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Chronic Pain Management

In the past I have written about preventing joint pain, which is something that is extremely important for our aging dogs. Unfortunately there comes a time when prevention isn't enough and we need to start looking at how to manage our dog's chronic pain.

Dogs can be in chronic pain for numerous different reasons including joint degeneration due to injury or age, cancers and other medical conditions, past surgeries such as a cruciate repair which can cause stiffness and soreness.

Signs of pain in our dogs can be subtle, as in nature animals do not show they are in pain because this has dangerous repercussions in a pack setting. Any, even slight, change in your dog's typical behaviour is always worth an examination with your trusted Veterinarian.

Signs of pain can include

  • Change in behaviour such as being "snappy" or "grumpy" or being antisocial

  • Having accidents in the house

  • Panting when in a resting state

  • Pacing

  • Whining

  • Reluctance to being handled or pet

  • Changes in sleep patterns/not settling at night

  • Holding their posture low, tucking their tail

  • Shaking or Trembling

  • Changes in typical eating or drinking habits

  • Excessive grooming such as respectively liking a specific area

You know your dog best and pain symptoms can range for every dog. If at any time you feel your dog might be in pain, a trip to your veterinarian is in order.

Once established what is causing the pain response, we are start to look at healthy management tools to integrate into their daily routine.

There is a time and a place for both holistic medicine and medical medicine and it's important to realize there are pros and cons to both sides. The point at the end of the day is that we need to find and understand what works best for our dogs.

Recently, with our own dog, Mayson that has had his hip and spinal pain managed through a balanced diet enhanced with optimal joint support and has been doing really great up until recently and through the help of our Veterinarian, we decided to add a monthly injection of Cartrophen to his regimen and the results have been amazing.

Natural ways to help control your dog's pain

Weight management and regular, low impact exercise

  • The absolute best thing you can do for your dog in regards to keeping their pain down is keeping them at an optimal, lean weight. ANY extra weight puts stress on your dogs joints and internal organs. Your dog should have a defined waist and you should be able to easy feel the ribs upon light palpation.

  • Often times when people have a painful dog that they should avoid exercise, but that isn't the case. Taking away your dogs regular exercise can lead to muscle degeneration which will lead to joint pain. Instead, we need to find optimal ways to exercise our dogs! Walks on soft surfaces like grassy fields and parks and low-impact exercise like Hydrotherapy can be a great option for dogs, especially seniors.

Optimal levels of Omega 3

  • Many diets (especially kibble) are lacking in Omega 3 fatty acids. Diets that are high in Omega 6 can contribute to inflammation and Omega 3's combat that and bring inflammation down within the body. Ensuring your dog is getting optimal levels of this by including whole fish (sardines, mackerel, herring, salmon), high quality fish oil or Green lipped mussel powder.

Arnica Montana

  • Arnica is a natural herb used very commonly in human medicine. The active ingredients are called sesquiterpene lactones and the main one is called Helenalin. These substances help open up capillaries, increase lymph drainage and also influence many inflammatory pathways in the body, which reduces swelling. Helenalin also inhibits blood clotting and can improve blood flow which in turn reduces bruising, congestion and inflammation.

  • Pure arnica is not safe for your dog. The only safe way to administer arnica to your dog is in its diluted form, which is in the form of homeopathic pellets.

  • The proper dosage and potency of arnica for your dog are based upon the symptoms they’re experiencing. Often, minor injuries require lower doses of 30C but Osteoarthritis pain may need a slightly higher potency. Dr. Judy Morgan (DVM) suggests 1-2 30c pellets given every 4 hours for 48 hours, then dropping to every 8 hours. Place pellets in the dog's cheek or dissolve in small amount of water and administer that way.

  • The Adored Beast "Jump for Joynts" contains Arnica and can be used for pain management


  • CBD Oil is derived from a special strain of cannabis known as hemp which is high in a cannabinoid compound called Cannabidiol. CBD is a natural anti-inflammatory that doesn't carry the same risk of side effects as drugs. It works by binding to CB1 receptors in the brain. These receptors stimulate the immune system to reduce inflammation within your dog's body

  • This study (click to read) found that there was "...a significant decrease in pain and increase in activity with CBD oil for dogs with osteoarthritis."

Physical Therapies

  • Dog massage, chiropractic adjustments, acupuncture and Red Light Therapy (click here to read my post on this) are all great natural ways to help manage your dog's regular pain.

  • Massage can relax your dog, increase circulation and lymph drainage and soothe stiff and sore muscles. For dogs who are afflicted with arthritis, however, massage plays a particularly therapeutic role, by increasing circulation and breaking up adhesions that form in connective tissue. Combined with stretching the limbs, massage helps to loosen up tight and strained muscles, increasing flexibility and mobility. All of this helps decrease inflammation and pain, leaving an arthritic dog feeling much better.

