Pain relief for toothache in dogs and catsand what not to give from your medicine cabinet

What can I give my dog or cat for toothache?

The short answer: whatever the vet has prescribed for your pet specifically. There are painkillers developed and tested for dogs and cats, but even these are chosen individually — after an examination and often after blood tests.

When choosing, I consider whether the patient is a dog or a cat, how much it weighs, its age, whether its kidneys, liver and stomach are healthy, what medicines it is already taking and whether anaesthesia is planned soon. The decision for an older cat with kidney disease and for a young dog will differ, even if the same tooth hurts.

Why human painkillers are dangerous for pets

Dogs and cats break down and eliminate medicines differently from people. A drug that helps a person with a headache can stay in a pet’s body much longer and build up to toxic levels. A human tablet is also made for a completely different body weight, and there is no safe way to split it “by eye”.

• Ibuprofen, naproxen, diclofenac and other human anti-inflammatory painkillers (non-steroidal anti-inflammatory drugs, NSAIDs). In dogs and cats they can cause ulcers and bleeding in the stomach and intestines and acute kidney injury, and in larger amounts liver or nervous system damage too. Naproxen is eliminated particularly slowly in dogs.
• Aspirin (acetylsalicylic acid). It irritates the stomach and impairs blood clotting, which is especially undesirable before dental surgery. Cats eliminate it very slowly, so they are poisoned more easily.
• Paracetamol (acetaminophen). For cats, one of the most dangerous medicines in the house: their liver cannot detoxify it, and even a small amount damages the red blood cells so that the blood carries oxygen less well. In dogs it damages the liver; whether it is appropriate at all, and in what amount, is for the vet alone to decide.
• Combination products: cold and flu powders, headache tablets, painkilling creams, gels and patches. They often contain the same substances. A cat can be poisoned simply by licking a painkilling cream off its owner’s skin.
• Medicines prescribed for another animal. The drug and the amount were chosen for that particular patient. Something your vet prescribed for the dog can be dangerous for the cat.

What to do if your pet has already swallowed a human medicine

Sometimes an owner has already given a tablet without knowing the danger, or the pet has found one itself. In that case act straight away:

Warning signs include vomiting (sometimes with blood), black tarry stools, refusing food, lethargy and increased thirst, and in cats after paracetamol, greyish-brown or bluish gums, laboured breathing and swelling of the face and paws. But do not wait for these signs: the sooner treatment starts, the less harm the medicine can do.

1. 01

   Do not wait for signs

   Poisoning can show itself hours or even days later, once the stomach, kidneys or liver are already affected.

2. 02

   Phone a vet

   Your own vet or the nearest 24-hour clinic. Say what the medicine was, how many tablets may be missing and when it happened.

3. 03

   Take the packaging

   The box or leaflet helps the vet quickly work out which substance, and how much of it, has been swallowed.

4. 04

   Do not make your pet vomit yourself

   Salt, hydrogen peroxide or fingers down the throat can do more harm than good. Whether the stomach needs emptying is for the vet to decide.

Why a painkiller does not treat toothache

Toothache is a signal that something in or around a tooth is damaged. Most often it is a fractured tooth with an exposed pulp (the living core of the tooth with its nerves and blood vessels), pulpitis and an abscess at the root, periodontitis with loose teeth, or, in cats, tooth resorption (TR). A tablet removes none of these causes.

A painkiller only turns the signal down. When it wears off, the pain returns because its source is still there. And while the pain is dulled, the process continues: the dead pulp becomes a source of infection, the bone around the root breaks down, and swelling or a draining tract appears.

There is also a less obvious trap: on pain relief your pet eats and plays again, and it seems as if everything has passed. The examination gets put off while the tooth keeps deteriorating. So pain relief before treatment is a bridge to the procedure, not a replacement for it.

Antibiotics do not relieve toothache either: they act on bacteria, not on pain. I explain when antibiotics are genuinely needed in Antibiotics for dental disease.

What you can do at home while waiting for the examination

A tooth cannot be treated at home. The aim is to avoid making the pain worse and to make eating easier:

How to tell that it really is the teeth that hurt, I describe in detail in Signs of tooth pain in cats and Signs of tooth pain in dogs.

1. 01

   Contact the vet

   Describe what you have noticed and arrange an examination and consultation. If you are not in Kyiv, start with an online consultation: photos and videos help judge how urgent it is.

2. 02

   Offer soft food

   Wet food or soaked dry food at room temperature, in small portions. Do not force your pet to eat.

3. 03

   Remove anything hard

   Bones, antlers, hard treats and toys, tug-of-war games — until the examination.

4. 04

   Keep out of the mouth

   Do not force the mouth open, wiggle the tooth or lance a swelling: it is painful and can spread infection.

5. 05

   Watch and take notes

   How your pet eats, which side it chews on, whether it drinks, whether a swelling is growing. A short video at mealtime is very helpful at the consultation.

How pain is managed during dental treatment

Dental treatment is painful, so pain relief is a plan that starts before the procedure and continues after it. Treatment and dental radiography are carried out under general anaesthesia: your pet is asleep and feels nothing, and pain is controlled at every stage.

Which nerves a local block numbs and how they reach each tooth is shown on a diagram in How a dog’s and cat’s mouth works.

How we prepare pets for anaesthesia and monitor them, I explain in General anaesthesia for dogs and cats: is it safe? and on the page Anaesthesia in veterinary dentistry.

1. 01

   Before the procedure

   At the examination and consultation I assess the pain and, if it is severe, prescribe pain relief to bridge the time until treatment. Pre-anaesthetic tests help choose medicines that suit this particular pet.

2. 02

   Multimodal analgesia

   We combine several medicines that act on different parts of the pain pathway. Pain is controlled better this way, and less of each medicine is needed. Pain relief starts before the first painful step.

3. 03

   Local nerve blocks

   Once your pet is asleep, a local anaesthetic is injected next to the nerve that carries sensation from the treated area. The block switches off pain from that area during the procedure and for some time after waking, and less general anaesthetic may be needed.

4. 04

   Waking up

   Your pet wakes up under supervision. We assess pain from behaviour, posture and facial expression and add pain relief if needed.

5. 05

   At home

   I give you a pain-relief plan: a medicine chosen for your pet, for how many days, and what to do if something goes wrong.

Pain relief at home after the procedure: how to give it properly

After an extraction or other procedure the pain is real, even if your pet does not show it. To make sure pain relief works and does no harm:

• give the medicine exactly as prescribed: at the same time each day and for as many days as the vet said;
• do not stop pain relief because your pet “seems fine”: a normal appetite does not mean it is not in pain;
• do not add anything of your own — no human medicines and no leftovers from previous treatment;
• keep to soft food for as long as the vet advised;
• if vomiting, diarrhoea, black stools, refusal to eat or lethargy appear, contact the vet the same day: they will tell you whether to continue the medicine;
• if your pet will not take a tablet or spits it out, do not quietly skip the dose — ask what to do.

Once the cause of the pain has been removed, many owners notice their pet becoming more active and eating more eagerly — and only then realise how long it had been putting up with the pain. I explain why in Why pets keep eating even with diseased teeth. For feeding and stitches, see Aftercare following tooth extraction.

Where to start if your pet is in pain

Start with an examination and consultation: I will find what exactly hurts, prescribe pain relief until treatment if it is needed and explain the plan. Every tooth can only be fully assessed under anaesthesia with dental radiography, following the COHAT protocol. If you are not in Kyiv, you can start with an online consultation.

Frequently asked questions