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Pain is often a clinical sign of many illnesses and injuries, but what exactly does it mean? To put it in basic terms, pain is an unpleasant, sensory experience representing an animal's awareness of damage--or threat of damage--to its tissues.

Like people, there are many painful conditions pets can experience. However, they can't tell us where it hurts or how they feel. Fortunately, over the past 20 years, there has been a greater awareness of the impact pain has on healing and the quality of life in our companion animals.

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Pain is classified in two categories: acute and chronic pain. Acute pain has a biological purpose and may resolve on its own. Pain from an injury is an example of acute pain and can be described in terms of severity. On the other hand, chronic pain is pain that has persisted beyond normal tissue healing time, does not have a clear end point, and/or is caused by conditions that have not healed. Chronic pain can result from conditions like osteoarthritis (OA), periodontal (gum) disease, cancer or tumors, and diseases that cause chronic inflammation.

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While younger pets are not immune from conditions associated with chronic pain, older pets (senior 6.1-9.7 years and geriatric 8.8-12.8 years) are more prone to developing a chronic illness and exhibiting chronic pain. Annual wellness exams are a vital part of maintaining your pet's health at any age and can help recognize certain conditions in the early stages. Reach out to our clinic at [INSERT CLINIC PHONE NUMBER] to schedule your pet's routine check or if you have any concerns about their health.

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Osteoarthritis (OA) is one of the most common causes of chronic pain in older pets. It is estimated that 20% of adult dogs suffer from OA pain, with that number jumping to 75% in medium and large sized dogs. Signs of OA can include difficulty getting up and down, difficulty with stairs, and tiring more quickly during walks. If you've noticed any of these signs in your pet, give our clinic a call at [INSERT CLINIC PHONE NUMBER] to schedule an exam to help diagnose the issue and come up with the best treatment plan.

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While there is no cure for osteoarthritis (OA), the earlier your dog's osteoarthritis (OA) is diagnosed, the easier it will be to keep your dog comfortable and active.

If you've noticed any of the following signs in your dog, give our clinic a call at [INSERT CLINIC PHONE NUMBER] to schedule an exam.

• Difficulty going up or down stairs
• Difficulty getting up or moving around after sleeping or resting
• Difficulty moving around after major activity
• Shifting weight from one limb to another while standing
• Getting tired more quickly during walks

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There are many conditions that can cause pain in our pets, and one of the most common is periodontal (gum) disease. This condition can be diagnosed at any age and involves inflammation of the tissues surrounding the teeth which results in progressive and painful loss of the supportive structures. Other conditions that commonly involve pain include cancer, inflammatory bowel disease, ear infections, and pancreatitis.

Behavior is the key factor in recognizing pain in these situations.

Some behaviors to take note of include:

• New behaviors (aggression, avoidance, vocalization)
• Changes in food intake or appetite
• Altered sleep patterns
• Changes in interactions with family and other pets in the household

If you've noticed any of these changes in your dog's behavior, give our clinic a call at [INSERT CLINIC PHONE NUMBER] to schedule an exam.

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If you suspect your dog is in pain, do not administer over-the-counter (OTC) pain medications. Many can be toxic to dogs. Your veterinarian is your best source of information and will perform a thorough physical exam along with the appropriate diagnostic tests to pinpoint the cause of your dog's pain. From there, they can create a treatment plan specific to your dog's needs. A multi-modal approach is usually recommended and may include a combination of weight control, medication, joint supplements, and/or physical therapy. As a pet parent, you play a vital role on your dog's healthcare team to find a treatment plan that will best suit your dog's lifestyle and tolerance of treatment.

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In recent years, additional treatment options, like regenerative therapies, have emerged to help combat canine osteoarthritis (OA). Regenerative therapies promote the body's self-healing of tissues through internal or external delivery of beneficial cells, cellular molecules, and support structures. In veterinary medicine, these therapies can help ease painful conditions like OA, improve function, and potentially slow down the progression of degenerative conditions.¹

There are several types of veterinary regenerative therapies that include serum-based and plasma-based treatments. Serum-based therapies use fluid that remains after blood has clotted and processed in a centrifuge. On the other hand, plasma-based therapies consist of fluid that remains when clotting is prevented by an anticoagulant and processed in a centrifuge. The veterinarian can recommend a specific treatment based on the dog's needs.

¹ Alves, J.C., Santos, A. & Jorge, P. BMC Vet Res 17, 207 (2021).

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While canine pain is typically easier to notice and has been studied for a while, pain in cats has been historically underrecognized since they are masters at hiding illness. As solitary predators, a cat's natural instinct is to hide pain and illness as a way to protect themselves from other predators. However, just because you may not notice visible signs, it doesn't mean they aren't experiencing pain.

