Alternative Veterinary Pain Control for Surgeries and Injuries
No matter what kind of surgery or injury an animal goes through, he is going to experience pain.1 Individual dogs, cats, horses and other animals have varying perceptions of pain, depending on their emotional makeup and experiences.1a No to moderate analgesia is needed for routine neutering operations, most dentistry work, and mild injuries, depending on the individual patient. Alternative (non-drug) therapies are often sufficient to control such minor pain. In certain individuals, however, and with more painful surgeries such as orthopedics, exploratory laparotomies and major trauma, conventional drugs may be helpful and alternatives may work even better. It is difficult to accurately evaluate for pain, since pets will often hide signs of discomfort in the presence of a caretaker.
There are many ways of decreasing pain from surgeries or injuries. Conventionally, analgesic drugs such as non-steroidal anti-inflammatory and narcotic medications are used for all types of pain. The side effects associated with these may make them unattractive to practitioners and pet owners, at least at their full recommended dosages, and many feel that the drugs alone may be inadequate for major pain relief. Using alternative methods in conjunction with analgesic drugs at lower doses is often acceptable for these more painful procedures.1b,1c
So what are the alternatives? Following is a list of therapies that are being successfully used for pain in a variety of veterinary practices.
Lasers are becoming popular in both conventional and integrative practices. Veterinarians using Class III and Class IV lasers on a regular basis see less post-operative pain in their patients, even when the lasers are applied for only a few minutes soon after surgery.
According to Companion Therapy Laser,1ci laser therapy is effective in treating post-surgical or traumatic pain and inflammation via a number of biological effects. It reduces painful inflammation, activates the lymphatic drainage system, and reduces pro-inflammatory mediators. Analgesia is also produced by “suppression of nociceptors, an increase of stimulation threshold, and an increased release of tissue endorphins”.
“The Respond Systems laser is my go-to modality for treatment of both acute and chronic pain,” says Jennell Appel, DVM, CCRT, of SPORTVET Canine Rehabilitation & Sports Medicine. “I utilize it for post-operative pain, soft tissue injury, joint pain, and wound healing. I use it not only for immediate pain relief with one treatment, but also for extended, longterm relief with just a few short sessions.”
Dr. Bill Inman1cii uses the following frequencies with Erchonia laser systems: 465 and 25 for pain, 300 for capillary vascularization, 20.5 for connective tissue rehabilitation, 365 for arterial supply, 100 for venous return, and 230 for lymphatic drainage, plus skin frequencies. “Treatments are applied twice a day on the day of surgery, twice a day the next day, then usually two more times within the next two weeks,” he says. “The 465 frequency increases the blood supply to the surgical site and actually diminishes the pain chemical by converting it as it moves through the arachidonic acid pain cycle. Healing fractures has been proven to be three times faster for simple fractures that are reduced surgically. Simple skin incisions heal 30% faster. The sutures should be removed at day seven instead of day ten to avoid ‘railroad tracks’.” For all trauma, use the basic frequencies 9, 16, 230 and 53. For general trauma pain, also use 3, 24, 111, 279, 465, 666, 25 and 125. For bone trauma, add 380, 1550, 802, 10000, 880, 787, 727 and 2720. For cerebral trauma, add 33, 60, 4, 9 and 151. For neural emotional trauma, add 60, 151, 1151, 465, 43 and 59.
Although acupuncture is applicable to almost every medical condition, it is classically known for its ability to control pain,1e both acute and chronic. Acute pain from physical trauma is a manifestation of the local stagnation of Qi (slight trauma) or of Blood (severe trauma, incision) caused in the area.2 Acupuncture aids the body’s self-healing and can resolve swelling, give pain relief, speed healing, and restore normal transmission of nerve impulses. Electro-acupuncture demonstrates even greater anti-inflammatory effect than dry needling. 3 Classically, the acupoints ST-36 and LI-11 are often used, as well as local points.
Essential oils have been used for over 5,000 years for people and animals. We often look to these oils for emotional help (e.g. Lavender for calming). They do have a wide range of actions, and can be important for pain relief and healing as well as emotional support.
Dr. Melissa Shelton1d applies the essential oils Copaiba, Peppermint, Helichrysum, and/or Myrrh to mucus membranes before surgery or during anesthesia to minimize pain and promote healing. Helichrysum has the added property of minimizing bleeding during surgical procedures. “For me, this has certainly replaced all our NSAIDs – and is doing a better job than many of them,” says Dr. Shelton.
