When a person is experiencing pain, he or she can run to the drug store to choose one of many options to help manage their pain, including both over-the-counter (OTC) and prescription medications. Further, many drugs and therapies are available to treat specific types of pain (e.g. tooth pain, sore muscles, headache, etc.). In dogs, treatment options for pain are not as accessible. This is because fewer options for pain exist in dogs, and most pain medications are potentially very dangerous when given incorrectly. This is especially true when pain medications used in people are given to dogs. People and dogs metabolize or process pain medications very differently. So giving ANY human drug to a dog carries a risk of causing very serious health issues, even death.
OTC Pain Medications for People Should Never Be Given to a Dog
Most OTC pain medications that are made for people, such as naproxen or ibuprofen, should never be given to dogs. Even at very small doses, they can cause life-threatening gastrointestinal (GI) ulcers, liver failure, and/or kidney failure. Lethal effects of these medications can occur very quickly, meaning that even with treatment, pets can die from eating only one dose. A few OTC pain medications are potentially safe in dogs, such as aspirin or acetaminophen. However, both have a very low margin of safety, meaning that they can be extremely unsafe even if used correctly. Further, they are only useful for pain in certain situations (e.g. arthritis or a joint injury not associated with bleeding/trauma) and can be harmful with other causes of pain (e.g. gastrointestinal/GI pain, pain from infection, intervertebral disc disease/herniated disc). Neither aspirin nor acetaminophen should ever be given to a dog without consulting a veterinarian first. To use these types of medications properly, a correct diagnosis for the cause of pain is needed. Plus, several canine-approved prescriptions are available that are safer and will work better, so it is rarely worth the high risks to use them.
Prescription Options for Pain in Dogs:
Nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAIDs are a type of pain medication that also decreases inflammation. They are cyclo-oxygenase or COX inhibitors, which are enzymes involved in pain and inflammation. Resolving inflammation can provide additional relief and quicker improvement from the issue causing the pain.
NSAID options that are approved for use in dogs include carprofen (e.g. Rimadyl), deracoxib (e.g. Deramaxx), etodolac (e.g. Etogesic), firocoxib (e.g. Previcox), meloxicam (e.g. Metacam), robenacoxib (e.g. Onsior), and mavacoxib (e.g. Trocoxil). Grapiprant (e.g. Galliprant) is not an NSAID in that it is not a COX inhibitor, but it works similarly to NSAIDs by decreasing pain and inflammation. Cost of such medications will depend on the size of the dog, generic vs. name brand, and which type is used. One week’s worth of pain control from an NSAID can range from $5-20 in a small dog using generic carprofen to $100-150 in a larger dog using a name brand therapy.
Opioids or opioid-like medications control pain but not inflammation. In many cases, they are used for very severe pain because they work on pain receptors. NSAIDs and opioids or opioid-like medications are sometimes used together to maximize control of both pain and inflammation. Examples of opioids include buprenorphine, codeine, butorphanol, and fentanyl. An example of an opioid-like medication is tramadol. Again, cost varies based on size of the pet and type used. Oral tramadol may range from $20-50, whereas a fentanyl pain patch may cost $50-100. Opioids are becoming more difficult to obtain for veterinarians because of their use as a recreational drug in people. This could mean the cost may increase as opioids becomes more difficult to dispense safely.
Gabapentin is a type of seizure medication that has proven useful for neuropathic pain in dogs. Neuropathic pain refers to pain associated with nerves, so its uses are limited compared to NSAIDs and opioids. Cost usually ranges from $20-40.
Steroids (also known as glucocorticoids; e.g. prednisone) are not used for pain, but they can be useful in situations where a lot of inflammation is present. One example of steroid use is spinal cord compression/slipped discs. Here steroids are used to decrease the inflammation-associated pressure the intervertebral disc is putting on the spinal cord. It is extremely important to be aware that NSAIDs and steroids cannot be given together, as serious GI effects, including ruptured gastric ulcers, can occur. This is especially important for owners that have attempted to help their dog’s pain by using medications they had at home, resulting in a potentially life-threatening situation without even realizing it. Never give medication without asking your veterinarian first. If you gave your pet something prior to his or her checkup, be sure to let the vet know exactly what it was and how much you gave.
