Vet Blog
05/14/09
 Acupuncture has been used in humans for at least 1000 years. It now is widely used in animals as well.
Some of my acquaintances from veterinary school perform acupuncture on animals. They are convinced it is effective. They also make a tidy profit from performing the procedure.
To this day, nobody can prove, nor disprove, that acupuncture truly works. Some studies have shown significant effects when acupuncture is used in specific circumstances. Others have shown no effect whatsoever. Many studies have been equivocal: they provide some evidence that acupuncture might be effective, but they don’t prove it conclusively.
Acupuncture therefore is perennially controversial.
The theory behind the traditional practice of acupuncture involves the flow of energy through the body. Our current understanding of anatomy and physiology does not back that theory up. Other theories of acupuncture state that the procedure leads to the release of endorphins (morphine-like chemicals that occur naturally in the body).
Plenty of people are willing to offer testimonials in favor of the effects of acupuncture in humans and animals. Many such people may comment on this post. But, as any student of science or medicine knows, personal testimonials are notoriously unreliable sources of information. They are highly subject to bias and confounding factors. Honest-to-goodness scientific studies are needed to verify clinical claims. When it comes to acupuncture, such studies generally have yielded conflicting results.
Some experts believe that acupuncture works mainly through the placebo effect. Acupuncture is not alone in this regard: some recent studies have suggested that Prozac’s effect in many people may be spurious.
Other experts point to some well run clinical studies that show significant effects from acupuncture when it is used to treat specific syndromes. In all, neither side can prove conclusively that it is right.
I personally don’t care why or how a treatment such as acupuncture may work. I care only whether it works. The information I have seen to date is equivocal.
I was therefore excited by a grippingly titled article in the May 1, 2009 Journal of the American Veterinary Medical Association (JAVMA): “Effects of adjunct electroacupuncture on severity of postoperative pain in dogs undergoing hemilaminectomy because of acute thoracolumbar intervertebral disc disease.”
The paper discusses the study of a special form of acupuncture used to treat pain in dogs recovering from back surgery. From the article:
Conclusions and Clinical Relevance–Results provided equivocal evidence that [acupuncture] might provide some mild benefit in severity of postoperative pain in dogs undergoing [back surgery] because of [slipped discs]. (J Am Vet Med Assoc 2009;234:1141-1146)
In other words, the study determined that acupuncture might have sort of worked to reduce pain after back surgery. But the study authors weren’t sure.
Suffice it to say that I was disappointed by the results of the study. I have been waiting my entire career for some hard science to back up or refute the practice of acupuncture. This study, like so many before it, did neither.
At this point, the only answer I can give to the question posed in this post’s title is I don’t know.
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05/05/09
 The other night I worked on a sad case. A wonderfully sweet dog came to see me. The dog was in a great deal of pain, most likely from a pinched nerve in his neck. He would spontaneously vocalize (that is to say, scream) in agony every few minutes. It was very hard to watch the poor dog suffer so intensely.
About two hours before they brought him to me, the dog’s owners gave him 200 mg of ibuprofen (a non-steroidal anti-inflammatory drug, or NSAID, that is the active ingredient in Advil and Motrin) to try to help with his pain.
Ibuprofen has a low safety margin in dogs. It is potentially toxic. Fortunately, the quantity that the clients had administered to their pet was well below the toxic dose.
Unfortunately, the ibuprofen prevented me from treating the dog’s pain as aggressively as I would have preferred. Dogs who receive ibuprofen should not receive any other NSAIDs or steroids for at least three days or they will be at very high risk of suffering from gastrointestinal ulcers. Of course, NSAIDs and steroids are the main drugs used to treat neck pain in dogs.
Being unable to use these classes of medicine made helping the dog much more complicated. I had to hospitalize him and give him drugs related to morphine to make him comfortable.
Talk to your vet before you administer any human medications to your pet.
Photo: Sage Ross.
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04/18/09
 My dog died today…he wasn’t well yesterday, I
gave him a pain killer because he couldn’t walk…is
it because of the medicine that he’s dead? Please
be honest.
Nikita
Delhi, India
Probably not. But honestly, I don’t know.
