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

Pain in Dog Cancer and Life Quality

Updated: December 13th, 2018

Many have concerns their dog may be in pain.  And rightfully so, since pain is a definite negative.  Pain control is a massive topic all by itself, and it is by no means strait forward.

There are different kinds of pain. Sometimes  dull, throbbing pain happens in cancers like osteosarcoma (bone cancer).  Severe pain in the abdomen can occur with bleeding hemangiosarcomas (spleen tumors). Mast cell tumors likely produce burning pain in the skin or in other locations. Pressure-associated pain can happen with nasal tumors like fibrosarcomas.  Bladder tumors like transitional cell carcinomas cause burning and irritation leading to urgency to urinate.

There are different kinds of pain, and they respond to different treatments.  We have tablets, capsules, liquids, injections, infusions, transdermal patches, cold, heat, acupuncture, physical therapy, mental techniques, and more.

The best approaches to pain management are always multimodal, which means we attack the problem from different angles to achieve a better result. This is true for the drugs your veterinarian prescribes too.  Many times lower doses of multiple drugs are a lot better than higher doses of single drugs.

The perception of pain not only involves the tumor or cancer itself, but also what the brain and spinal cord do with those signals.  In some cases, pain can actually be amplified above and beyond what is expected by what is happening in the central nervous system (previous pain, anxiety, fear, depression, and others). These areas can be focused on too as part of a total pain control plan.

By combining approaches from different angles, you get a better result.  Less pain, better life quality! Ask you vet about combining different approaches.

Let’s look at more life quality topics in the next post.

Best to all,

Dr Dressler


Discover the Full Spectrum Approach to Dog Cancer

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  1. Susan Kazara Harper on March 11, 2014 at 2:09 pm

    Hi Catherine, I know this is difficult; you don’t want your girl to be uncomfortable. There are a couple of things to consider. It’s great that you have an eye specialist who can help keep track of her condition. It’s possible that your girl squeals when the others bump into her because she feels vulnerable, and/or because she can’t see very well. She may also be picking up on your loving concern and feeling both her years and her condition, whether or not pain is involved. You know her better than anyone, and better than the best vet. Do you have any way to take a short video of her when she exhibits this behaviour? A smart phone, or a friend or family member with a phone who would do this for you? It can be invaluable for your vet to see what you see. If there is pain present there are often other signs like panting, distancing herself from activity, lack of appetite, reluctant to play or enjoy things etc. And sometimes there isn’t. Our dogs are masters at masking signs of weakness. Trust your gut, but please don’t get wrapped up in a lot of worry which won’t help either of you. All the best, Susan

  2. Catherine brown on March 11, 2014 at 2:42 am

    Hello, I have a very old terrier who has a tumour behind her eye. Her eye is red, bulging and cloudy. I have taken her to an eye specialist last year and he said that she may need to have it out in the future but she wasn’t in any pain. She must be in pain because she squeals when the other dogs bump into her. Is my dog in pain? the vet says not but she looks and sounds in pain! anyone had experience of this?

  3. Nancy on December 18, 2013 at 6:19 am

    My 10 year old Cane Corso Nico was diagnosed with bone cancer in his lower jaw. They say removing it would just make it grow back, so how do I manage his pain and his diet as this progresses? As of now he is on Tramadol but with this breed they are very pain tolerant so it’s hard to tell if he is in pain. Today he is still eating normally but sleeping more. Any advice would be helpful since my vet refereed us to NC State Vet School Oncology. They wouldn’t even talk to me they wanted me to bring him up there which is a 3 hour drive one way. All I wanted was a medicinal plan for him. They said they’d call my vet, that was yesterday nothing yet. I’m so frustrated because they are one of the top rated Vet Schools in the US and they are not help!

  4. v on May 22, 2013 at 7:53 pm

    Dear Dr Dressler,
    My 12 year old Westie lost use of his hind legs in October. Vet said it’s most likely spinal cancer though he recommended not doing biopsy. He has since lots alot of weight. Lately has has some spasms across his back when he is resting. He had this before he started on Gapabentin but now it’s more.

    I know he is probably in pain when we touch a certain area, and when he gets up at night to adjust to another position. But other than that, can’t tell. He’s still interested in food, people, other dogs.

