Surgery in veterinary patients, and humans, is not an uncommon option for treatment or prevention of a health problem. However, unlike with humans, veterinary species cannot tell us how painful they are following such a procedure. So how do we know if they are in pain? And furthermore, are some procedures more, or less, painful than others? This article aims to explore these questions in a little more detail.
What is pain?
A potentially sensible place to start is with the definition of pain. Pain, as defined by the International Association for the Study of Pain (IASP), is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage”. So, pain is the uncomfortable feeling, both physical and emotional, that happens when the body is hurt – or even when the body just thinks it might be hurt.
For example, imagine you sustained an injury such as a twisted ankle or sprained wrist. Obviously, these types of injuries hurt, but on occasion your body assumes something will hurt before actual pain occurs. You might be hesitant to weight bear on the ankle or move your wrist in a certain position. So, even though pain isn’t occurring at that exact second, it might if you move a certain way – and your body anticipates this. Similarly, if your dog injures themselves, for example they have a healing wound on a leg, they might no longer be in pain but may anticipate it. When the vet touches the surrounding area to check on progress, the dog may wince or pull away even though the wound is not being directly touched.
Types of pain
Dogs can experience several types of pain, just like humans. The type of pain present needs to be considered and assessed to determine if and/or how much pain relief is required. Acute pain is short-term and comes on suddenly, often from an injury or surgery. Chronic pain, on the other hand, lasts longer and can be ongoing, often due to conditions like arthritis or other long-term problems. There’s also neuropathic pain, which comes from nerve damage or dysfunction and may feel like burning, tingling, or shooting pain, and referred pain, where discomfort is felt in one area even though the problem is somewhere else. Understanding the type of pain helps vets choose the right treatment to make your dog more comfortable.
How do we know a dog is in pain?
The short answer? Experience! And lots of it!
Vets and nurses become better and better at recognising pain the more experienced we become. There are lots of things to watch out for which may indicate a dog is in pain, including demeanour and pathology present. But, in the case of surgery we need to be able to predict and minimise any painful things we need to do in order to reduce, or eliminate, the pain felt by your pet.
So, how do we know how painful a surgical procedure will be?
Experience!
It is important to remember here, that all dogs are individual little beings, so there isn’t a ‘textbook’ reaction to pain. One dog may react minimally to a painful procedure, whilst another may be incredibly sore. So, vets and nurses have been trained to always interpret the individual in front of them. The list below is very generalised, designed to provide an overview of the types of factors we consider.
But apart from this, we can consider many different factors which commonly do influence how painful a dog may be after a surgical procedure, which include:
1. Type of surgery
- Minor procedures e.g. superficial lump removals, dental cleanings typically cause mild to moderate discomfort.
- Moderate procedures e.g. keyhole or small incision spaying, castrations, wound repairs, or tooth extractions cause more tissue disruption and thus moderate pain.
- Major surgeries e.g. orthopaedic repairs such as cruciate ligament repair, thoracic surgery or open abdominal surgeries often result in more significant post-operative pain.
2. Surgical skill and technique
Minimally invasive techniques, such as laparoscopy, generally result in less pain than traditional open surgeries. Furthermore, surgeons who use gentle tissue handling and good surgical technique, especially those who have undergone additional training in surgery, will reduce discomfort felt by the patient.
3. Duration and positioning
Longer surgeries can increase the risk of the patient being stiff or uncomfortable afterwards, as they have been laying in one position for a longer amount of time. You especially need to consider this if the patient has any other health conditions or co-morbidities, such as arthritis, as positioning can worsen this kind of discomfort.
4. The patient’s size, age, and temperament
Younger dogs may bounce back more quickly, while older dogs or those with concurrent illnesses may experience more discomfort and/or a slower recovery. Temperament also plays a role; some dogs are more sensitive or anxious, which can seemingly amplify pain responses, whilst others are more stoic in nature and seem unbothered by the surgery they just had.
How do we minimise surgical pain?
Vets and veterinary nurses take pain management seriously, and reducing discomfort is a key part of every surgical plan. The control of pain doesn’t just start after surgery. It is inappropriate to simply wait until pain occurs to do something about it, we, where possible, prevent / minimise the pain from happening. We can achieve this via several different modalities:
Behavioural considerations
In some patients, behavioural considerations may be appropriate to reduce stress. Although not technically pain, elevated stress levels can increase the risk of injury to self and staff as well as potentially leading to poorer patient outcomes. So, your vet may give you a tablet or two to give to your dog prior to arrival, and potentially the night before. This aims to reduce your dog’s worries to make their vet stay a much better experience.
Analgesia
Actual pain relief medication can be given at a number of different times during your pet’s vet visit. It is commonly given prior to anaesthesia, via premedication, and also during the surgery itself. The type of analgesia given depends on many of the considerations discussed above but will always be tailored to the individual dog in front of us. Often these analgesics can be repeated throughout the surgery, and after if required.