I am very sorry to learn of the loss of your dog. Please accept my deepest sympathies.
Severe adverse reactions to pain killers can cause animals to die. You do not state what sort of medicine you used. Some human medicines are not safe for dogs. Some canine-specific pain killers are not safe in dogs that are sick.
So, honestly, there is a chance that the medicine caused your dog to pass away.
However, in my opinion the medication is not the most likely cause of death. You mention that your dog could not walk the day before he died. I suspect that he may have been weak from a disease such as kidney failure or internal bleeding due to cancer.
It is most likely that your dog died because of whatever sickness made him unable to walk.
Regardless of what happened, I do not feel it is appropriate for you to blame yourself for your dog’s death. Once again, I am sorry for your loss.
Photo: Michelle Tribe. Photo license: CC.
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04/15/09
 I love lobster and crab. Or, rather, I love eating melted butter on lobster and crab. Or at least I used to. A few years ago I decided that I couldn’t justify eating any animal with a brain that was boiled alive. And now a study has forced me to conclude that dipping bread in melted butter may be the best way to go.
From the April 17, 2009 issue of The Week:
The Agony of the boiled lobster
That scream you hear when you place a live lobster into a pot of boiling water is just the air escaping from its innards. But make no mistake, says new research, your lobster is feeling the agony of being boiled to death. Some scientists–and most lobster lovers–have long contended that with their primitive neural systems, crustaceans such as crabs and lobsters cannot feel pain. But a new study on hermit crabs in Northern Ireland has placed that theory into question. Researchers found that after they zapped the crabs with electric shocks, the animals did more than recoil in a reflexive manner–afterward, they exhibited stress reactions such as grooming (scratching their bellies with their legs) and tapping against the undersides of their shells, much like a human might lick a burned finger. What’s more, the crabs seemed to remember the pain. Even after the crabs migrated to other shells, their stress behaviors continued. As with other animals, study author Robert Elwood tells Discovery News, pain alerts the crab to tissue-damaging injuries and protects it by provoking such “a huge negative emotion or motivation that it learns to avoid that situation in the future.” He found that when shocked crabs were given aspirin, they acted relieved, and their stress-related behaviors subsided.
Sadly, pain is one of the most fundamentally important sensations in life. Rarely, cats and dogs are born unable to feel pain. They rarely survive more than a few weeks because they do not learn to avoid dangerous situations.
Meanwhile, I will hope that no similar studies force me to stop eating mussels. After all, their nervous systems are much less developed than crabs’.
Photo: Martinvoll
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01/22/09
 Ever since my female cat went to be fixed, she
has had a cough. I was wondering if there is any
thing I can do to help her. Also, she has become
more aggressive since she has been fixed. Is
that normal?
Steph
Kansas City, KS
Cats and dogs often cough for several days after surgery or anesthesia for dental work. This occurs for two reasons. First, to safely perform anesthesia, a special breathing tube must be inserted in the throat. The tube ensures that animals are able to breathe properly. It also protects the lungs from foreign material during the procedure. However, it occasionally causes minor irritation to the windpipe that leads to coughing for several days.
Also, remember that all major medical procedures are stressful. Stress weakens the immune system and makes pets more susceptible to minor respiratory ailments.
In either case, the coughing should not be accompanied by symptoms such as lethargy, weakness, loss of appetite, or difficulty breathing. If you see these symptoms, or if the coughing persists for more than a few days, contact the vet who performed the surgery.
Pets that undergo spay or neuter surgeries before puberty should not experience permanent personality changes. In fact, one of the benefits of early spaying and neutering is the prevention of undesirable personality changes that occur at puberty.
Temporary personality changes can occur after surgery, especially if proper pain management isn’t utilized. Aggression can be a sign of pain in both cats and dogs. I strongly recommend that you talk to your vet as soon as possible about your cat’s new aggressive tendencies.
It should be noted that when pets are spayed after puberty personality changes are not uncommon. The most frequently encountered changes are decreased levels of aggression and decreased interest in sexual activity.
Photo: Zipper shows off the site of her spay surgery.