    He is currently on anti-inflammation medication, meloxicam and Gabapentin. However a doctor friend of mine said for human patients Gabapentin is usually not enough. How do I know if he needs opioids or something else? In your experience, what kind of pain medication is best for spinal cancer dogs?

    And is there anything I can do to alleviate side-effects of all these?

    I’d like to do some research before going back to the vet.

    Thanks so much for caring for cancer dogs,

  5. Jolene on April 9, 2011 at 12:21 pm

    My dog Tyler too, has been diagnoised with bone cancer. I have her on tramodol and galvapentin three times daily. I also was given an option to have a nerve block done on her to help relieve the pain. I like everyone else I’ve read about, can’t bear the thought of losing my bestfriend. She is 15 year old lab/mix that was thrown from a car, my mom stopped to show her to me before she took her to the pound they had for stray animals around here, I just lost my other dog to kidney failure and wasn’t really ready for a new one yet. She won my husband and I over quickly. thanks for listening

    • DemianDressler on April 13, 2011 at 10:50 pm

      Dear Jolene
      thinking of you during this hard time.
      Dr D

  6. R on April 22, 2009 at 12:04 am

    My heart too has recently been tested. My 11 yr old Yellow Lab, just finished 15 weeks of chemo for Multifocal Lymphoma. I was breathing a sign of releif when he was finished a week ago, & in remission – & doing GREAT! Except for sepsis after 1 round of chemo in Feb, he never suffered nor had any pain.

    Fast forward to this week. His 1/2 brother, my 9 yr old other Yellow Lab, starting having what appeared to be a stroke, or maybe seizures. HORRIBLE episodes (4 in 6 days …. 2 really severe ones, 2 minor ones) of screaming in pain, being sort all contracted, crunched up – it looks like almost some sort of nerve compression in his neck & back … or something like that. Its pathetic to witness & Im terrified that he is in horrible pain. Im afaid as well, the leave him alone & have something happen with out me there for him. Upon vet examination, they found a bunch of small masses around his anus. The 1st thought was this was where the pain was coming from (as he also cannot sit down when he has an episode). 3 days later, my own vet saw him, & he found his back popliteal lymph node was the size of a football. Aspirate showed MAST cell 🙁 Sana already HAD MAST cell, 3X, 3 yrs ago, & all tumors were removed with all clean margins. He has been VERY healthy & active since. No one can beleive he is almost 10.

    The HUGE fear is that the cancer has either spread to his brain, causing these neuro type symtoms/episodes, or there is an internal mass or something, pressing on a nerve, his spinal cord, or somewhere, causing all this pain when the episode happens. Pathology came back today on the MAST cell in the leg, we are still awaiting pathology on the small anal masses. My vet said hopefully those are benign – or they too could be MAST cell … or God forbid, another kind of cancer as well.

    We dont know if its all related, or if the neuro/pain stuff is a totally seperate issue. I dont EVER want him to be in any pain – but I cant just decide this isnt treatable right now. If it IS a tumor causing the neuro issues, then chemo may help reduce the tumor, & the pressure on a nerve or WHATEVER it is thats causing it, then I need to try.

    This is all new b/c my Lymphoma dog really never suffered. This IS suffering when he has the painful neuro-type epidoses … but as I said, its only been 2 bad ones (10-15 min) in 6 days now. But Im terrified it will increase. A steroid shot seems to have helped & he is on Tramadol Q 8 hours.

    If anyone has any words of advice, Id be grateful. Thank you

  7. Sharon Richardson on April 13, 2009 at 5:39 am

    We have an 11 1/2 year old pug and he has been vomiting (now stopped)watery diarea,not eating,very tired but tail up most of the time.has has xrays,bllood work ,meds but seems now to have bright yellow urine and dark watery stool.Will not eat.We’re taking him to vet today again .How much should we continuie to do since the vet hasn’t found any thing with all the test.Have’nt done an ultasound but we feel if it is cancer at his age we would not want him to go thru that.What should we do?We love him so much and we can’t bear for him to be in pain.

