There are so many subtle signs of pain that are really easy to overlook and can show themselves in their behaviour and can be the driving force for why they are demonstrating the behaviour.

There are different kinds of pain, which the dog can respond very individually to – some dogs will feel this more than others, just as people do. There is neuropathic pain (nerve related – which is hard to treat and often long term), somatic (trauma or damage to tissues in the body – excessive activity can cause this), visceral pain (injury to internal organs), acute (short lasting often from injury or trauma) or chronic (long lasting pain).

Based on their evolutionary history, showing weakness could make a dog vulnerable, so they instinctively hide pain. That means by the time your dog shows signs of pain, they have probably been suffering in silence for a while. Your best way to detect pain is vigilance and observation of your dog’s normal routine. Dogs show pain differently depending on breed, individual makeup and age. Behaviour can change slowly and can be hard to spot.

This could be changes in:

Mobility

  • Altered posture: Your dog may sit or lie down more often, hold an arched back, carry their head low, or position their tail abnormally. They may lay in a different position than normal – upside on their back, or with their legs stretched out behind them (frog legs)
  • Stiffness or limping: They may favour one limb or exhibit difficulty walking.
  • Trouble moving: Difficulty sitting, climbing stairs, or getting up from a resting position. The dog may also struggle to get in and out of the car – or change how they get in/out of the car (such as more rapidly or slowly) – be reluctant to get in or out.

This can also include how the dog moves – in walk or trot they move both legs on the same side (rather than a 4 time movement or diagonal pairs) – they move forward and their limbs/body are not in line. Again, this can be subtle but indicates a physical problem and pain

  • ‘Sloppy’ sitting: a change in how your dog sits – or a hunched sit
  • Male dogs squatting to pee or having their penis often popped out (this is not normal behaviour)
  • Moving away when you go to sit on the sofa, or touch the dog they move away or growl

Changes in activity level

  • Restlessness: Pacing or an inability to settle. Your dog may hide away
  • Lethargy: Your dog might seem unusually tired or unwilling to move. They may ‘plant’ their feet and refuse to move on a walk
  • Reluctance to exercise: Slower walking or hesitation to engage in physical activities. They may not want to play or walk fast
  • Sleeping more: older dogs do tend to sleep more, but in context this could be associated with pain

Behaviour changes

  • Vocalizations: Whimpering, yelping, howling or groaning.
  • Social withdrawal: Hiding or avoiding interaction.
  • Increased neediness: Seeking more attention and affection than usual.
  • Reactions to touch: A normally affectionate dog may now react negatively to being touched or held. They may sharply turn their head to you when touched – growl, stare or move away
  • Excessive grooming: Licking, scratching or chewing at a specific area on the body.
  • Irritability or aggression: Uncharacteristic snapping or growling.
  • Panting: Excessive panting even at rest.
  • Facial expression changes: Change in expression such as flattened ears, grimaces, or glazed eyes.
  • Fear: greater reactivity to known things such as being in the garden, people, other dogs etc
  • Excessive licking: especially where there could be pain. This includes licking surfaces
  • Noise phobia: changes in how your dog responds to noise they have previously been unconcerned about – washing machine, traffic etc
  • Star gazing or fly snapping: staring into space and snapping at ‘flies’ which you cant see
  • Pica: eating inedible things – such as stones, their own poo, soil etc
  • Compulsive behaviours: such as chewing feet, or intense licking – tail chasing – spinning – light chasing
  • Guarding behaviours: such as guarding the water bowl
  • Prayer position: seen like a play bow and can be where there is digestive discomfort
  • Destructive behaviours –
  • Unable to settle – especially at night
  • Separation anxiety – nudging, pawing or anxiety at being left, toilet indoors
  • Lack of ‘normal’ dog behaviour – this may not necessarily bother the humans but does mean that there is something wrong which needs investigating

**Not all are pain as some are behavioural but must be taken in context. Some of these could indicate other medical conditions which should be investigated.