This author often applies Lavender essential oil to an incision immediately post-op, and has clients do the same for one or two days as an analgesic and anti-inflammatory, and to deter licking.
One of our oldest holistic treatment modalities, herbs have been well-known for centuries as a way to relieve pain during wars, epidemics, childbirth and more. Dr. Cynthia Lankenau3e sees excellent results using: Yunnan Paiyao for bleeding control and pain; The Great Mender, a patent Chinese herb formula, especially for bone pain; and Corydalis for soft tissue pain,with Indian Pipe if cancer is involved. The herbal formula should match the total pattern in the herbal Materia Medica.
Dr. Ihor Basko treats “injury or post-surgical trauma by using ‘Blood Moving’ herbs both internally and topically… sometimes along with ‘blood cooling’ herbs. It will make a large difference with pain (without blocking any pain receptors) and recovery.”
In this author’s practice, we apply wheat germ oil to an incision or traumatic wound twice daily by pin-pricking the Standard Process gel cap. You may want to mix with a bad-tasting deterrent like Lavender essential oil. This greatly assists healing and comfort.
While chiropractic treatments are regarded as mostly useful for injuries and chronic lameness, they are also effective for acute pain and post -surgery.
“It is important to note that just opening up the tissue with the scalpel blade will create a phenomenon of vertebral subluxation complex, which will produce a vasoconstrictor response at the site, therefore causing pain,” says Dr. Inman. “(VOM) adjustments can treat the subluxations and are given while the animal is recovering from anesthesia, the next day, seven days later, and then 14 days after that.”
By rebalancing the quantum field, homeopathy can heal almost any illness or condition. It is excellent for acute as well as chronic conditions. For acute pain, it can give immediate relief, and since it is absorbed through the mucus membranes, it is easily given during surgery or to comatose injured animals.
Many holistic veterinarians give Arnica, directly in the mouth or dissolved in water, just after surgery or a traumatic occurrence. An article in JAMA reported that facial reconstructive surgery patients taking perioperative homeopathic Arnica montana exhibited statistically less ecchymosis.3a The keynote to Arnica for pain is that the patient is so painful he does not want to be touched. Even a very sweet dog may bite or growl. Bellis is needed for deep organ or muscular pain when Arnica does not help. Hypericum is effective for puncture wounds, pain at injection sites, and gum pain.
The strength of the medicine may vary, based on the practitioner’s assessment of the energetic level of assault on the body produced by the trauma or surgical procedure, and the energetic level of the animal’s vital force. For example, a gentle routine surgery usually requires just 30C whereas a very recent severe accident in a young animal may call for 10M.
Ozone has become very popular over the last few years in the veterinary field, although it has been used in the human field for decades. Many studies have documented its efficacy for pain relief, such as a meta-analysis of randomized trials on lower back pain.5
Dr. Margo Roman6 gives “a saline infusion of ozone which has been percolated with ozone for 30 minutes at 80 Gamma. Dosage ranges from about 30 cc to a 10 lb cat; 100 cc to a 40 lb dog; 160 cc to a 80 lb dog.” Ozone injected into joints (prolozone) can stop the pain/inflammation cycle in orthopedic surgery or joint trauma. Areas of trauma can also be covered with a plastic bag and ozone gas mixture pumped into it with a tube or large syringe (bagged) to control pain and promote healing.
A variant of homeopathy developed by Hans-Henrich Reckeweg, MD, homotoxicology uses specific combinations of homeopathic medicines to address specific health issues. It can be very effective for pain of surgery or injuries.
Dr. P.J. Broadfoot3b routinely uses Traumeel (from Heel – now owned by MediNatura) post-surgery, both IV and SQ (and it can be sent home with the owner). “You can also use other homotoxicological preparations for specific cases,” says Dr. Broadfoot. “Zeel, Discus comp for bone surgeries, Cutis comp for dermatology support, Echinacea comp if there is some concern about secondary infections, Placenta comp if there is poor circulatory function or compromised blood supply, Nux Vomica/Hepar/Veratrum if doing GI surgery, etc.”
Dr. Richard Palmquist3c cautions that when using Zeel after joint surgery, it is more effective to concurrently use Traumeel, especially topically in its gel preparation. “If you are starting detox or a natural program, it can be hard to suddenly hit a patient with surgery,” he says. “So be sure she is stable on her current program before you do the surgery.”3d Dr. Palmquist has seen good pain control by giving Traumeel by dropper or sublingual tablet just before and just after surgery; having the client continue it TID for three days, and BID for two more days; and giving narcotic medications for more severe pain.