Some subtle signs of pain you might notice in your cat can include:

• Decreased appetite
• Changes in food intake (e.g. dropping kibble, pawing at mouth, head shaking)
• Decreased play
• Changes in normal routines
• Altered petting preferences
• Changes in grooming habits
• Changes in interactions with the family or other pets in the household

If you've noticed any of these signs in your cat, give our clinic a call at [INSERT CLINIC PHONE NUMBER] to schedule an exam.

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Have you noticed your cat doesn't jump up on furniture as much as she used to? Has she started avoiding upstairs rooms in favor of the lower floor? These could be signs of osteoarthritis (OA) and can be more common in cats than many pet parents realize. In fact, approximately 90% of cats have radiographic (x-ray) evidence of OA but only 40%^1,2 of cats with OA actually show noticeable signs of pain. While one of the most recognizable signs of OA is limping, that sign isn't always noticeable in our feline friends.

Less obvious signs of OA in cats include:

• Subtle changes in jumping behavior (decreased jumping, hesitation before jumping up on a surface, using intermediate surfaces to get to higher surfaces, or not jumping to higher surfaces at all)
• Change in normal resting places (e.g. avoiding an upstairs sunny spot or cat tree)
• Housesoiling may occur if pain is associated with posturing or difficulty accessing the litterbox

If you've noticed changes in your cat's behavior, or are concerned your cat may be experiencing pain, the best course of action is to contact your veterinarian who can conduct a thorough examination to determine the underlying cause and recommend a treatment plan. You can schedule an exam by giving our clinic a call at [INSERT CLINIC PHONE NUMBER].

¹ Slingerland LI, Hazewinkel HA, Meij BP, Picavet P, Voorhout G. Cross-sectional study of the prevalence and clinical features of osteoarthritis in 100 cats. Vet J. 2011 Mar;187(3):304-9.

² Lascelles BD, Henry JB 3rd, Brown J, Robertson I, Sumrell AT, Simpson W, Wheeler S, Hansen BD, Zamprogno H, Freire M, Pease A. Cross-sectional study of the prevalence of radiographic degenerative joint disease in domesticated cats. Vet Surg. 2010 Jul;39(5):535-44.

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True or False? If my cat isn't limping, he can't have osteoarthritis (OA).

False. While 90% of cats may show evidence of OA on x-rays, only about 40% of cats with OA will show clinical signs.^1,2 However, you may notice subtle changes in your cat's behavior like decreased jumping, hesitation before jumping, using an intermediate surface to get to higher surfaces, or simply not jumping on higher surfaces at all. Housesoiling may also be a sign if there is pain associated with posturing or difficulty accessing the litterbox. Though these signs may be subtle, your veterinarian can determine if there is an underlying cause and work with you to determine the best treatment plan for your cat.

¹ Slingerland LI, Hazewinkel HA, Meij BP, Picavet P, Voorhout G. Cross-sectional study of the prevalence and clinical features of osteoarthritis in 100 cats. Vet J. 2011 Mar;187(3):304-9.

² Lascelles BD, Henry JB 3rd, Brown J, Robertson I, Sumrell AT, Simpson W, Wheeler S, Hansen BD, Zamprogno H, Freire M, Pease A. Cross-sectional study of the prevalence of radiographic degenerative joint disease in domesticated cats. Vet Surg. 2010 Jul;39(5):535-44.

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Another common cause of pain in cats of all ages is periodontal (gum) disease. This causes inflammation of the tissues that surround and support the teeth and can result in progressive and painful loss of these supporting structures. Over 40% of feline patients in private veterinary practices were found to have tartar, gingivitis, or periodontitis.¹ Some behavioral changes that may indicate periodontal disease include decreased appetite, as well as changes in eating and food intake like dropping kibble, pawing at the mouth, and head shaking.

¹ Lund EM, Armstrong PJ, Kirk CA, Kolar LM, Klausner JS. Health status and population characteristics of dogs and cats examined at private veterinary practices in the United States. J Am Vet Med Assoc. 1999 May 1;214(9):1336-41.

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In addition to osteoarthritis (OA) and periodontal (gum) disease, there are other common conditions that can cause pain-especially in older cats- including back or neck pain, dermatitis, inflammatory bowel disease, pancreatitis, constipation, and cancer pain. Behavioral changes-like lack of appetite, changes in normal routines, altered grooming habits, and changes in the interaction with other members of the household-are a signal to contact your veterinarian. With a thorough examination of your cat, they can determine the underlying cause and recommend an appropriate treatment plan.

Pain Scales Context

For the best experience with our pain scales, please download this toolkit on your computer. To download the Pain Scales on your mobile device, please tap the images above. The Acute Pain Scales are intended for on-hand use in your clinic. They are not intended for use in social media, however, you are welcome to use them in social posts if you see fit.