Advanced Pain Management for Pets

TotalBond Veterinary Hospitals has long been at the vanguard of taking a comprehensive and progressive approach to the recognition, prevention, and treatment of pain in animals. The practice emphasizes staying at the forefront of developments in pain management and applying the most modern, evidence-based pharmacologic and non-pharmacologic methods in everyday care. Veterinary team members are committed to continual learning because pain management is a rapidly evolving field of knowledge.

Pain Management Philosophy

Understanding that traditional ways of thinking about pain are changing, the hospital prioritizes preventing and relieving pain whenever possible. They do not wait to see if an animal “appears in pain” before intervening—because research shows animals often mask discomfort. If a procedure or condition (like surgery or arthritis) logically causes pain, pain control is provided as part of the care plan.

TotalBond Veterinary Hospital at Forestbrook is noted as a leader in veterinary pain relief strategies. Dr. Mark Epstein — one of the clinic’s veterinarians — was among the first Certified Veterinary Pain Practitioners (CVPPs), served as president of the International Veterinary Academy of Pain Management, is an ABVP Companion Animal Pain Management Founding Fellow, and is recognized nationally and internationally as a speaker and author in this field.

Multimodal Pain Management

Their pain control programs include both medications and non-drug therapies. Examples include:

Pharmacologic approaches (medications):

NSAIDs and other anti-inflammatory drugs
Opioids and other pain modulators
Local and regional nerve blocks
Adjunctive Pain-modifying analgesic medications
Disease-modifying agents and biologic therapeutics
Intra-articular injections such as Platelet-Rich Plasma (PRP)

Non-pharmacologic approaches:

Low-stress handling and Fear-Free techniques
Cold compression and coaptation (bandaging/splinting)
Nutritional support and weight optimization
Massage and passive range of motion
Physical rehabilitation therapies
Acupuncture

Pain FAQ

The International Association for the Study of Pain defines pain as:
“An unpleasant sensory and emotional experience associated with actual or potential tissue damage.”

However, an important addition was made in recent years, because it reflects the reality of non-verbal patients…including animals! “The inability to communicate in no way negates the possibility that an individual is experiencing pain and is in need of appropriate pain relieving treatment.”

The important point is that pain is a conceptual sense, always subjective to the individual, always unpleasant, always elicits a cascade of stress chemicals and hormones, and is always both an emotional and physiologic experience.. and that in animals, it can be sometimes very difficult to know with certainty how much pain is being experienced.

Sometimes, pain is good; it protects us from further tissue damage (no one keeps their hand on the hot stove!). This would be considered “normal” or “adaptive” pain. But depending on its type, intensity, and duration, pain can become bad, dangerous, harmful, debilitating, and self-perpetuating, not only to one’s state of mind but to the body itself; we call this “maladaptive” pain. Preventing and treating maladaptive pain is a key part of both acute and chronic pain management.

Dogs and cats are non-verbal, so they can not tell us directly! But they can “speak” to us through the absence of normal behaviors or the appearance of new ones.

Onset of New Behaviors:

Limping
Vocalizing
Trembling
Aggression
Licking at a particular site
Hiding

Absence of Normal Behaviors:

Decreased activity
Getting up on front legs before the rear limbs
Difficulty on stairs
Diminished appetite
Altered sleep patterns

Osteoarthritis (OA) can be particularly difficult because the onset is so gradual – but many, many dogs and cats have OA joint and behavior changes even in young-middle age – it is not just for older pets!

See these helpful sites to recognize the possibly subtle signs of OA in dogs and cats:

Cats: https://www.zoetispetcare.com/checklist/osteoarthritis-checklist-cat
Dogs: https://www.zoetispetcare.com/checklist/osteoarthritis-checklist

Understanding Pain

The page discusses that pain — especially chronic pain — can be hard to recognize because animals often hide discomfort. Pain is defined as both a sensory and emotional experience, and even when pets don’t clearly show pain, appropriate pain relief may still be necessary.

Acute, Peri-operative, & Chronic Pain

The content explains how pain works — physically and neurologically — in both acute situations (like surgery or injury) and chronic conditions (like arthritis). In both cases, proactive pain control can help improve comfort, speed recovery, and enhance quality of life.

Physiotherapy & Supportive Care

Physiotherapy methods are described as complementary to the pain program and can improve strength and mobility. When pets may benefit from more advanced therapies, the hospital can recommend certified practitioners in one of our affiliated sister hospitals.

Regenerative & Biologic Therapies

The page also mentions regenerative medicine — treatments intended to help the body heal itself through biologic responses — and notes that these may be part of select pain protocols or offered through referral.

Palliative & Hospice Care

For pets with life-limiting conditions, such as advanced disease or cancer, the hospital provides palliative care focused on comfort and pain relief, including at-home treatments and support. Humane euthanasia is mentioned as part of compassionate end-of-life planning when needed.