So, off the back of the last post – let’s say that you’ve now got that little niggling thought in your head: “Maybe my dog IS in pain…?”
So what do you do now?
The first step
Your first port of call is probably going to be a visit to the vets for a full vet check, but let’s hold fire for one second.
The vets can be a stressful place for a lot of dogs, and if that’s the case for your dog – as I mentioned last time – adrenaline and cortisol will be coursing through their bloodstream, overriding any sensation of pain. So the underlying cause of pain will still be there, but in that setting they won’t be feeling as much, or even any pain.
And so they’re unlikely to show many physical signs of pain, even if thoroughly assessed. Which means it can be really difficult for your vet to be able to see that anything is wrong, much less be able to diagnose the root cause of chronic pain in a 10 or 15 minute check up.
[Now you might be thinking… well what’s the point of going then? 🤔 But the next step to identifying what’s going for your dog is probably going to be one of three things: a pain trial, a referral to a veterinary physiotherapist, or some sort of imaging scan ie x-rays, CT etc. And none of those are going to happen without an initial vet visit.]
So, help your vets out… the more prepared you are for your appointment, and the more specific you can be about your concerns, the more they can help you.
Top tips #1
✅️ Take videos or photos of your dog, to capture anything you’ve spotted in terms of how they walk, how they hold themselves etc. You can show these to your vet to illustrate how your dog moves naturally when they’re not in a stressful environment. (And before you ask, yes, I have taken a video of Alice pooing before now. And no, the neighbours didn’t ask what I was doing. They know me as the crazy dog lady already 🤣)
✅️ Keep a diary to track symptoms, be that behaviour or physical changes. This can help your vet to get a wider view of what’s going on for your dog.
✅️ Make a list before you go of all the things you want to cover. I know from personal experience that it’s very easy to know exactly what you want to say in an appointment, and then for your mind to go completely blank when you get in there 🙈 So write down all the little quirks that are creating your suspicions about pain, all the questions you want to ask, and what you want to get out of the appointment ie your next step.
✅️ You can even email some or all of the above to your vets ahead of your appointment, so you can make the most of your time with them.
But my dog hates the vets
Now I said your first port of call is “probably” going to be a visit to the vets, rather than “definitely” going to be a visit to the vets.
Because it might be that you can’t even contemplate taking your dog to the vets 🫣 They’re too scared or stressed. Maybe the last time you braved it, it was a complete car crash, and you really don’t want to put your dog and yourself through that again.
If this is the case, speak to your vets and see how they can support you.
Top tips #2
▶️ Can the vet see your dog in the car park?
▶️ Can they make adjustments so that you can get into the building: Can you come in via the back door so you avoid the waiting room? Can you have an appointment at the quietest time of day? Can you wait in the car park until the vet is ready and you can go straight into the consulting room?
▶️ Can you build up to an appointment gradually? By first getting your dog used to the car park, then entering the reception area, just hanging around eating treats, and gradually work your way up to an actual appointment?
Even if it’s still a no go with all of the above, don’t worry – you still have options!
▶️ You can have a phone call appointment. Or you could attend an appointment without your dog. Either way, you can share videos and photos of your dog, and discuss your concerns with the vet. Your vet will probably still need to see your dog afterwards, but either of these mean that you can have a good discussion and get all your points across, without also having to worry about how your dog is coping.
▶️ Or something else to consider is a Dynamic Dog Assessment. This is completed entirely hands off, and so can be done virtually. It’s a thorough analysis of gait and posture, with consideration of behaviour and daily activities of your dog. Your Dynamic Dog Practitioner will provide you with a detailed report that you can share with your vet, and they can then support you through appointments and help you advocate for your dog. You can find out more information about Dynamic Dog assessments and practitioners here:
https://www.dynamicdog.co.uk/dynamic-dog-assessment
https://www.dynamicdog.co.uk/find-a-practitioner
Next steps
Hopefully, based on all your input, your vet is going to take your concerns seriously and recommend one or more of the following three options:
⭐️ Further investigation via x-rays, CT scan etc, depending on the suspected condition
⭐️ Referral to a veterinary physiotherapist: a physio assessment is far longer than a vet appointment and therefore they can explore and investigate more thoroughly than is possible in a vet check. A physio will check joint motion, gait and posture analysis, muscle mass, and much more besides.
⭐️ A pain trial: This is where your vet prescribes pain medication for a period of time, so you can monitor whether there is any change to your dog’s symptoms/signs once they’re on pain relief.
This needs to be longer than a week or so, usually four to six weeks as a minimum. Sometimes painkillers can take time to build up in the dog’s system and to take effect. Also, if a dog has been in pain for a considerable amount of time, they may continue to hold themselves or move themselves in compensating ways even after the pain has gone away, because that’s what they’ve become accustomed to doing, to minimise the pain.
Keeping a diary during the pain trial can be really useful, as it means that you can be more objective about whether the meds are making any difference or not, especially when the symptoms were subtle to begin with.
Also, it’s important to note that just like in humans, different medications target different types of pain. Typically anti-inflammatory meds would initially be prescribed for a pain trial, but just because your dog doesn’t respond to the first meds you try, that doesn’t mean they’re not in pain. Perserving with further trials with different types of pain relief might be what’s needed to find out what’s actually going on.
That didn’t go so well…
So what do you do if you don’t get a satisfactory response from your vets?
❌️ what if your vet says it’s a training or behavioural issue, not a medical one?
❌️ what if your vet prescribes behaviour medication, not pain medication?
❌️ what if your vet says the things you’ve noticed are normal for your dog, or their breed?
❌️ what if your vet won’t try a pain trial, won’t give you a referral to a physiotherapist, or won’t consider further investigations?
❌️ ultimately, what if your vet says your dog isn’t in pain?
If you’re not happy with the response from your vet, you are absolutely entitled to seek a second opinion. You could ask to see a different vet at the same practice, or you could see a vet at another practice. If you are working with a trainer or behaviourist, they may be more than happy to accompany you on a vet visit to help you advocate for your dog.
Legally, only a vet can diagnose a medical condition and prescribe treatment for a dog (or any other animal). But a vet cannot diagnose that a dog ISN’T in pain.
Only the dog knows whether they’re in pain or not. And unfortunately they can’t tell us in words. But if they’re telling us in other ways, it’s essential that we listen to them ❤️