    • Dr. Dressler on April 15, 2009 at 10:39 pm

      I must say that there may be other things causing the problem excluding cancer that could be found with the ultrasound.
      I will address your question in more detail in the webinar:
      Short story: go for the ultrasound and then reassess if you can..

  8. Donna on April 11, 2009 at 12:11 am

    Well the vet was realy pleased yesterday, the wound has finally closed over and is healing…which is about the best news we could’ve got. She is saying a few months of quality life is left in her as she is going too the toilet normally again.
    No medication to given as yet, as she has no symptons of escess hisatime but i have them here at home for when the time comes.

    We are crossing everything she see’s a final summer with us but with these types of tumours everything can change in a matter of days.

    thank you so much for having posted on this site, as in the hundreds of web pages i have found, no one that was in the same position.

  9. Chris on April 10, 2009 at 3:17 pm

    Thank you so much Donna – it is a relief to be able to talk to someone who knows and understands what we’re going through. I stayed with our little man right to the end – call me stupid but I didn’t want him to be scared – both me and his “grandma” were there – my poor husband had to leave the room.

    I wish your family all the best. I sincerely hope that your little buddy is able to carry on for a long time to come.

    I don’t know if the vet has suggested this but try 3 tablets of 25mg. benadryl three times each day (8 hours apart if you can manage it – our little man weighed 75 ibs so that is what I’ve based the amount on guessing that your little buddy is close to the same). The mass cells release huge amounts of histamine into the body and cause an enormous amount of discomfort.

    Once again – I appreciate the contact and your tears – between us we’ll soon have a river.

  10. Donna on April 10, 2009 at 3:11 am

    i’m so very sorry to read that you’ve said goodbye to your buddy. I know that i have that decision to make and i’m crying for you and me at the same time.
    We have the vet today, they have mentioned steriods to us but there is no way my dog can have them when they wound isn;t healing.

    I realy feel for you and you husband.

  11. Chris on April 9, 2009 at 7:26 pm

    Donna – I found out that the type of cancer our little man had was indeed causing him pain, he was still eating an drinking but that was the only way in which he remained normal. He was having trouble breathing because of the prednizone he was taking and the other drugs were making him tired, and unwell and so we made the decision. We said goodbye to our little man today at 9:30 a.m. My heart is bleeding.

    We made this decision based on just how much we loved him. I didn’t want him to go through liver or kidney failure or wait until it moved into his lungs and suffer an agonizing death.

    I am so very sorry to hear of your friend – I’m crying for us both right now.

    Your buddy’s wound may not heal – Mast Cell has that effect. If he’s not going to the washroom then please call your vet – I was told that once it got into the lymph nodes it traveled extremely fast – once again I am so very, very sorry – if I could spare anyone the agonizing pain that my husband and I are experiencing I would.

    My husband and I will never attempt to replace our little boy as he was so very unique that it would just not be possible – I’ve been “looking” for him all day – and it has ripped out my heart everytime I realize I’ll never see him again.

    • Maria Neal on February 2, 2011 at 6:21 pm

      I have a wonderful son named Hydro who’s given me so much unconditional Love, he’s 6 yrs old. But he’s my baby. I ordered the Apococaps and began giving them to him on Saturday. He was diagnosed with lymphoma cancer just alittle bit after Christmas I ordered the Dog Cancer Guide, which I really would recommend to all of my friends, it such a GREAT book written with unconditional Love for all those in need of this information. It is one of the best decisions I ever made was to purchase this book. It has alot of wonderful knowledge and has helped me tremendously care for my Hydro. When I feel depressed about the things that are going on with Hydro I turn to the book to remind me and keep me on track emotionally so I can focus on his quality of LIFE. Hydro has his up and down days, I started feeding him raw food it has helped, He’s on prednisone 20 mg twice a day and I reduced the Apococaps to 6 a day I am giving him the meds 12 hours apart, Hydro is doing much better everyday. We are doing Reiki and it has been a blessing. We are also doing crystal healing in his water and this has help tremendously. With a combination of therapies and apococaps and the prednisone his tumors on his neck are decreasing in size. He is more active and now wants to start taking walks agian. My intention is to heal my dog with the various treatments. God is a good God and I know that he will heal. Thank you Dr. Dressler for being such a kind and caring individual and helping us dog Lovers with your knowledge and unconditional LOVE. You truly are a very special person and I want to personally THANK YOU for all you do. With kindness and unconditional love Maria Neal