Nerve blocks or local analgesia
A slightly different type of pain relief is the nerve block. This is where a specific type of drug, a local anaesthetic, is injected directly at the site of pain or potential discomfort. This numbs the area so reduces pain felt e.g. when the surgeon cuts through the skin.
Positioning
As alluded to above, how we position your dog can affect the comfort levels experienced after surgery. We gently lay your dog down on the operating table and position them in a way to ensure blood is flowing to every extremity. Imagine crossing your legs for a long time – after a while you start to feel pins and needles in the part of your leg where blood cannot get to. This is essentially what we’re trying to prevent. When blood flow, or nerve sensation, cannot reach an area of the body for a prolonged amount of time, complications and subsequent pain can occur.
Close monitoring
During the procedure a vet or nurse will closely monitor your pet whilst under general anaesthesia. They will be able to detect immediately if any parameters change, which may indicate pain. This may be indicated by an increase in heart rate or blood pressure. If this is detected, pain relief can be administered immediately.
How can you tell if your dog is painful?
After your dog’s surgery, sometimes despite our best efforts your pet may still be a little uncomfortable. Sometimes this is expected, but sometimes it may indicate that a complication has occurred, for example your dog may have accidentally irritated the surgical site by licking at it or jumping off a piece of furniture. Irrespective of the cause, it is important for owners to watch for any behavioural or physical signs that may indicate pain. These include:
Behavioural signs:
- Whining, whimpering, or howling
- Growling or snapping when touched
- Hiding, shivering, or seeming withdrawn
- Licking or biting at the surgical site
- Reluctance to move or interact
Physical signs:
- Changes in posture e.g. hunched back or stiffness
- Restlessness or inability to settle
- Panting, even when not hot
- Reduced appetite
- Elevated heart rate or breathing rate
If you notice any of these signs, it’s important to contact your vet immediately. Also, it is important to never try to medicate your dog with human painkillers – many of these can be toxic to dogs.
How to minimise pain after surgery at home
The owner’s role in their dog’s recovery is crucial. Here are some tips to help minimise their pain and support healing:
1. Follow the medication instructions exactly
Even if your dog seems comfortable, it is important to not skip doses immediately following surgery. Pain can flare quickly and is harder to control once it escalates.
2. Create a quiet, comfortable space
Avoid high-traffic areas and provide soft bedding. Use baby gates to prevent access to stairs or furniture if necessary.
3. Limit activity
This can be incredibly difficult if your pet feels well, but is essential following a surgery. Too much movement can increase pain and risk complications. Follow your vet’s instructions on lead-walking or crate rest. Additionally, physiotherapy may be an essential component of your dog’s recovery, so it is imperative these instructions are also adhered to.
4. Prevent licking
Prevent licking or chewing at the incision site as self-trauma can delay healing and subsequently increase discomfort. Often your vets will discharge your dog with something, such as an Elizabethan collar (cone) or recovery suit, to help prevent this. It is important to clarify with your vet if these types of prevention are suitable for your dog’s individual surgical wound.
5. Monitor the incision site
Redness, swelling, or discharge may indicate infection, which will increase pain and delay healing. Contact your vet immediately if you note these changes.
Are spays and castrates painful?
This final section has been included as neutering, whether spaying (neutering a female dog) or castrating (neutering a male dog), are the most common surgical procedures performed in veterinary practice. But even though they are routine and preventative surgeries, as with any surgery, they do involve some level of discomfort.
Castration, which involves removing the testicles, is generally considered a routine and relatively low-pain procedure. The incision is small, and most dogs recover quickly with minimal discomfort when given appropriate pain relief. That said, we are still removing organs with a rich nerve supply, and so it is rare nowadays to send a post-castration patient home without pain relief, as was normal until quite recently.
Spaying, on the other hand, is a bit more invasive. It requires opening the abdomen to remove the ovaries and sometimes the uterus, which means it’s a more invasive procedure than castration. As a result, it causes moderate pain and a slightly longer recovery time. Compared with castration, spaying is an intra-abdominal procedure, so by nature is more invasive as we have to gain access to a body cavity.
Both procedures absolutely require pain relief. Dogs undergoing these procedures are usually given multi-modal analgesia, so rely on multiple different techniques and medications to provide such pain relief. Your pet will be discharged with tablets (or liquid formulations) to continue this pain relief at home. It is as important to monitor your dog’s pain levels following neutering as it would be for any other surgery, routine or otherwise.
Conclusion
While it’s natural to worry about your dog being in pain after surgery, it should be reassuring to know that modern veterinary care takes pain management incredibly seriously. From routine procedures like spays and castrates to more complex surgeries, veterinary teams use a range of medications and techniques – before, during, and after surgery – to keep your dog as comfortable as possible.
Dogs can’t tell us when or where they hurt, so it’s important to watch for signs of discomfort and work closely with your vet.
Further reading
Multimodal Pain Management in Small Animal Veterianry Medicine – Veterinary Practice
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