Pain management is a growing field, and distributor reps can keep their customers on track with the right products and services.

Pets today are receiving better care at a younger age. Indeed, veterinarians and their clients tend to be more focused on nutrition, supplements, vaccines and preventives, such as heartworm medication, than they once were. So, when it comes to pain management, it should be little surprise that animal lovers expect the same level of care for their dogs and cats as they would for themselves.

With better treatments and techniques at their disposal, it’s unethical for veterinarians not to treat pain in animals, according to experts. And, given the huge variance in the way pets respond to pain medications and treatments, veterinarians should be prepared to offer a range of solutions. By building a trusting relationship with their customers, sales reps can encourage them to stay open to new products to keep their patients healthy and active.

Why the pain?
Pain may be acute, as with post-surgical pain, or it can be chronic, such as joint or back pain. In some cases, pain may start out as acute and become chronic over time. So, if a dog’s ligament rupture is not corrected through surgery, it may become arthritic later in life.
Depending on the breed, different animals may experience different types of pain, and at various stages in their life. For instance, Dotsons sometimes experience back pain early in life. Larger dogs, such as Labradoodles, German Shepherds and Golden Retrievers, are more prone to hip and joint issues. Typically, osteoarthritis is a middle-to-old-age disease in dogs, although “middle age” may vary depending on a breed’s average lifespan. Cats, whose symptoms often are more subtle than those of dogs, generally do not present symptoms of osteoarthritis before eight years of age. At that time, they might have difficulty leaping or standing in their usual position to urinate.

Solutions
Pain management almost always involves weight control, note experts, who point out that excess weight, which places additional stress on cats’ and dogs’ joints, is a complicating factor in pain. Patients needing to lose weight tend to respond to low-fat, high-protein diets, but this can vary by breed or from one pet to the next. Sales reps should be knowledgeable about a variety of diets and pet foods to meet the needs of each customer’s patients. It’s important for veterinarians to be confident in the products they offer their patients, so they likely will appreciate seeing studies and literature that support them.

Supplements and medications are available to help alleviate a pet’s pain and accompanying symptoms. Sometimes, veterinarians prescribe a combination of the two, with a goal of weaning the pet off of medication, if appropriate. Supplements, such as glucosamine chondroitin, can be beneficial, as long as the veterinarian and pet owner proceed with caution and sensibility, according to experts. As more diets that include supplements become available, it is becoming easier for pet owners to ensure their dogs and cats receive them. However, FDA-regulation of veterinarian-recommended supplements and vitamins is minimal, so it’s important to understand the science behind how a company manufactures each ingredient in a product. Depending on how a product is manufactured, it may be more or less absorbable. In addition, veterinarians must be confident that the compounding pharmacy is adhering to standards. The more sales reps stay on top of these issues, the more qualified they are to service their veterinarian customers.

Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to control the pain of osteoarthritis – and sometimes post-operative pain – in dogs. But, due to the risk of any prescribed drug, the U.S. Department of Health and Human Services, Food and Drug Administration, recommends that veterinarians and their clients be aware of the following facts:
Oral NSAIDs are only safe for dogs, and all dogs should undergo a thorough history and physical exam before starting NSAID therapy.

Appropriate blood and urine tests should be performed to establish baseline data prior to administration of an NSAID. Such tests should be performed on an ongoing basis during NSAID therapy.
Veterinary NSAIDs may be associated with gastrointestinal ulcers and perforations and liver and kidney toxicity.
Generally, veterinarians should avoid using NSAIDs in conjunction with other anti-inflammatory drugs, such as corticosteroids.

Patients that are dehydrated, on diuretic treatment or who have pre-existing kidney, heart and/or liver problems are at highest risk for kidney problems.

Although NSAIDs are not considered safe for cats, meloxicam (under the brand name Metacam), a nonsteroidal anti-inflammatory drug, is reportedly safe for treating their acute pain.

Pet rehab
Old and achy, young and athletic – now more than ever before, dogs and cats receive the same standard of physical therapy as their owners would. In fact, veterinarians trained in physical therapy rely on many of the same techniques and equipment as human physical therapists. In addition to reducing pets’ pain, pet rehabilitation can accomplish a number of life-enhancing goals, including the following:
Increase mobility and flexibility.
Facilitate recovery from an injury or surgery.
Improve agility.
Maintain function and prevent further problems.

Today, pet rehab specialists rely on such products as laser and e-stimuli devices, as well as underwater and land treadmills. Products sales reps should keep their eye on include:

Land treadmill. Although some land treadmills are designed for dogs, they can be used for cats as well. Used for patients with minimal or managed pain, treadmills help increase strength, balance and proprioception (awareness of where the feet are placed).

Hydrotherapy. Exercising in water tanks or swim tanks helps build strength, muscle endurance, cardiorespiratory endurance, range of motion, agility and psychological well-being in patients. Whereas certain injured animals may have difficulty using a limb on land, they are more likely to do so in the water, particularly since limbs bear less weight in the water. In addition, water provides a source of stabilization and buoyancy, and its resistance helps with muscle strengthening and cardiovascular training.

Low-level laser. Whereas high-level lasers destroy cells and tissues, low-powered lasers help modulate cellular activity in tissue, thereby facilitating tissue repair and cell growth in skin, tendons, ligaments and muscles. Low-level laser technology also helps maintain cartilage use during periods of inactivity, as well as manage chronic pain.
Neuromuscular electrical stimulation (NMES). During NMES, low-level electrical currents are sent through electrodes, which are placed on the skin, to depolarize the motor nerve and produce a skeletal muscle contraction. A common treatment for orthopedic and neurological conditions, NMES helps control pain, reduce edema, strengthen muscles, reduce muscle spasms and prevent atrophy.

Therapeutic exercise balls and balance boards. Therapeutic exercises help maintain or improve joint mobility, and improve flexibility of muscles, tendons and ligaments.

Therapeutic ultrasound. When sound waves are applied to tissues, their energy is scattered and then reabsorbed, resulting in localized heating of deep tissues. Ultrasound heating helps with treatment of such musculoskeletal conditions as restricted range of motion due to joint contracture, pain and muscle spasm, and wound healing.

Thermotherapy. Although cryotherapy (cold) is generally used during the first 24 to 72 hours following surgery, after that, it often is used together with heat therapy. Benefits of thermotherapy include decreased pain, decreased inflammation and decreased localized blood flow, resulting in an increase in overall bloodflow.

In addition, veterinarian physical therapists are trained to perform massage therapy to increase blood flow, improve oxygen delivery to tissues, facilitate muscle recovery, reduce pain and more.
(Source: Peak Performance Veterinary Group, Colorado Springs, Colo.)

The rep’s role
Veterinary students are better trained in pain management today. As they become more knowledgeable on the issues, chances are they expect their sales reps to be aware of the latest trends. Reps should stay informed about new diets, supplements, medications and rehab technologies, and provide their customers with the literature and studies to back their products. They should ask their customers questions, listen to their concerns, and provide solutions that truly fill their pain-management needs. By building a foundation of trust with their customers, distributor reps will be in a better position to bring that over-and-above value that their customers depend on.