Veterinary Options

As mentioned, you should be having open conversations with your trusted vet about your dog's pain management routine. Some dog's need more help when it comes to managing serious long-term pain and that is when we can turn to modern medicine to give us a boost. There are different options you can discuss with your vet, but always ask and learn about any side effects from the option you settle on

Metacam / Meloxicam

  • Many dogs are on this medication to manage pain because it works, and that's great, however, there can be serious side effects to regularly dosing your dog with Metacam

  • First, what is Metacam? "METACAM is a prescription non-steroidal anti-inflammatory drug (NSAID) that is used to control pain and inflammation (soreness) due to osteoarthritis in dogs."

  • NSAIDs help stop the the production or function of prostaglandins (enzymes) that are involved in inflammation

  • While NSAID medications can be very effective for pain, they do come with a long list of side effects including Kidney failure. Dogs on Metacam require routine blood work to monitor kidney levels while on it. You can make the personal decision to use this for your dog, but please do your research and ask questions.

  • Metacam is not approved or safe for puppies under 6m of age

This is direct from the Metacam product information insert:

"As with any NSAID all dogs should undergo a thorough history and physical examination before the initiation of NSAID therapy. Appropriate laboratory testing to establish hematological and serum biochemical baseline data is recommended prior to and periodically during administration. Owner should be advised to observe their dog for signs of potential drug toxicity and be given a client information sheet about METACAM. Precautions: The safe use of METACAM Oral Suspension in dogs younger than 6 months of age, dogs used for breeding, or in pregnant or lactating dogs has not been evaluated. Meloxicam is not recommended for use in dogs with bleeding disorders, as safety has not been established in dogs with these disorders. As a class, cyclo-oxygenase inhibitory NSAIDs may be associated with gastrointestinal, renal and hepatic toxicity. Sensitivity to drug-associated adverse events varies with the individual patient. Dogs that have experienced adverse reactions from one NSAID may experience adverse reactions from another NSAID. Patients at greatest risk for renal toxicity are those that are dehydrated, on concomitant diuretic therapy, or those with existing renal, cardiovascular, and/or hepatic dysfunction. Concurrent administration of potentially nephrotoxic drugs should be carefully approached. NSAIDs may inhibit the prostaglandins that maintain normal homeostatic function. Such anti-prostaglandin effects may result in clinically significant disease in patients with underlying or pre-existing disease that has not been previously diagnosed. Since NSAIDs possess the potential to induce gastrointestinal ulcerations and/or perforations, concomitant use with other anti-inflammatory drugs, such as NSAIDs or corticosteroids, should be avoided. If additional pain medication is needed after administration of the total daily dose of METACAM Oral Suspension, a non-NSAID or non-corticosteroid class of analgesia should be considered. The use of another NSAID is not recommended. Consider appropriate washout times when switching from corticosteroid use or from one NSAID to another in dogs. The use of concomitantly protein-bound drugs with METACAM Oral Suspension has not been studied in dogs. Commonly used protein-bound drugs include cardiac, anticonvulsant and behavioral medications. The influence of concomitant drugs that may inhibit metabolism of METACAM Oral Suspension has not been evaluated. Drug compatibility should be monitored in patients requiring adjunctive therapy."

Due to this statement, I do not recommend long term Metacam use unless absolutely needed for the dog's quality of life and all other healthy options have been explored.


  • Used for more severe pain, this class of pain-relief medication includes morphine, codeine, fentanyl, buprenorphine, and hydromorphone. Opioids are used to treat severe surgical pain and may also be used in advanced cases of cancer or to control severe arthritis pain. Opioids have a place in selected cases to maintain a good quality of life for a dog experiencing extreme chronic pain. These are a last resort and extreme case basis.


  • Cartrophen is a MUCH better option for a chronically sore dog. Cartrophen is a Pentosan Polysulphate Osteoarthritis drug from plant origin that has very minimal side effects and is NOT and NSAID.

  • It is given as 4 subcutaneous injections, once a week for 4 weeks and then it is given as needed monthly, or every 2 months. It works by inhibiting the enzymes that break down cartilage and stimulates the natural inhibitors of these destructive enzymes. It increases blood circulation and stimulates the production of lubricant and cartilage building molecules.

  • It has been concluded in studies (read one here) that Cartrophen injections come with very minimal, mild side effects. Most common being vomiting 15 minutes after injection. There is no evidence, unlike Metacam, that this treatment does any damage to internal organs when given long term.

A few months back, Mayson's groomer had let me know that he had struggled to stand for the longer duration during his appointment and that told me that he needed some more help on top of his regular management routine so, we made a Vet appointment and talked about our options and I settled on this one. Mayson is currently on his 3rd week of the loading dose injections and the results are undeniable. He has been throwing paws on everyone and jumps around the house like a puppy, and I'm so thankful it has him feeling so good and it's definitely something we will continue for him. In comparison to Metacam, which is crazy expensive, the Cartrophen injections are completely affordable as we are paying under $30 per shot - but any amount would be worth him feeling so good!

*Prices will vary depending on your personal Veterinarian.

I hope that you never have to consider how to manage chronic pain in your woofer, but if that time comes I hope this article gives you some insight into your options and what ones have your dog's healthiest state in mind! If you'd like some guidance on managing your dog's pain, please reach out ❤

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