      • DemianDressler on March 8, 2011 at 9:36 pm

        Dear Maria
        thank you so much for your kind words. I truly appreciate them.
        I hope Hydro is doing okay
        Dr D

  12. Donna on April 9, 2009 at 12:01 am


    I have just found my self in the same position as you and you best friend. My lab is 7 nearly 8 years old and on monday i got the devastating news that she has a grade III mast cell tumour that is already affecting the lymph nodes. The tumour is attached to the chest wall in the muscle and there is no way to remove it, we have went for pallative care.
    I have the same questions as you. I know my dog is in pain, the stopped her painkillers to see if she was coping, but she’s eating and drinkin loads but not urinating very often. And is it kinder to end things before i no longer know the dog? And her wound isn;t healing, thats 2 weeks since her op and part of it is still open…

  13. Chris on April 7, 2009 at 7:50 pm

    My best friend was recently diagnosed with Stage III Mast Cell Cancer, he has multiple invasive tumours, they’ve removed what they can without amuputation. We love our “little man” and don’t want him to be in pain – he’s constantly licking the remaining tumours (and there are alot +12). I asked about these “lumps” previously and was told that he probably just had really bad arthritis (he’s taken to the vet regularly as well) I don’t know how everyone missed it – I can’t describe how we feel – our hearts are broken and the guilt is tremendous – we’ve let down our little buddy and now all we want to know is just how much pain he’s in – if it’s alot (and I’d appreciate a very straightforward answer) then we’ll make the decision that needs to be made – he’s 8 years old and such a good dog it’ll be the hardest thing I’ve ever done in my life. He’s on medication right now – simply palliative care as we’ve made the decision not to prolong his suffering. I’m very worried that there will be alot of pain from secondary problems, ie. gastro, etc. He’s still eating and appears happy – just tired – lots of meds. I guess I’m looking for two answers – 1 what would his pain level likely be? and 2 – should we be considering ending things for him before he’s in agony? Please – any information you can give me would be appreciated.

  14. diana on February 1, 2009 at 10:00 am

    m y dog ,they say he has cancer behind the eye,also lump on top of head eye dosent look good closed nastey if it is cancer what kind???????can you help me

  15. Pain in dog cancer and life quality | ozwj.com on January 15, 2009 at 4:19 pm

    […] Pain in dog cancer and life quality […]

  16. Dr. Dressler on August 22, 2008 at 5:53 pm

    Yes, it posted on the 22nd even though i clicked “post” on the 21st, sorry..D

  17. Lori Michaelson on August 22, 2008 at 4:18 pm

    Can’t find the one you are refrerring to with that date (8/21/08) — same day as your above post to “se the next blog post….”.

    Did you mean the one really dated 8/22/08 covering chemos, intralesional triamcinolone, etc?

    Lori 🙂

    • Layla on July 16, 2010 at 1:27 am

      My dog has been diagnosed with bone cancer he has a large tumor on his shoulder, we have been giving him 6 50mg tramadol in the morning with 1 and half tablets of previcox, and 6 tramadol at night, he still wants to go for his walk the last couple of days starting to limp again, im heart broke he is my best freind and only 8yrs 8mths old, he is a big rottwieler, and such softy, i love him so much, he must be in alot of pain even on this amount of medication, everyone is telling me he will let me know hes had enough? he still eating and drinking and happy to see me which makes it so hard!! how much pain is my boy in, and is it truely the wright time to set him free?? please be honest, i need help as my husband works away and back end of july, but i realing think this is his last wkend. help

  18. Dr. Dressler on August 21, 2008 at 10:57 pm

    Lori, see the next blog post (8/21/08). I hope it helps you and your dear Golden friend!!
    Warm Regards,
    Dr D 🙂

  19. Lori Michaelson on August 21, 2008 at 4:06 pm

    I am glad that you brought up mast cell tumors/cancers because my husband and I have a beautiful 9 1/2 yr-old female Golden Retriever who is both an early retired service dog as well as a full-fledged family member and only daughter to my husband and I. To our surprise and absolute horror — she was diagnosed on Aug 7th with Mast Cell Carcinoma – Grade 3. The only sign was a growth on her tummy that went unnoticed for numerous reasons. There were no outward signs like her licking the area, etc.. It was pride pickling invisible to the naked eye and pretty much had to be felt for diagnosis. She had just been to the same doctor exactly 5 months prior for her shots and he always spends a great deal of time feeling around her underside. And he felt nothing then.

