Could your dog be in pain? None of us want that to be the case, but knowing how to identify pain is key to supporting your dog’s well-being.
There is No Test for Pain
There is no test or diagnostic that your vet can run to definitively rule out pain. This includes bloodwork, fecal or urine testing, x-rays and other imaging, etc.
These diagnostics can be, of course, extremely valuable. They can identify some sources of pain, if present, and medical issues that need to be addressed. But normal results do not rule out pain.
Treatment for pain doesn’t rule out continued or re-occurring pain either. Maybe the treatment helped in the moment but the issue returned. Or maybe the treatment was insufficient. Unfortunately, pain can be complex to treat and our first attempts aren’t always successful. This does not mean pain isn’t present.
Behavior is often the best indicator you will have. Observing your dog and knowing what is normal for them is a key measure of how they are feeling.
Sources of Pain
Pain is difficult to diagnose in dogs because they tend to hide the signs and there are many possible sources. This includes:
- Dental disease, broken teeth, and other mouth issues
- Gastrointestinal disease or disorders
- Skin conditions (including itchiness/allergies)
- Problems with ears and eyes
- Orthopedic conditions
- The presence of masses/tumors
- And more
Chronic Pain
Most people know what “acute” pain looks like – the dog who suddenly isn’t themself. Signs are usually distinct and obvious. Acute pain is new – typically due to an injury or illness, but possible after a surgery or painful medical procedure. If your dog has a sudden change in behavior, call the vet immediately.
Chronic pain is different. This is pain that continues longer term. It can have more subtle but still very problematic effects. Chronic pain may linger after a normal recovery period or after your dog has “recovered” from an injury or illness. Some conditions, such as hip dysplasia, luxating patella, arthritis, or GI disease, can cause chronic pain. Chronic pain can be present in young dogs as well as old.
Dogs with chronic pain often show subtle signs, possibly only behavioral ones. Because these may have existed for a long time, can creep in over time or because the original acute condition has been treated, signs of this pain are easily missed. Behavior changes associated with chronic pain frequently get mislabeled, even by skilled professionals, as behavioral only.
By understanding the effects of chronic pain and potential sources, you can advocate for your dog and get them the support they need.
Signs of Pain
A general exam may not be enough to identify pain, particularly if your dog is fearful at the vet. To support your dog and vet, you’ll need to be prepared with all of your observations.
Include:
- Behavior issues or concerns
- Even if they are “normal” for your dog
- Especially if you remember a time when your dog was different
- Irritability or avoidance of people or pets they usually like
- Especially if it is just sometimes or your dog goes through “moods”
- Changes in energy or play preferences
- Even in an older dog, “slowing down” may be a sign of a treatable condition
- Fluctuating appetite or elimination habits
- Variable interest in food that cycles over the course of days or weeks
- Dropping food out of their mouth while chewing
- Stool quality that changes/gets worse and then better, even without diet changes
- Eliminating in the house when the dog was previously housetrained
- Inability to hold still while peeing or pooping (walking around, not holding a squat, wobbling when lifting a leg)
- Skin changes or abnormalities
- Twitching skin
- Scratching or licking, in general, but especially if it’s focused on one area
What To Do Next
Identifying and addressing pain in dogs is an ongoing journey. If you are concerned, stick with it!
- Keep observing
- Track signs in a journal to determine frequency and patterns.
- Take video to show to your care team.
- Ask for next steps
- If the currently recommended tests/treatments don’t show anything, what does your vet recommend next?
- Even if nothing is found, if the signs are still present, your vet should keep working with you.
- Get a second opinion or specialist evaluation
- Getting a second opinion from another vet isn’t a sign of mistrust or dislike of your vet. It’s just bringing more brains to a tricky situation.
- Most vets have some knowledge about a huge range of topics (that’s what general practice requires), but specialist skills may be needed to go deeper into particular areas. Again, not a sign that there’s anything wrong with your vet’s skills.
- Be patient and persistent
- Answers can be slow, treatment can require multiple trials – it’s worth it!
Remember: There is no test that can rule out pain in any individual. You need to observe your dog and keep observing. If you are concerned, be persistent. Your dog will thank you!
If your dog has a behavior problem that you need help solving, consider scheduling a private behavior consultation.