Other changes

  • Loss of appetite: A reduced interest in food.
  • Altered sleeping patterns: May sleep more or cannot get comfortable trying to sleep
  • Accident in the house: Urinating or defecating indoors uncharacteristically.
  • Changes in their coat: whirls or pattern changes in the coat can indicate pain

Breed – conformation and posture

Some breeds have been bred to fit a certain look – but this in itself can be detrimental to their health and can leave them in chronic pain. Consider pugs with their very short faces which can affect breathing (amongst other things), German Shepherds with sloping backs, Daschunds with their long backs etc

All dogs should have straight columns of support – straight legs and paws. Some dogs can have turned out feet, cow hocks or bowed legs. This can lead to a lack of balance and abnormal loading into the joints and high wear and tear which can then bring on early arthritis.

Posture adaptations such as hunched backs, lowered head or legs further under the body can evidence back pain or gut pain. If this is left unaddressed this can affect them over the long term. Your dog will shift weight away from pain, so if they stand or sit crooked this can show you they have some underlying pain.

Other things to consider:

  • The age of your dog – as they get older they may be more reluctant to jump in the car so consider teaching them ahead of this time how to use a dog ramp, or climb steps
  • Managing their weight – excess weight can worsen pain so consider how to manage this
  • Keep water and food bowls at a height which suits them – especially with big breeds. Having bowls in a raised stand can support long term health
  • Plenty of soft beds/access to comfortable sleeping places so your dog can stretch out comfortably to sleep
  • Cover slippery surfaces such as hard floors to prevent the dog slipping
  • Never give human pain medication to dogs.

How does pain affect learning?

Some dogs, right from being puppies, are reluctant to train. Maybe they don’t want to move into a certain position – like a sit or a down. Maybe they demonstrate defensive behaviours right from puppyhood – don’t like to be touched in a certain area, move away if you sit next to them on the sofa, don’t like strangers touching them. Maybe they can lack focus or have a changeable mood.  All of these can be signals of underlying pain.

If your dog is older and starts to fidget or refuse a particular known cue like sit – then this could be pain related.

What about particular behaviours?

Reactive behaviours

Some dogs can be reactive towards people or dogs (or both). This can be pain based behaviour. If your dog is reactive on lead this could be a way of your dog ensuring that a person or dog doesn’t approach (in case it hurts them more). If the dog is tense, this can exacerbate the pain they feel. The dog can then link the pain they feel with the approach of a dog or person and this this causing the reaction. It becomes a self fulfilling prophecy.

Resource guarding

This can be mistakenly diagnosed as resource guarding in some dogs where there is actually underlying pain. Guarding a location, such as being on the sofa, or in their comfortable dog bed – an interesting piece of research recently showed that dogs can also guard the water bowl and this was a sign of underlying pain.

Travelling

Getting in and out of the car can be very painful – some dogs will refuse to get in or out. The dog will then brace themselves in the car so they don’t fall around when you go around a corner or brake – this tension can worsen the pain. Some dogs will pace around and cannot settle. Some dribble, drool or are sick and shake. Travelling in the boot of the car can be ‘hard’ due to the fact that cars are not necessarily designed for a smooth ride in the boot and so travelling the dog in the front of the car or back seat can be more comfortable. Some dogs will show exhaustion when the journey is over, due to the amount of energy used by the travel.

What should you do?

Firstly, gather lots of evidence to share with your vet. Dogs are great at masking pain, especially when stressed at the vets.

  • Keep detailed notes – what changes have you seen? When? Particular time of day? After exercise? When waking? Detailed notes about their day will provide good evidence to help your vet.
  • Video your dog – video when they walk or trot away from you (preferably off lead if possible). This can demonstrate if the dog is ‘wonky’ or uneven and things like a roached back (indicating pain)

Make a vet appointment and share all the evidence with them. Bear in mind that it can be very hard to diagnose pain by vet exam since it is subjective to the dog as well as the stressful experience (positive or negative) for most dogs at the vets so the more evidence you have the better. Just because your dog doesn’t show pain at the vets or on xrays/scans doesn’t mean that your dog doesnt have pain – gather as much evidence as you can to help the vet diagnose.

There are specialist vets for almost every part and system of your dog as we have as humans so you are well within your right to ask your vet to send imaging and results to a specialist for additional review. At times, this specialist knowledge could spot something that your general vet isn’t a specialist in. You could also ask for a referral to a vet physio for additional support for your dog.

Different medications are prescribed for pain, so if your dog doesn’t respond to pain medication it doesn’t mean they don’t have pain – it may be it’s the wrong medication or it hasn’t been taken long enough (especially for chronic pain). Talk to your vet and ask more questions.