Featuring Demian Dressler, DVM and Susan Ettinger, DVM, Dip. ACVIM (Oncology), authors of The Dog Cancer Survival Guide

Dog Cancer Pain Control

Updated: November 27th, 2018

Pain is a very important part of dog cancer, since it is one of the main life quality negatives for a canine cancer patient.

However, not many guardians are aware of all of the tools in a veterinarian’s toolbox to help with pain.  In this post, we will look at both common and uncommon ways of helping dogs with cancer feel more comfortable and pain-free.


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It is important to know about these different tools, so if one is not working well, you may discuss another option with your veterinarian or oncologist. In addition, any intervention can create side effects, and a side effect may mean we have to change course.  Being your dog’s primary health advocate is an important part of the Guardianship philosophy discussed in the Guide. You will also find more information about signs of pain in this book as well.

One of the most common ways to help decrease both pain and inflammation is by using a drug class called the NSAIDS.  These are the Non-Steriodal Anti Inflammatory Drugs.  Common examples are Metacam, Previcox, Deramaxx, and Rimadyl.  These meds are suitable for mild to moderate pain.  Liver and kidney safety should be established for use with these medications with blood testing.  Metacam comes as a liquid, and the others are tablets, some of which are chewable.

The narcotics are also very commonly used.  The most common these days is Tramadol.  It is nice because in humans it has been shown to have some antidepressant effects, and it could be argued that some dogs with cancer may indeed be depressed.  This drug by itself at usual doses is good for mild to moderate pain.  At very high doses, it may be enough for severe pain, but the doses will usually cause a lot of sedation.  However, this medication can be combined with one of the NSAIDS above for a very nice pain control cocktail without many side effects. This drug comes in a tablet.

For lower grade and chronic pain, there are a couple of neurotransmitter modifier medications that can help certain pain syndromes.  These include gabapentin, amantadine, and Elavil.  These are better used for long term pain.  They can be combined with the other drugs above to smooth out and relax dog cancer patients. They come as tablets and in some cases liquid.


For more helpful information and tools, get a copy of the Dog Cancer Survival Guide


Some vets like Tylenol with codeine for their patients.  In my humble opinion, I don’t care for it as much due to the incidence of diarrhea, vomiting, and loss of appetite.  But it does indeed control pain very well in dogs.

Sometimes topical medications can aid in pain control, like lidocaine or benzocaine ointments, or cortisone-containing topical preparations.  I have used DMSO gel for a nice local anti inflammatory effect as well.

Fentanyl patches can be used for dogs in more severe pain.  These are applied to the skin and the narcotic Fentanyl is absorbed into the blood stream. They last for about 3 days, and do cause sedation often.  Fentanyl patches are suitable for more severe pain. They must not be consumed by the patient and disposal of the patch should be discussed with your vet.

Acupuncture is good for low grade to moderate chronic pain.

Icing, cold compresses, and hydrotherapy (running cool water over the area) can be helpful for painful, inflamed, or warm areas.  Warmth (compresses, hydrotherapy with warm water, etc) and massage are good for cold, stiff, sore areas of more chronic  low grade or moderate orthopedic pain.

I hope this helps,

Best,

Dr D

Discover the Full Spectrum Approach to Dog Cancer

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  1. Norene on December 21, 2018 at 10:53 am

    I just found out the other day that my dog has a liver tumor and I was wondering what would be good for him to take as a supplement because he is not wanting to eat the science diet l/d dog food. I have bn cooking him boil chicken and rice with carrots and peas, but I know that it’s not enough nutrients for him. My. Vet prescribed some metoclopramide HCL 10 mg and Gabapentin 100. He will be 14 year’s old in March and we rescued him when he was only 8 weeks old, I love him and just looking for answer for him to help him with his quality of life. Thank you.

    • Dog Cancer Vet Team on December 24, 2018 at 8:42 am

      Hello Norene,

      Thanks for writing! We’re not veterinarians here in customer support, so we can’t offer you medical advice. However, we can provide you with information based off Dr. Dressler’s writing 🙂

      In the Dog Cancer Survival Guide, Dr. D writes there are many things that you can do to help your dog, such as conventional treatments, diet, nutraceuticals, mind-body strategies and immune system boosters and anti-metastatics. Here’s a link to the Dog Cancer Diet PDF that readers of the blog can get for free : https://store.dogcancerblog.com/products/the-dog-cancer-diet

      There are many things that make a dog’s life great, from their perspective, and Dr. Dressle created a Joys of Life scale to help readers determine their dog’s quality of life. You can find out more on life quality in the articles below 🙂 :

    • Life Quality in Dog Cancer
    • Life Quality, Is My Dog in Pain?
    • Time and the Joys of Life in Dog Cancer
    • If you’d like to try some mind-body strategies, Molly wrote an amazing article on Magical Thinking and Dog Cancer that you may find helpful

      We hope this helps Norene!

