The following article about Tripawd pain management is written by longtime Tripawds member Topher (aka @blackdogcompanion), who joined us after adopting Cora, a blind Tripawd puppy with many physical and behavior challenges. Inspired by her resilience, Topher entered the veterinary field do help more animals live a great life on three.
I used to be a Tripawd ‘s human and the Tripawd’s forums were of great support to me. I learned a lot from Cora, my Tripawd, and all the other critters that have shared my life. I now work as a vet assistant and am in school to be a vet technician. I started at a general practice veterinary clinic and then moved to veterinary oncology. I recently moved to Rehabilitation and Sports Medicine. We focus on getting pets healthy and mobile, and we always operate under the idea that pain management comes first.
Through Cora my Tripawd, I saw firsthand that pain management can make a tremendous difference in a pet’s life.
Her personality changed dramatically when we got her pain managed. I want to help our wonderful Tripawds (and their people) be happy, so I’ve gathered some information about pain and pain management to share with you.
If your pet is a Tripawd, thinking about pain management can be important. Even the most fit Tripawd may get muscle soreness and if there are any additional issues (arthritis, cancer, etc.) pain can be a significant factor in your pet’s life.
The most important thing to remember is that you should always work with your veterinary team first!
A bit about pain in three-legged animals
Pain is on a different neural pathway than many forms of sensation. You can have a limb that doesn’t respond to touch but can still fire off pain signals. There are many types of pain. As you have probably experienced, pain can feel sharp, dull, throbbing, burning or more. Two categories to be aware of are acute pain and chronic pain.
Acute pain
This type of pain occurs if there is a new damage to the body through injury, illness or trauma. Surgery is an example of a trauma. This pain serves the vital function of communicating that behavior should be modified. For example, pain signals keeping a pet from using an injured limb before it’s healed.
Chronic pain
Chronic pain can occur from many causes. A simplistic way to think about chronic pain, for our pets, is that the nervous system has been altered by the severity or duration of damage to the body. Pain signals can continue to fire, long after the injury has healed. Sensitization then occurs which means that pain receptors fire more easily and touch receptors can become more sensitive.
Signs of pain in dogs and cats (and other animals)
Most animals mask their pain, because in the wild pain makes them vulnerable to attack Certain types of pain, like dull and throbbing, are less likely to be shown by your pet. Because our pets can’t verbalize that they are in pain and tell us where it is, we need to be mindful of the signals they are sending out. Any sudden change in your pet’s behavior should be a cause for observation and concern.
With chronic pain, the changes can be small and gradual
This makes them easy to miss. Changes in vocalization, posture, activity, appetite, daily routine (like increased sleeping, restlessness, activity level, etc.), grooming or behavior (aggressiveness) could be signs of pain.
There are also clinical signs like excessive panting, dilated pupils, or trembling. These can be signs of severe medical issues so it’s vital you bring these changes to the attention of your veterinarian to determine the cause.
Learning how your pet’s body feels and looks when they are relaxed and not in pain can help you notice changes.
I like to pet my critters when they are sleeping, so I can feel how their muscles are when they are at ease. Don’t forget to look at their face. In animals, changes in expression are subtle, but some people become experts at reading them, especially for their own pets. I once had an owner tell me they knew their dog was sick simply because of the look in the dog’s eyes, and they were right.
How you can manage pain in your own pet
Of course, if you are trying to manage pain, you should consult with your vet first! There are many things you can do to manage and prevent your Tripawd’s pain.
Make sure you keep your pet a healthy weight. This is especially important for amputee pets, who are already working extra hard to get around.
You should also manage your pet’s exercise and movements.
Some pets are great at self-regulation, but most pets will do things that can make their pain worse.
A part of why my senior dog Floyd had such bad arthritis is that when he was excited, he refused to slow down. When he was young, he injured his knee. He was on rest; leash walks and medications to keep him calm. I distinctly remember taking him out on leash to potty and when he saw a squirrel he started pogoing up and down with all four feet.