Used for over 100 years, totally safe flower essences are essential in the hospital as well as for home care. While often considered primarily for emotional treatment, they are excellent for many physical ailments, especially pain with its emotional component.
Dr. Christina Chambreau3g believes every clinic (and person) should be using Rescue Remedy, a combination of five Bach Flower Essences selected to relieve pain, decrease shock and aid healing. Rescue Remedy is 100% safe and has no negative interactions with conventional or holistic therapies. Many clinics give a few drops (diluted 4 drops in 1 ounce water) before every surgery, mist the surgical suite before surgery, and frequently post-op until the animal is back on his feet or resting comfortably. Other Bach essences can deal with specific pains,4 and additional companies (Green Hope Farms, Spirit Essences, and Anaflora to name a few) have specific combinations for use after surgeries for pain and emotional changes. Clients can give the dilution orally on the mucus membranes, or rub a bit on the inner ear flap any time they observe any hint of pain in their companions.
SOME FINAL THOUGHTS
Dr. Carvel Tiekert, founder of the American Holistic Veterinary Medical Association, counsels that good anesthetic and surgical techniques are also important in minimizing surgical discomfort. Handle tissues gently, use firm but not tight subcuticular skin sutures, apply a little procaine in the incision just before closing, and/or apply wheat germ oil to the closed incision from day three after surgery, to reduce the potential for electrical disturbances at the scar. For elective procedures that he knows will be significantly traumatic, Dr. Tiekert starts the patient on enzymes two days prior to surgery. Dr. Palmquist adds that keeping the incision small, and using surgical laser and appropriate fluid therapy, also helps prevent surgical pain.
Pain is increasingly being addressed with drugs in veterinary clinics. These along with holistic modalities can offer safer, gentler ways to resolve the pain arising from surgeries or injuries. Other modalities that relieve pain include biofield therapies, Reiki, massage, sound therapy, prolotherapy, Sonotron therapy, hydrotherapy, magnet therapy, hyperbaric chambers, and more. Employing one or more commonly used alternative therapies can adequately control the pain of surgery or trauma, or at least reduce the dosage of opiates or other medications needed, thus enhancing recovery and general healing.
1a Hansen, Bernie. “Assessment of Pain in Dogs: Veterinary Clinical Studies”. ilarjournal.oxfordjournals.org/content/44/3/197.full
1b Wynn and Marsden. Manual of Natural Veterinary Medicine. pp 474-480.
1c Schoen and Wynn. Complementary and Alternative Veterinary Medicine
1cii Inman, Bill. (Private e-mail). Inventor of the Veterinary Orthopedic Manipulation (VOM) chiropractic technique.
1d Shelton, Melissa. (Personal communication). Crow River Animal Hospital, and founder of Animal EO, OilyVet.com.
1e Bresler et al. “Review of research findings of the UCLA Research Project”. 1975, anesthesiolrev, p 10, Jan 1976.
2 Maciocia, Giovanno. The Foundations of Chinese Medicine. Elsevier 2005.
3 Schoen, Allen, Ed. Veterinary Acupuncture. Mosby 1994.
3a Seeley, Brook, MD et. al. “Effect of homeopathic Arnica montana on bruising in face-lifts –results of a randomized, double-blind, placebo-controlled clinical trial”. Arch Facial Plast Surg. 2006;8(1):54-59.
3b Broadfoot, PJ. (Private email). Broadfoot Veterinary Clinic, Van Buren, AR.
3c Palmquist, Richard. (Private email). Centinela Animal Hospital, Inglewood, CA
3d Palmquist, Richard. CAVM website.
3e Lankenau, Cynthia. (Private email). Holistic Center for Veterinary Care, Colden, NY; and president of the Veterinary Botanical Medicine Association.
3f Basko, Ihor. All Creatures Great and Small, Kapaa, HI. Wrote on CAVM website.
3g Chambreau, Christina.
4 Graham, Helen; Vlamis Gregory. Bach Flower Remedies for Animals. Findhorn Press 1999.
5 Magalhaes FN, et al. “Ozone therapy as a treatment for low back pain secondary to herniated disc: a systematic review and meta-analysis of randomized controlled trials”. Pain Physician, 2012 Mar- Apr;15(2):E115-29.
6 Roman, Margo. Main Street Animal Services, Hopkinton, MA