When looking at the management of pain, we provide a multimodal approach to maintaining your pets’ quality of life when surgery is not an option. We focus on traditional medical management in addition to many holistic treatments and alternative therapies. Any therapy and pain management protocol will be specifically tailored to your pet and could include changing and optimizing your pet’s medications, physical therapies or dietary and lifestyle changes.
To ensure that the most effective treatment is established, we need to know the exact source of pain that we are managing – so accurate diagnosis prior to establishing a plan is very important. With that in mind, it is important to ensure that all appropriate testing has been done to narrow the source of pain down. If a specialist is needed to aid in the diagnosis, we will direct you to the most appropriate specialist for referral.
When your pet is seen by one of our clinicians to discuss the pain management protocol, the initial consultation will entail a comprehensive assessment. Any additional recommendations such as blood testing may be recommended prior to starting any new medication to ensure your pet is healthy enough for additional medications. You will discuss your pet’s history, discuss overall quality of life, the goals in managing your pet’s pain and review current medications your pet is on. Once this has all been discussed, the clinician will then discuss findings and recommend a course of treatment that is most appropriate for your pet.
To help you understand if your pet is experiencing pain and to what degree, we have provided you (below) with pain assessment tools for cats and dogs. These are free to download and will help you identify common clinical signs your pet may be experiencing so that you will hopefully have a better understanding of how painful your pet potentially is. Please click one of the below names to open and view the species-specific pain scale evaluation tool. Better yet, if you have a scheduled appointment with us, bring the completed form with you for the veterinarian to see.
1. Acute Pain Scale (Dog)
2. Acute Pain Scale (Cat)
In addition to physical therapy recommendations, acupuncture has become increasingly popular as an alternative treatment method for managing pain.
What is Acupuncture?
Acupuncture is the practice of inserting fine, solid needles into the body in various locations for relief of pain or, in some cases, to help the body deal with other conditions / diseases. Acupuncture works via the nervous system, with the needles blocking the pain messages and encouraging the brain and central nervous system to produce more of the body’s natural painkillers.
What conditions are treated with acupuncture?
Typically pain associated with osteoarthritis, muscle strains, pain secondary spinal disc disease and bony changes to the spine.
Will it hurt my pet?
Not likely! Acupuncture needles stimulate nerves that send a message to the brain, blocking pain. Sometimes animals can react to this sensation as though it hurts, but don’t worry! They typically relax and most of the time accept the fine needles with no adverse reaction at all. In fact, they usually become extremely relaxed and a bit sleepy during the treatment session – oftentimes looking forward to their next session!
Platelet Rich Plasma (PRP)
What is PRP?
Canine Platelet Rich Plasma (PRP) offers a safe and natural cell therapy to relieve the pain of joint disease or injury, promote healing and reduce recovery time using your dog’s own blood.
What are platelets?
Platelets are a cell-like component of blood and are primarily responsible for the development of clots. Platelets also contain a remarkable array of growth factors involved in healing. The list includes platelet-derived growth factors (PDGF), ß-thromboglobulin, fibroblast growth factor, insulin-like growth factor 1, epidermal growth factor, and vascular endothelial growth factor. These growth factors are primarily responsible for the recruitment and differentiation of progenitor cells; promoting angiogenesis, new tissue growth, and replenishing the extracellular matrix.
How long has platelet therapy been around?
Platelet therapy has been used since the early 1970’s in periodontics for the treatment of severe gingivitis and in maxillofacial surgery to build bone mass in the jaw in preparation for dental implants. Since then, the use of platelets from a patient’s own blood has been employed in the treatment of tendon and ligament damage, popularized recently by televised reports of its use in professional athletes.
Platelets: Current evidence suggests that platelet concentrations at least 3 times above naturally occurring levels provide effective treatments. There is some evidence to suggest that extreme concentrations, roughly 10x or more, may be less effective in some applications. It is important to note that preparations with equal platelet concentrations can differ in the amount of growth factors they deliver depending on the activation status of the platelets. C-PRP produces a 3-4x non-activated platelet preparation.
What are the risks?
In a pilot study of 60 dogs treated with C-PRP, no adverse reactions have been reported. In addition, the use of filter-based platelet therapy in horses for ligament damage exceeds 2,500 cases without a single untoward incident related to administering the platelet therapy
What is the likelihood of success of the treatment?
Pilot data suggests that dogs under the age of 10 with significant lameness show the best response, with 91% of them experiencing a clinically compelling improvement in lameness when rated by both dog owners and vets alike
How long does it last?
The first dogs treated in one C-PRP pilot study had retained benefits for over 1 year and counting.
Do patients need more than one treatment?
There may be value in providing an additional treatment but this has not been studied yet. Researchers are currently evaluating the use of multiple treatments for dogs over the age of 10, a population that was less responsive to a single injection of the therapy in our pilot study.
How will the patient feel immediately after the treatment?
Some dogs have displayed discomfort that can be treated with ice for the first 20 minutes post-procedure. If needed, an oral analgesics may be used the first day or two after the treatment.
How long does it take to recover from the treatment and see benefits?
Most owners report seeing benefits within the first few days. A handful of owners reported a mild to moderate relapse of symptoms approximately 2 weeks after treatment before seeing a sustained benefit from the treatment.
Polysulfated Glycosaminoglycan (PSGAG) Injection
What is a PSGAG you ask? It goes by brand names such as Adequan® and Chondroprotec®. It is a medication used to treat osteoarthritis and to help prevent joint degeneration and also to help protect the intra-articular cartilage of joints. Its use in dogs and horses is approved by the FDA but in cats, its use is ‘off-label’. Many medications / drugs are prescribed for off label use in veterinary medicine and are safe to use in such a manner. It is important to follow the instructions set forth by your veterinarian so that the proper dosing is given.
PSGAG is typically administered via injection in the hospital setting. It can be given into the muscle or directly into the affected joint. This medication can take a few weeks before the full effects are seen but you should notice subtle improvements.
This medication is very safe and side effects are unlikely. When administered into the joint, joint swelling and discomfort may occur. Rarely, vomiting / diarrhea, decreased appetite and decreased energy may occur.
Holistic Supplementation
Here at NVC we also implore the use of many holistic medications. We have several manufacturers we work with to provide holistic solutions for various conditions. For example, we recommend several supplements which contain ingredients such as curcumin, turmeric and boswellia serrata all of which are known to be anti-inflammatory and aid in pain relief. We believe in providing supplementation for all areas of the body from head to paw! We are careful in the products we recommend and ensure all of the products we recommend exceed stringent requirements. In addition, most of these products have been endorsed by many holistic practitioners from all over the United States, Canada and India!
