By Suzanne Gould. Canine Behaviourist and Dynamic Dog Practitioner.

Alright, let’s talk about pain relief trials for dogs. Hands up if your dog has been given a pain relief trial ‘just to see what happens’. Many of my clients’ dogs are often put on one when we discover signs of pain, but even after seeing the vet, the location of the pain hasn’t been found. So a pain relief trial is prescribed to see if that makes a difference. 

My clients are often given two weeks’ worth of pain relief and asked to speak to the vet at the end of the two weeks to discuss changes. Now, the problem I always come across with this is that the vet rarely makes it clear what my client should be looking for during the trial. Generally, my clients come away expecting to see a marked improvement to the dog’s physical concerns or behavioural challenges, the truth is that in two weeks there is unlikely to be any change. 

The lack of guidence from the vet is unhelpful to be blunt. I have been in the same situation with my dog Erick, after being given two weeks of NSAIDs due to suspected OA. At the time, the vet checked in after two weeks, and all I could say was that there were no changes to note. Had I not pushed for further pharmaceutical options, the vet was happy to assume Erick wasn’t in pain. 

Since then, I have been on a long journey to understand what being on a pain relief trial means and what we, as owners, should monitor and feedback to the vet. I now give all my clients a form to fill in when their dog has been placed on a pain relief trial to help them track ALL changes. 

What often gets overlooked but is very important is that if your dog’s been put on one, you’re a vital part of the team regarding tracking changes. We can’t expect our dogs to show a marked improvement after such a short time because that isn’t how pain and the body work. It’s about working with your vet to ensure your dog’s as comfortable as possible.

Why Pain Relief Trials, Then?

When it comes to figuring out if a dog’s in pain, we’re really relying on what they do (think their behaviour) and how their body reacts (think gait and posture changes), pain is a subjective experience, and its accurate evaluation remains a challenge. This is when pain relief trials are needed, so we can asses changes and adapt them as required.

Every dog is different. They process meds at different speeds, and their pain tolerance varies. This means a one-size-fits-all all approach for pain relief trials doesn’t work. Research shows that using established pain scales and getting detailed feedback from owners helps vet better assess how a dog manages pain. For example, the Canine Brief Pain Inventory, or CBPI, is a great tool for chronic pain in dogs. It just shows how important having solid, standardised ways to assess pain really is. (Like Brown et al. showed back in 2007).

What You’re Looking For: A Practical Guide

You’re the one who spends the most time with your dog, so your observations are golddust

It’s important to note what your dog is like at the start of the trial so you can compare changes at the end of the trial. Remember, it’s important to track both the positive and the negative. 

Here’s what to keep tabs on:

Movement and Activity:

• Think things like how fast they’re moving, Is your dog moving more freely? Are they keener for a potter around the park? 
• Time how long it takes them to get up from lying down. That ‘rise time’ can be a really good clue about muscle or joint pain. Are the stretching more?
• Keep track of any changes in how they handle stairs, rough ground, or just getting around in general.
• Conversely, are they still limping, stiff, or reluctant to move?
• Be specific. Instead of “walk was alright,” try “walked for 20 minutes, slight limp on right back leg after 15 minutes.(Budsberg et al., 2006)

Behavioural Changes:

• Facial Expressions Watch for changes in their face like:
  • Ear position (are they pinned back? Or more relaxed)
  • Eye tension (are their eyes tight or bright?)
  • Muzzle tightness (is it tense and closed or relaxed and open?)
• Social Interactions:
  • Keep an eye on how they interact with other pets and people. Are they more playful, more interested in you and other pets, or less grumpy?
  • If they’re pulling away or not engaging like they usually do, Are they more lethargic, anxious, or aggressive? Are they panting excessively or restless?
• Displacement Behaviors:
  • Note how often they do things out of context, like:
  • Lip licking
  • Yawning
  • Scratching
  • These can be signs they’re stressed or anxious, which can be linked 
• Note when you see these changes. Pain can vary throughout the day

Eating and Toileting:

• Are they eating and drinking normally, more or less. Have they changed the times when they eat or drink?
• Are their bowel movements and wee routine the same? Or has the frequency increased? Do they look more comfortable or more tense as they toilet?

Sleeping:

• Are the sleeping more or less? 
• Are they sleeping soundly, or are they restless and waking up a lot? 
• Are they struggling to get comfortable?

Vocalisations:

• Are these common for your dog when relaxed, such as whining, whimpering, or yelping, if yes then are they happening more or less than usual?

Side Effects:

• You should also watch for potential side effects from the medication, such as vomiting, diarrhoea, or changes in appetite.
• Note down anything out of the ordinary 
• Any side effects should be immediately reported to your vet.

How to Keep Track: A Simple System

• A Daily Diary: A notebook or a notes app on your phone will do. Write down your observations each day, Remembering to include times, too. 
• Pain Scoring: If your vet’s given you a pain scale, use it. If not, a simple 1-10 scale can work.
• Videos: Short videos of your dog moving can be helpful for your vet, if you have example of them before the pain relief started, so you can compare.
• Consistency: Try to observe your dog at the same times each day for a fair comparison.

What Happens Next?

Towards the end of the trial, collate your information to allow you to present the positive and negative changes to your vet easily. Your input is crucial. By keeping a close eye on your dog and keeping good records, you’re helping your vet make the best decisions for your dog’s comfort. 

Remember, a pain relief trial isn’t about your dog being pain-free after 6 to 8 weeks, as that is rarely the case. Things like your dog ‘being happier, or being more playful, or wanting to cuddle more’ are all good signs the pain relief is having a positive effect. Plus, positive behaviour changes like your dog barking less at their triggers and being able to cope a little longer on their own. 

The vet after talking to you, should use your observations and their own assessment to decide what to do:

• If the medication works, they might continue or adjust the dose.
  • Then discuss further steps to uncover the cause/source of the pain
• If it’s not working, they might try a different medication or explore other options.
• They may also want to do further tests.

Remember, finding the right pain management plan can take time, so be patient. It took 6 months with my dog Erick to find the right balance of medications to help him. 

Remember, if your dog is showing signs of pain via behaviour changes and or adaptations to normal body movements, a pain relief trial is a useful way to determine if there is pain. However, there is unlikely to be significant changes within two weeks. Also, it is key to record all changes, positive and negative, changes to sleeping habits, whether they are playing more or less, whether they seem happier, etc. We are not looking for signs they are now pain-free on a pain relief trial. Your observations are vital to helping your dog.

More to read – Pain and Behaviour: Why a 15 minute vet check is not enough.

One Week Wonder: Why Your Dog’s Pain Relief Trial Demands More Time

Referances

Brown, N. O., Budsberg, S. C., & Papich, M. G. (2007). Evaluation of two questionnaires for assessment of chronic pain in dogs. Journal of the American Veterinary Medical Association, 230(2), 209-213.

Budsberg, S. C., Verhagen, A. P., & Farnbach, G. C. (2006). Force plate analysis of weight bearing in dogs with experimentally induced stifle joint synovitis. American journal of veterinary research, 67(1), 108-111.

Hewitt, D., Danbury, C., & Murray, J. K. (2012). Development of a behaviour‐based clinical pain assessment tool for use in dogs. Veterinary Record, 170(17), 447.