If you are uncertain of how to manage your pet’s activity, you can keep a journal of your pet’s activity and movement. This will make it easier for you and your veterinary team to spot changes or patterns that can help determine next steps.
Keeping your pet moving is great. A sports med and rehabilitation veterinarian can not only provide exercises, but information about all the things I’m going to mention.
Specific pain management tools
PEMF: Pulse electromagnetic field therapy
Pulse Electromagnetic Field Therapy uses a device that owners can purchase to deliver electric and magnetic fields to tissues to decrease swelling and heal tissues. It has been used in both human and veterinary medicine. It is not invasive, electric or heat based.
PEMF should not be used if you or your pet have a pacemaker. Evidence in human and veterinary medicine supports use for fractures, pain, and wounds. PEMF devices reduce inflammation and pain. It works best when used in conjunction with other treatments.
When using a PEMF device the evidence suggests similar efficacy of short treatments (approximately 20 eighteen-minute treatments). Or, longer treatments (approximately 9 one-hour treatments).
Obviously, you will need to consult with your vet to get specific treatment recommendations.
The PEMF loops we recommend at our practice are: KT loop and PEMF Loop for Dogs.
Red light therapy
Red Light Therapy uses wavelengths of red and near-infrared light to stimulate cellular activity, which can help with a variety of issues. This is another treatment that can be purchased and used by pet owners at home. Red light therapy can be beneficial for pets dealing with pain, inflammation, wounds and even mobility issues like arthritis.
The specific wavelengths of red and near-infrared light used in red light therapy are absorbed by the mitochondria (the powerhouse) in cells. This absorption of light energy stimulates the production of adenosine triphosphate (ATP), the energy currency of cells, and increases blood flow to the treated area.
General recommendations are to use red light therapy once daily for 20 minutes.
The only precaution is you don’t want your pet looking directly at the light. As it comes as a pad or wrap, it’s usually easy to avoid this.
Floyd would never lay still for the PEMF loops, and the tape provided didn’t hold them on him. However, he would relax with the red light pad.
The one we recommend at my practice is: Red Light Therapy Belt.
Massage therapy
Like humans, pets like Tripawds can benefit from massage. It doesn’t just feel good, it releases endorphins and serotonin. Research shows it helps with canine arthritis, swelling, and secondary muscle issues.
If you have had medical massage therapy, you probably know it can be painful and there is often deep tissue work. This should never be done with your pet.
If you do massage, you should focus on touch that feels good. You should not do massage with your pet if they have a fever, skin issues, a new injury or acute inflammation.
How to perform massage therapy on your pet
To begin, find a place where you are comfortable. Then:
- Begin massage with effleurage, a gentle stroking technique that helps to warm up your pet’s muscles. Lightly stroke your pet in long, smooth, soft motions, following the direction of the fur. It should feel good
. - Don’t just massage the affected areas, give them a nice full-body experience that will increase relaxation and also help you to bond together. I think this can be especially important when you have a pet that needs lots of care. I know how hard it can be when you feel you are doing things to them they don’t like.
- Other techniques you can use, always being gentle and cautious, are petrissage and friction:
- Petrissage is kneading and compression. While this technique can be especially helpful for dogs with arthritis, it is also the easiest to accidentally cause pain. It can help reduce inflammation and promote healing as it releases tension and increases blood flow.
- If you decide to try petrissage, do small amounts and be gentle. You will gently press and knead the muscles surrounding the affected area. You can focus on areas of tension but avoid sensitive or painful areas.
- Friction is a technique where you rub or apply circular motions to apply steady and direct pressure to sore and tense muscles. This technique helps to break up scar tissue and adhesions. Adhesions are areas where muscle fascia, the connective tissue that supports and encases muscle, binds together impinging and limiting muscle. Sessions should be short and can be done daily.
- You can read more about adhesions, here.
Always remember when you are massaging your pet, they should be enjoying it. When you see your pet becoming more relaxed you know you are doing it right!
What about pain medication?
Here is where it’s vital for you to have a good relationship with your veterinarian and be willing to advocate for your pet.