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12/01/08
 My dog got her back paw caught in the door and her
whole nail came off. Now just the quick is
showing. I got the bleeding to stop but now it is
slimy and has a bad odor. Have you seen this before
and what should we do????
Melanie
Sarnia, ON, Canada
Nail injuries are very common in dogs. They occur when nails snag on carpet or vegetation, or when a nail catches on any stationary object.
In some instances (such as the one described by the questioner), trauma to the nail causes the nail to come completely off. In other cases, the nail is torn partially off.
In either case, a trip to the vet is in order. Nails that have been partially torn off may need to be removed. Both types of injury can lead to infection. Melanie, I suspect that an infection is the source of the bad odor that is emanating from your dog’s nail. Antibiotics may be necessary to help her heal.
Also, both types of injury can be painful. Your vet can recommend pain killers to make your dog feel better.
Most nails grow back normally after nail injuries. However, in rare cases the nail grows back in an irregular fashion. This rarely harms the affected dog. However, you may have to pay special attention to the nail in question. It may require frequent trimming.
For more information on injured nails in pets, click here.
Photo hat tip: Nicci.
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11/14/08
 Why aren’t animals given any pain relief after
operations? When I ask this I am referring to the
time when pets are allowed home after having
surgery. Humans are in pain for weeks after an
operation, what it would be like if we were given
no pain relief at all? Imagine what it’s like for
a cat or dog who has just had surgery and are sent
home with nothing to ease their pain. They must be
in complete and utter agony for weeks. Why is no
form of pain relief offered or given to an animal
when it is sent home?
Joanne
Warwickshire, United Kingdom
There was a time not that long ago (that is to say, within my lifetime) when legitimate scientists debated whether dogs and cats truly felt pain. Certainly, they were noted to respond unfavorably to adverse stimuli. But it couldn’t be proved that they feel pain in the same way as people do.
That debate, thankfully, has been put to rest. No reasonable scientist or veterinarian would now deny that every mammal perceives pain in basically the same manner as humans. And no reasonable person would deny that the sorts of injuries and disease processes that cause pain in people will cause similar pain in mammals. (Some people continue to debate whether “lower” animals truly feel pain. I, for one, believe that birds, reptiles, amphibians, and fish feel pain. I’m not 100% certain about insects, but I can say without hesitation that insects respond unfavorably to adverse stimuli . . .)
After it was agreed that all mammals feel pain, a new debate emerged among veterinarians. Some vets argued that pain was good for animals. Their argument was that the pain from a broken leg would keep a dog from walking on the leg. Similarly, the pain from a surgical incision would keep a cat from licking the incision.
The argument that pain is good turned out to be as poorly reasoned as it seems. Vigorous research has shown that pain is, in fact, bad.
Pain leads to physiological changes in the body that delay healing. Pain suppresses appetite, which in turn prevents animals from obtaining the nutrition they need to heal. Pain hurts. Pain management is now a standard part of care in veterinary medicine.
Joanne, I don’t have an answer for your question. Animals that undergo surgery are supposed to go home with pain medicine.
If you have a pet that did not receive pain medicine after a surgical procedure, it might have been an oversight. Or your vet may be one of the rare ones left who hasn’t adapted to modern practices. You may want to ask him or her why no analgesic (pain control) drugs were prescribed.
Most veterinarians now are proactive about pain control in their patients. Pain in animals is less common than it used to be. But it still happens. If you believe that your pet is in pain, do not hesitate to contact your vet to work out a solution to the problem. No veterinarian I know wants to see a patient in pain.
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10/03/08
 Will vicodin harm a dog?
In a 12 lbs toy breed can they die?
m
SF
Vicodin and most other human painkillers should never be administered to pets.
In fact, unless your veterinarian specifies otherwise, never give any sort of human medication to your pet. Also, don’t give canine medicines to cats. And don’t give feline medicines to dogs.
Dogs and cats react to and metabolize medicines in unique ways. Medications that are generally safe for people can be toxic to pets. The acetaminophen (also known as Tylenol or paracetamol) in Vicodin is especially dangerous to cats. In dogs it has a low margin of safety.
