At Harrisburg Regional, we spend an insane amount of time and effort to prevent and treat pain in our patients.

Let’s take the example of Tucker, a 9-year-old Lab, who had major knee surgery today – a TPLO – to address a torn ACL. And let’s count the ways we used to help with his pain management before, during, and after surgery. Please note that this blog pertains to a dog, and our pain management is very similar to cats.

1. Pain management before surgery
Tucker received a pain medication (gabapentin) (#1) and a tranquilizer (trazodone) the night before and the morning of surgery. Shortly before surgery, he was given doggy morphine IV (#2). Then he was given IV fluids that deliver doggy morphine (#3), one drop at a time.

This has 3 important benefits:

  • It allows us to use much smaller doses of medications, and therefore it decreases potential side effects.
  • It prevents the need for repeated injections throughout the whole process.
  • It provides constant pain relief, without the peaks and valleys we commonly see with medications given by mouth.

2. Pain management during surgery
Half of a dose of carbocaine (#4), a local anesthetic, was injected into Tucker’s knee. This is similar to what we get at the dentist to numb our gums.

The IV fluids & doggy morphine (#5) were continued throughout the surgery. At the end of the surgery, Nocita (#6), a long-acting local anesthetic, was injected all around the surgery site, which it numbs for 3 days. Then the second half of carbocaine (#7), the local anesthetic, was injected into the knee.

3. Pain management after surgery
After surgery, carprofen (#8), an anti-inflammatory drug, was given as an injection under the skin. Then 2 pain medications were sent home: carprofen (#9) and gabapentin (#10).

So we used 10 different ways to help Tucker remain comfortable.
As I always say, “pain is not acceptable.”

Unfortunately, we can’t take the discomfort away, at least we can keep patients pain-free.

While I would never claim this is a fun experience, I think it’s fair to say that it’s hard to provide more pain relief than that. And the fact is, we hardly ever have a pet owner ask for more pain meds.

A discussion about pain management is also a great reminder that 90% of the above modalities were provided by our wonderful nurses, who are a critical part of patient care and patient comfort.

If you would like to learn how we can help your pet with safe surgery, safe anesthesia, and excellent pain management, find more info at

Phil Zeltzman, DVM, DACVS, CVJ, Fear Free Certified