It's all about stopping a problem or preventing it before it happens. So it's risk avoidance. We would rather not have a problem happen than talk about trying to treat it. It's a lot cheaper that way, too. What you put out, to begin with, is a lot cheaper than what you have to take care of if you ignore it.

Initially, for every acute pain episode, absolutely. That animal should be assessed. For chronic pain, sometimes animals that we're diagnosed with arthritis chronic pain, for example, are on something daily. So we will refill based on their mandatory one to two exams a year and their blood work once to twice a year. So in the cases that we've got them on a maintenance plan, and it's a management plan, they can just have it dispensed at times, but if there are any changes in the animal's behavior or we haven't seen them for over a year, we need to see that patient.

You can give medication to your dog, usually by mouth. Sometimes you may have to hide it in something which is like a pill pocket, or, depending on the dog, a little piece of cheese or something like that. There are also liquids, which we sometimes have access to if you have a dog that does a little bit better with something on the food or squirted in the mouth. There aren't so many available for dogs, but there are also some transdermal options. We tend to use those more in cats because their skin's a little thinner. We can also help if you have to give it by mouth, without any of those extra things. We can help teach you how to do that. In fact, I think we have a video or will have a video on how to peel your dog. We give injections in the clinic, and then there are a few kinds of medications that are considered nutraceuticals. One of them, Adequan, is injected, and it can help with chronic pain as well. There's a variety of alternative therapies that we can use to help with pain as well.

At this point, I would not call anything an alternative. Even some of the herbal things can get metabolized into products that may interfere with medication that would be more effective for your dog. When they talk about that, they're talking about the CBD wonder meds, and there's just not enough research out there to make those decisions. What studies have been done on CBD oils? CBD products have not shown efficacy in a dog for pain, and they actually sometimes affect liver enzymes. So typically, those aren't even recommended, and we can't recommend them due to legal reasons.

I don't recommend that you give your dog any human pain medication without at least consulting us to see if it's okay. There are very few recommended things for a dog. Regarding dosing, your veterinary professional would have to help you with that, as they're all very different. Some of them are based on the age of the patient and their kidney and liver health, and so on.

We commonly prescribe nonsteroidal anti-inflammatories, which is what NSAID is short for. They're very effective pain medications, and there are lots of them available. They all have different safety profiles, and we choose them based on the individual and what their blood work might look like. Also, regarding the delivery system, some are liquids, some are chewable, and some are capsules, and that's really important for a lot of owners because some dogs have preferences about what delivery they want.

Most over-the-counter medications are not recommended because they interact with more effective things that we can give. Typically, before you give your dog, and your cat especially, anything at home, we would recommend that you call, and we might recommend making an appointment to get an appropriate medication for your dog. Many times we've heard that owners have given Tylenol to their dog, which limits what you can do for the pain to help the dog. Some of those medications are quite toxic to their liver and kidneys. Tylenol in excess, for instance, and even aspirin can have some side effects on the stomach. Even baby aspirin.

We'll do a physical exam. We'll put our hands all over the dog, move the dog's neck, and move its legs and feet. We look for a vocalization. We also look for arthritis, which can manifest as almost a crunching feel in the joints. We assess the overall body condition of the dog and how the dog moves, and things like that. That may prompt us to talk to you about x-rays and similar things to assess further.

If your dog is exhibiting any abnormal behaviors that you're unsure about, you should come in. If you touch your dog and it cries, if it starts limping, if its appetite decreases, those are some signs that perhaps we need a trip to the doctor to see if your dog is in pain or maybe there's something else happening with it.

Many things can cause pain, anything from an injury, like a bee sting, to something like a knee injury, like a torn cruciate ligament, to arthritis. I would say arthritis is one of the biggest types of pain that we manage. That would probably fall under the chronic pain category. Dogs tend to adapt to it, and it's not until it's advanced that owners recognize it many times.