      Warm wishes from all of us here! x

  • Laurel McClendon on December 8, 2018 at 4:35 am

    Hello, my dog Annie has bone cancer. She’s out of her pain meds. And her vet will not fill until Monday and it’s Friday. Why are people like that? They don’t care if my dog suffers. What can I do for her over the weekend? Thanks

    • Dog Cancer Vet Team on December 10, 2018 at 7:35 am

      Hello Laurel,

      Thanks for writing, and we are sorry to hear about Annie. We’re not veterinarians here in customer support, so we can’t offer your medical advice. However, we can provide you with information based on Dr. Dressler’s writing 🙂

      As Dr. D writes in this article, different types of pain require different types of drugs. In Chapter 17 of the Dog Cancer Survival Guide, Dr. D writes that acupuncture, pamidronate (for osteosarcoma), warm or cool compresses, and gentle massage may help with dog cancer pain– check with your vet, or holistic vet first, to ensure that these options can work alongside your girl’s current treatment plan.

      We hope this helps!

  • susan townshend on September 20, 2018 at 5:48 am

    my 8 year old dog has secondary cancer and is taking tramadol for pain relief .is it kinder to put her to sleep.

  • LovesJESUS My GOD on April 14, 2018 at 10:49 am

    I had my dog on it for over 8 months. He had cancer, he was 16 years and 4 months old when we lost the battle thursday. I had to put him to sleep. I had just ordered his latest meds, so I have over 100 tabs that they won’t take back. never opened. Anhyway They were his saving grace. after just a week the cough went away, and he didn’t cough until the night before I had to have him put to sleep. Those along with extra support of cancer herbs and supplements, and a detox soup I would make him. He was also on a non GMO food/ Fromms. He got losts of herbs, and love. The hydrocod/homoa tabs though kept his cough and pain at bay. But I do believe the tumeric and other supplements helped too.

  • Jackie on March 15, 2012 at 2:59 pm

    I saw you on facebook by one of the facebooker who share your article.
    My dog is dying of cancer in her lungs. she is gagging and coughing. How can I help her to feel comfortable? Thanks jackie

  • Dori Demarbieax on March 8, 2012 at 2:11 pm

    If my dog is already taking Prevacox, is it safe to also add the Apocaps? Would it be too much anti-inflammatory ingredients in the mix?

    • Dr. Demian Dressler on March 16, 2012 at 12:55 pm

      Hi Dori
      for information about Apocaps, see:

      Can I give Apocaps with prednisone, prednisolone or other anti-inflammatory agents?

      You can, but with some caution. Apocaps has an anti-inflammatory effect, so we recommend reducing the dose of Apocaps by half if you are using prednisone or any NSAIDs.

      I would read the rest FAQ page too!
      Please be sure to have veterinary supervision with all treatment steps for your loved dog…
      Dr D

  • Gordon Sandelier on March 8, 2012 at 5:35 am

    I lost my dog to lymphoma and sugar. We treated him for both. We had to put him down after six months. he was 10yrs. I learn alot from your E-mails.
    Thanks

    • Dr. Demian Dressler on March 15, 2012 at 4:06 pm

      I am sorry Gordon. Sending our sympathy
      Dr D

  • vicky on March 7, 2012 at 10:10 am

    FOR PAIN, I HAVE USED RIMADYL-AND IT WORKS. THE PROBLEM IS I AM ALMOST OUT OF IT 3 MORE HALF A TABLET FOR A 50 LB DOG. HE IS 17 YRS OLD AND HAS COPD AND SKIN CANCERS–THAT A FEW OF THEM HAVED TURNED BLACK AND ONE –BLEEDS NOW AND THEN. HE ALSO HAS FATTY TUMORS. I HEARD—IBUPHROFEN–ADVIL IS THE SAME AS RIMADYL. CAN I USE THAT FOR HIM–SINCE RIMADYL IS SO EXPENSIVE–OR ARE THERE ANY ALTERNATIVES–I CAN USE–I AM ALSO USING CURAMIN–BY(TERRY NATURALS BRAND) STRONGER THEN OTHERS. CAN YOU PLEASE HELP ME AND HIM (BLUE) I KNOW HE IS IN PAIN–BECAUSE HE PACES SO MUCH! THANK YOU SO MUCH!!! vicky