There are many valid reasons that your vet might be slow to prescribe pain meds and may only try one medication. Your vet has to think about your pet’s age, breed, other health conditions, side effects and so much more.
It is also true that veterinary medicine has, sadly, been slow to recognize the importance of pain management. The first textbook on veterinary pain management didn’t come out until 1992. However, a lot of progress has been made since, and the science of pain management continues to advance.
Advocating for your pet’s pain management
You are your pet’s advocate. Some things to keep in mind, when talking to your vet:
- The vast majority of veterinary clinics are understaffed. Add to that, it can be a very stressful job and there is, sadly, a growing trend of verbally abusive clients. This can make it harder for veterinary staff to hear and be receptive to what you are saying.
- Staying polite and giving staff time to respond can aid in having a conversation. A vet who has time to research or consult with other vets, may have different answer to a vet that feels pressured to give an answer in 30-minute appointment.
- It is ok to disagree with your veterinary team. Each vet has a different skill set, experience and opinions. It can be a hassle, but getting a second opinion can be beneficial for you and your pet.
Understanding the effects of gabapentin and opiates on your pet
As I am not a veterinarian, I am not going to say much about specific medications. Two meds I wish owners (and veterinarians) better understood are gabapentin and opiates.
I have had owners that were positive that opiates are the best thing for pain control, and they feel deprived when their vets aren’t prescribing them. There are many laws that regulate when and how veterinarians can use these medications. There is also growing evidence that while injectable opiates given in the hospital help pets, opiates in pill form don’t.
The other medication, gabapentin, is currently prescribed by veterinarians quite often for a variety of issues including pain management. However, there is limited research on gabapentin for pain management.
Current research suggests gabapentin helps with neuropathic diseases, and post-operative pain when used with other pain management therapies.
For most other pain issues, current research shows no or very limited evidence that gabapentin helps. Based on my experience and what I’ve heard specialty doctors say, it’s not particularly effective for acute or chronic pain. It is also not without side effects.
As well as drowsiness, gabapentin can cause ataxia. Ataxia is a lack of coordination in the limbs and can include weakness and loss of balance. In my personal experience, this can be especially true of older patients. As Floyd reached the geriatric stage he had increased ataxia on gabapentin. I have seen many other dogs with this issue, especially as they age.
Does this mean that if your vet has prescribed gabapentin it’s inappropriate? Absolutely not. However, this information can be a useful talking point with your veterinarian, especially if your pet is only on gabapentin for pain relief.
Managing pain, embracing joy
You are not alone in this journey. I know that seeing your pet in pain can be awful. The uncertainties about how our pets are doing and how to help them can be hard to deal with.
You can reach out to friends, family and therapists to get support when needed. Sometimes, if they know your pet, they can provide a fresh perspective. There are also a lot of great veterinary teams, including specialists, that will care deeply for both you and your pet.
You also have all the great resources here at Tripawds. Finally, you have your pet. That love and bond is special. Don’t forget to embrace the joy it brings you.
References
Downing, R., & Della Rocca, G. (2023). Pain in Pets: Beyond Physiology. Animals, 13(3), 355.
Federica Di Cesare, Negro, V., Giuliano Ravasio, Roberto Edoardo Villa, Draghi, S., & P. Cagnardi. (2023). Gabapentin: Clinical Use and Pharmacokinetics in Dogs, Cats, and Horses. Animals, 13(12), 2045–2045.
Gaynor, J. S., Hagberg, S., & Gurfein, B. T. (2018). Veterinary applications of pulsed electromagnetic field therapy. Research in Veterinary Science, 119(29775839), 1–8.
How to Manage Your Dog’s Arthritis with Massage Therapy. (2023, May 4). Simon Veterinary Surgical. Simon Veterinary Surgical.
How to heal your pets faster – red light therapy. (2025). The Pet Show.
Moir, R. (n.d.). General 1: Adhesions. Doric Dogs.
Murrell, J. (2020). Chronic pain in companion animals. Vet Times.