Alternative Medications for Pain in Dogs
Joint supplements, such as those that contain glucosamine, chondroitin, and/or MSM, can be very helpful for controlling arthritic pain when used regularly. They don’t actually stop pain, but they work to keep the joint healthy. This helps to decrease pain over time by decreasing how much it worsens. Joint supplements are formulated as chews (e.g. Cosequin), capsules, liquids, and as injectable medications (e.g. Adequan). Oral medications range form $30-60 and injections, usually given once every 4 weeks, have a similar price per shot. Other supplements that may be effective for pain include St. John’s wort, turmeric, and cannabinoids (CBD). While some research indicates these therapies could help with pain, more research is needed to prove it and nail down safe and effective doses. The Food and Drug Administration doesn’t fully regulate how such supplements are made, so it is difficult to say how well a dog is metabolizing the drug involved and what else might have been formulated with it. Further, some supplements can be problematic when used with other treatments or with certain types of diseases. For example, St. John’s wort tends to interact with numerous other drugs, which may make the other medications the dog is taking less effective. CBD is becoming increasingly popular in pain therapy, but it isn’t yet clear how much is needed and how effective it is for each type of pain. Until more research is available, discuss any alternative medication options with your veterinarian before trying them on your dog.
Alternative Therapies for Pain in Dogs
Therapeutic laser is an alternative treatment for pain when medications are not helping or cannot be used. The laser used is falls within a type of laser classification that offers improvement in pain and healing speed. Acupuncture, ideally performed by a certified veterinary specialist, is another option that can be used when pain medications are not enough. Both laser therapy and acupuncture tend to be more useful in pets with chronic pain, but improvement can be seen with certain other types of pain as well. Laser and acupuncture pricing ranges quite a bit. Laser therapy sessions may be $50-150 a session, and acupuncture tends to cost $75-150 per session. In patients that have injuries associated with muscles, bones, or joints, physical therapy can be an option for helping improve pain. Again, a veterinary specialist is ideal for such cases, as poorly performed physical therapy can also make the problem worse. Physical therapy can be costly, ranging from $50-200 a session.
What You Can Do at Home for Your Dog’s Pain
If your pet is in pain, some things can be done at home to help with the pain while you are waiting to see the veterinarian:
Rest: Rest is key with any type of pain, especially pain from injuries. Don’t let your dog run around if he is hurt, even if he wants to. Rest speeds up healing time.
Ice: An ice pack wrapped in a towel is another way to help some injuries. Do not use an ice pack on open wounds or when the pain seems to be internal (e.g. belly pain). If your pet is too painful to allow you to use an ice pack, don’t force him as he may hurt you or hurt himself further. If he lets you, icing a wound can be done for 5-10 minutes, twice a day.
Heat: Heat therapy is another potentially helpful option, but not for recent injuries, wounds, or swollen/inflamed areas. As with an ice pack, wrap the heating element (e.g. warm, wet wash cloth in a plastic bag) in a towel so it isn’t too hot. Heating pads are usually too hot for a dog’s skin, even on the low setting. Heat is not always recommended because depending on the injury, it can make the pain worse, so ask your veterinarian first before using it.
Distraction: Distraction is another great way to help your painful pup. Pet him gently, offer him treats, and keep him comfortable. A favorite chew bone, squeaky toy, or a Kong stuffed with peanut butter can be a distraction from minor injuries and pain while waiting to see the vet.
The Bottom Line on Helping Your Dog Manage Pain
Treating your dog’s pain needs to be done under the care of a veterinarian. While the cost of veterinary care for causes of mild to moderate pain can be expensive ($150-500), the cost to care for a pet that was given a dangerous medication can be worse ($500-2,500), and your pet may not survive. Seeing the vet also ensures that the problem which caused the pain is accurately diagnosed and treated. Doing this potentially eliminates the source of your dog’s pain much faster than if you tried to care for him at home without figuring out the problem. So if you think your dog is in pain, call your vet to see what your options are. Never give medications or supplements without talking to the veterinarian first.