Cats and small dogs are especially vulnerable to adverse effects from human medicines. Small pets easily can be over dosed with medicines that might otherwise not cause problems. Severe complications, including death, are possible.
The take-home message is very simple. Do not ever give any medication to your pet without first consulting your vet.
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09/03/08
 When a person is in pain, he or she usually makes it clear that something is wrong. Humans can speak, and we can ask for more pain killers. It is generally accepted in human medicine that effective pain control not only makes patients more comfortable. It also helps them heal.
Sadly, animals cannot give clear signals of pain, and they can’t ask for pain killers. But their need for pain management equals that of their human counterparts. This puts them, and the people who want to help them, at a disadvantage.
Years ago, veterinarians questioned whether animals could even feel pain. That ridiculous debate has been put to rest. But later an equally nefarious philosophy evolved. Many veterinarians believed that pain was good for animals. Pain helped keep animals from walking on broken legs. It kept post-operative patients from being excessively active–or so the theory went.
The idea that pain is good in any way has been completely discredited by modern veterinary medicine. All decent vets now agree that animals feel pain, and that pain is bad. It causes stress and interferes with healing. Pain hurts, and it causes suffering.
Veterinary practitioners now recognize that pain management is critical to their patients’ comfort and healing. And we have an ever-widening array of pain management solutions at our disposal.
Options include conventional painkillers such as opiods (related to morphine) and non-steroidal anti-inflammatory agents (NSAIDs). Local anesthetics are useful in some procedures. Rehabilitation and physical therapy are useful in other situations.
Newer pharmaceuticals and nutritional supplements show promise in the treatment of acute and chronic pain. Lasers, stem cells, and extracorporeal shock wave therapy have the potential to help many animals.
The moral of the story is this: advances in animal pain management are occurring at breakneck speed.
If you suspect that your pet is at risk for pain–from dental disease, a surgical procedure, arthritis, trauma or any other sort of injury–talk to your vet. He or she should be willing to discuss a modern, comprehensive pain management protocol tailored specifically to your pet’s needs.
Veterinarians have lots of options for managing pain in their patients. There is no excuse for your pet to suffer.
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02/29/08
In the last week I have received several questions about the safety of Rimadyl. Since it seems to be a hot topic, I will devote this post to issues surrounding Rimadyl and related medicines.
Rimadyl is a pain killer and anti-inflammatory medication. It is a class of medicines called prescription non-steroidal anti-inflammatories (prescription NSAIDs). Other commonly used medicines in this class include Deramaxx, Previcox, Metacam and EtoGesic.
In veterinary medicine, prescription NSAIDs commonly are used to treat pain and inflammation from arthritis, trauma, surgery, strains, sprains and pulled muscles. Prescription NSAIDs are used frequently in dogs. They are used less often in cats.
All of the prescription NSAIDs have similar side effects (gastrointestinal upset is most common). All of the prescription NSAIDs are metabolized by the liver and excreted by the kidneys. This means that all of them have the potential to damage the liver, and all of them must be used cautiously in animals that have impaired liver or kidney function.
Extreme reactions to prescription NSAIDs occur very rarely. However, when they occur they can be fatal. If you google any of the medicines that I listed above, you will find web pages in which people have written about their bad experiences with each of them. These cases are very sad. However, they are the exception, not the rule.
Rimadyl, in particular, has received some bad press for being linked to liver failure in some Labrador retrievers. However, in my experience adverse reactions to prescription NSAIDs are unpredicable, and Rimadyl does not seem to cause more adverse reactions than the others. One dog may react badly to Rimadyl and tolerate Deramaxx. For another dog, it could be the other way around.
I have said many times on this blog that in veterinary medicine one must weigh the benefits of a treatment against its risks. Prescription NSAIDs may cause side effects or, very rarely, severe adverse reactions. However, they are potent pain killers, and they give some arthritic dogs new leases on life. For most dogs, the benefits outweigh the risks.
Long-term use of prescription NSAIDs is safe for most dogs. However, regardless of which one you use, your vet should check your pet’s liver and kidney function periodically to make sure that no damage has occurred.
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