By Jessica Vogelsang, DVM
There’s a reason pain management is a specialty all unto itself in medicine: there’s a lot to know about pain! And while we wish there were one simple pill that works for every type of pain, the answer as to what is the best pain medication for a patient really depends on a variety of factors.
In each case, it’s the veterinarian’s role to decide, “In this scenario, what is the best pain management plan for this dog?” The goal is to alleviate pain using medications that are safe, effective, and convenient for the owners to obtain and administer.
The first question a vet asks is, “What is the type of pain we are trying to manage?” Chronic pain from an ongoing problem is different than an acute pain resulting from trauma or surgery. Cancer pain is complicated enough to be considered its own category.
The next question a vet thinks about is, “What types of pain medications should I use in this case?” The main categories of pain medications are opiods, NSAIDS, steroids, neutraceuticals, and alternative medications. Each class targets a different part of the pain pathway. Certain types of pain respond better to one class of medication than another. Some pets may be unable to tolerate a specific medication due to reactions with other medications or underlying medical conditions.
In many cases, the best pain management protocol is actually a combination of medications, an idea referred to as “multimodal pain management.” With a variety of medications attacking pain at different points along the pain pathway, we often need less of each individual medication and achieve a better overall result.
The final question is, “What is the best choice for this patient and family?” The veterinarian must take into account such concerns as cost, how frequently a medication must be administered, and how easily it can be given. It doesn’t matter how good a drug is, if the owner can’t get the pet to take it!