think about it, they actually sleep better than I do.
Dr. Wooten: Well, thank you so much, Robin, Dr. Downing. We really appreciate hearing from you. Hopefully, this has been helpful to our viewers. Thank you so much for watching.
Dr. Downing: Thank you very much, Dr. Wooten. I always appreciate the opportunity to speak with you.