    As soon as WE noticed this flat, somewhat scaly growth on her underbelly we called our veterinarian for an appointment right away. We took her in on July 30 and our veteran Veterinarian (25-30 yrs) shaved the entire area for a better look and then came to us saying that, from the looks of it, it was most likely nothing “bad” but certainly something that should be removed. He is not one to hold back information to make one feel good so that was not the case. He did surgery on the same day and when we came to pick her up — he told us that he had to go a little deeper than he thought he would “to get it all” but that was all. There were about 25 or 30 stitches to be removed 10 days – 2 weeks later. Our girl was not even phased by their presence either.

    He wanted to have a biopsy done either way but, just prior to going to get her, my husband and I did not think we wanted to go ahead with the biopsy because if it WAS cancer we would not allow any further surgeries (any more openings to ANY species including humans) make it “Oh happy day” for cells to metastasize much quicker than leaving well enough alone. In addition to the money factors of further surgery and her age. And if it was NOT cancer — waste of a biopsy.

    But our veterinarian made many good points as to why we should go ahead and do it anyway. And now, if she gets sicker sooner or later, at least we will know what it is from. Our vet was super surprised at the pathology report and said that it may not have even been there a month ago with as rapidly as these tumors spread.

    Anyway, as you know, Goldens are very stoic and we have no idea whether she is in pain or not. I think I had heard once that if a dog pants alot — that may indicate pain or discomfort. Well, she always pants alot here in Tucson, AZ summers so we do not know if this is a sign or not. I remember noticing that she was panting more just before summer began (and since) but I have no idea whether if it is related or not and I can beat myself up until I am blue about wondering “back then” if I should have been more attentive.

    Other than that there are no outward telltale signs. She has slowed down significantly over the last 10 months because she has hip dysplasia AND she began exhibiting signs of shoulder or elbow dysplasia or arthritis by limping — favoring her front right leg. Ever since her diagnosis of hip dysplasia almost 5 years ago she has been on Piroxicam every other day which has helped her greatly up until about 10 months ago. Five months ago when we were at the vet I asked him if there was anything “more” besides the glucosamine/condroitin supplements which seemed to be doing nothing for her “new” front leg joint pain.

    Ironically he said he had been having an ongoing debate with his colleague in the same office as to whether glucosamine/condroitin was more effective IN DOGS or Omega-3s were. My veterinarian was in favor of the latter so we started her on those. They did not do anything.

    I remembered he had also mentioned COSEQUIN but only in passing. I told my husband about this and he did some research finding that it was basically glucosamine/condroitin so there was no sense in trying it.
    Well, I could not stand to see her limping so I ordered three bottles of it online. Within 30 days she was no longer limping! So we have kept her on that.

    Like humans, I think it all comes down to what works for the individual. But now that I know that she has mast cell grade 3 carcinoma — we have no idea how many weeks or months or years she has left. The veterinarian said he removed everything that was there but did not sugarcoat or hide the fact from us that it was an infamously rapidly spreading form of cancer. Which will lead me to another post regarding the thread on omega-3 fatty acids.

    Thank you for reading this long post!

    Lori Michaelson

    • Cristina on April 1, 2010 at 2:58 am

      my Brandy is a mixed lab almost 12 years old…I have always loved her with all my heart. She has been my baby before i had my son and she has remain my baby after he was born…to this day she is still my little girl. A little less then 2 months ago she was diagnosed with a very aggressive form of mammarian glands cancer and they found that she also has a tumor in her vagina which was causing her bleeding. The vet believed that given the aggressive form of the cancer any type of therapy would be useless. They could remove the mass inside her vagina to help the bleeding, but he thought that such an operation would cause her much stress and in the end it wouldn’t help.
      so we settled on pain meds.
      she has been pretty happy for these few weeks but in the past few days she is deteriorating. This morning she just cried the all morning even after i gave her her meds. I called the clinic and they told me to bring her in because it might be time. I thought i could have died right then and there….but the doctor looked at her and decided to give her a different meds and see if it could help her. She is sleeping now, i just love her so much and I don’t want her to be in pain.

