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The APMC is a veterinary referral practice located in the Buffalo, NY area devoted to improving the quality of our pets' lives while also increasing the time we have with our furry loved ones. To achieve this two part benefit we focus on two problems: pain and weakness. We coordinate several related disciplines; advanced anesthesia, advanced pain medicine, cancer management, physical rehabilitation therapy, myofascial and acupuncture needle therapies, as well as herbal therapy.
Most doctors lack the knowledge needed to treat tough pain and weakness.        
Pain pathways and muscle are no different than joints, heart, or eyes; life takes its' toll and these systems often fail us and our pets.        
Pain and weakness can have a profound impact on quality of life and longevity. Pain and weakness can be the reason we lose a pet.        
Timely intervention is the key to optimal outcome. The more severe and the longer standing the problem, the tougher it is to treat.        
Cancer and the pain it causes can often be controlled.        
When pain and weakness are effectively controlled we can enjoy a wonderful life extension with our loved ones.        
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Dr Stein and Stephanie, 
I just wanted to say thank you for everything that you did for Buck the past 10 months. That was 10 more that I was able to share with him that I would not have had. You guys do amazing things there and he loved coming there every week.

Buck's Mom


      Pain Emergency?
        (consultation fees apply)
          Featured Case  
      Featured Video - Acupuncture Used To Help Pets      
            Special Thanks  
          Gabapentin Liquid Warning!  
      Is your dog on tramadol?      
      Questions or problems regarding this web site should be directed to DRSTEIN@MANAGINGPETPAIN.COM.
Copyright © 2011 ASAH. All rights reserved. Last page update: February 4, 2014
Tramadol is a medication that dogs metabolize many times faster than people do. Most of the patients that we see are grossly underdosed. This drug needs to be given at 3 to 5 mg/kg three to four times daily in order to provide an effective pain relieving dose. 1 to 2 mg/kg once to twice daily is not an effective dose schedule. For more information see the 2004 Kukanich/Papich research paper, Pharmacokinetics of tramadol and the metabolite O-desmethyltramadol in dogs.
The effectiveness of laser therapy has been greatly overhyped in the veterinary profession. We strongly suggest that you call us before you waste money on laser-only pain therapy. And yes, we do have, and frequently use, a therapeutic laser as they should be used; as a small part of a much larger, comprehensive patient pain management program.
Do Not Use Liquid Gabapentin to Treat Dogs! Commercial liquid gabapentin preparations contain the artificial sweetener xylitol which can be highly toxic to dogs. Cats appear less susceptible to this effect but caution suggests it not be used to treat cats either.
Too often our patients have well established osteoarthritic pain or severe weakness before they arrive at our practice. It is remarkable what we can do to help the most challenging patients but osteoarthritic, back pain, cancer pain, and weakness patients must be seen early in the course of their disease in order to make the best possible impact on long term patient outcome. The sooner we see the patient the better.
Our director has over 30 years of successful cancer management experience. You may be surprised to know that chemotherapy is usually very well tolerated by our patients. Irrespective of the chemotherapy decision, pain strategies, physical rehabilitation, acupuncture, and anticancer herbals can all be useful tools to improve patient comfort and extend their longevity.
The longer a painful disease or functional challenge exists, the harder it will be to control. Too often we see patients who have been suffering for weeks to months, sometimes for years, prior to seeking our advice. The result is lost time with your beloved pet.
Life can throw us many curves; some with the potential to cause pain or weakness of such severity that we consider putting our pets to sleep. Severe arthritis, spinal disease, and cancer are all disorders that many might consider life ending and yet, the pain and weakness generated by these disorders is usually responsive to our therapies.
The changes that occur within pain nerve pathways and muscle fibers can lock these systems into an unrelenting state characterized by constant pain and weakness. Our pets may no longer enjoy their time and their activities with their family.
This is not a criticism, it is simply a fact and it is a reality in both human medicine and veterinary medicine. Most doctors are unaware of the best medication strategies for effective pain control. Most do not understand the critical need for rehabilitative care and the benefits of needle based muscle pain therapy. There is too much dependence on NSAID drugs; too little consideration for more balanced methods. Our program is the culmination of over 15 years of intensive pain management and functional rehabilitation study.