  20. Dr. Dressler on August 20, 2008 at 5:16 pm

    You make a great point. How can we really be sure? I cannot say if another PERSON feels the same pain as I do, or see the same color of blue as I do. We have to do our best to extrapolate and make assumptions based on the information we have at hand. So, from an abstract standpoint, forgetting about dogs for a moment: when you use the label (word) in discussing the color blue, I make an assumption that I EXPERIENCE the same blue that you do. We can certainly agree that something is blue based on our mutual communication, but the actual experience…who knows?
    (Another point is that not all cancers cause pain, I was referring to those that do.)
    Okay, so more directly, when a skilled vet makes a read on what an animal is experiencing, we use labels other than words to gather information, since the dogs don’t speak. The labels are clusters of observations that are grouped in our heads that refer to our own experiences projected onto the dog. Again, the ability of persons differ in their sensitivity to detect these observations. The hemaniogsarcoma pain that I have seen in some cases of this cancer in the spleen happen around the time the tumor is rupturing. I gather it is deep (because I have to press deeply to elicit a pain response), and dull (because they tense their abdomen and look at me when I palpate instead of pulling away, biting, or jerking as if it were sharp). I then reflect on myself and use what my reactions would be when experiencing a certain type of pain. So the experience that is described is an assumption, just like you experiencing the color blue as I do is an assumption.
    When mast cell tumors cause pain, they release histamine, cause substance P release and other chemical signals, which is what your body releases when you get stung by a bee. These dogs lick, chew, and rub the mast cell tumors that cause discomfort. Bladder cell tumors cause bladder inflammation, just like a bladder infection. When bladder tumors cause pain, these dogs strain to urinate, urinate small amounts frequently, and posture for long periods with no urine being produced as they have emptied their bladder long ago. These are classic signs of bladder irritation, which humans describe as burning and increased urgency to urinate.
    So we take information from lots of sources to formulate the specifics on what a dog feels. We also rely on intuition and empathy.
    Hope this answers your question 🙂
    Dr Dressler

    • exendymep on February 28, 2010 at 10:40 am

      He gripped Tykirs hip, lest they both topple from the strength of his thrusts. Hed tried to get his men to turn back, then, when they wouldnt, to fight. She turned down the wide corridor that stretched past the arched entrance to the gardens. Radins mental warning didnt help. The one she wanted to lash at was herself. He thumbed a tear from her cheek. Gala knelt at her side, a reassuring hand on her shoulder. That was, perhaps, the most frightening part of the spell. She needed to do this. This hadnt been part of her agreement with Radin. Through a veil of unwanted tears, she glared at the receding door. Kneeling in the middle of her mattress, she hurled a pillow at them. Shouldnt you all be with Nialdlye? What shed done before had only amplified it. Chuckling, Brevin slid arms around Tykirs chest. None of the others had been carved to look like a reedy young tree. She could have enslaved the raedjour. That, and you havent asked to talk to me alone before. We arent exactly a monogamous society. His strange eyes shone but didnt swirl.

  21. Lori Michaelson on August 20, 2008 at 1:32 pm

    As you describe the different types of pains associated with different types of cancers – HOW can YOU know if it is “burning” or “throbbing” or “pressure associated” or “sharp”, etc. when an animal can’t talk? These are very specific pains but an animal cannot tell you if it is sharp or burning, etc. As a human with a severe disability doctors and nurses have always asked me to rate and describe my pain and it is difficult enough for me let alone an animal that cannot explain pain. I would have to say that the only REAL way to know if there is any pain at all (let alone the type) is by any different behaviors in the animal as you go on to describe. But I am still curious as to your second paragraph. 🙂

    • Renee Santos on August 25, 2009 at 5:06 am

      My 9 year old mixed shepard and “sooner” beloved dog was just diagnosed with “lung Cancer”.She lives in a non-smoking household.Please help me with any suggestions on her care.Thanks,Renee santos

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