September is Animal Pain Awareness Month and an opportunity to shine a brighter spotlight on the way pain impacts our dogs’ behavior and wellbeing.

Most of us would agree that if we knew our dogs were in pain, we would intervene immediately and do everything we could to alleviate their pain. I know I would.

It’s not for lack of caring that so many dogs experience unrecognized and untreated pain. Pain goes unnoticed for several very real reasons.

One, when we think of pain, we think of more acute and overt manifestations such as limping, yelping, or major changes in mobility and behavior. In reality, discomfort can show up as more subtle signs that aren’t obvious unless you know what you to look for.

Two, myths about pain are far too prevalent. We still think that younger dogs are less likely to be in pain or that some breeds of dogs have higher thresholds for pain. These preconceived expectations about which dogs are more or less likely to experience pain can prevent us from recognizing the signs.

The truth is that all dogs will experience pain at some point of their lives, some more extensively than others. The sooner we’re able to recognize the signs, the sooner we can help them.

What is pain:

According to the World Small Animal Veterinary Association (WSAVA) “pain is a complex multi-dimensional experience involving sensory and emotional components.” In other words, ‘pain is not just about how it feels, but how it makes you feel’ and it is those unpleasant feelings that cause the suffering we associate with pain.” (Monteiro et al., 2022)

Recognizing that pain is an emotional experience helps us see that the impact of pain goes beyond just the physical sensation of pain.

Dogs experience both acute and chronic pain. Acute pain is often a result of trauma or injury, generally improves in a short timeframe as the injury heals, and serves an adaptive function to minimize damage and maximize healing. Chronic pain, however, is not adaptive, is associated with long-term chronic conditions and can become a disease in and of itself.

Almost 40% of all dogs experience chronic pain from conditions such as osteoarthritis, dental disease, and cancer (Gruen et al., 2022).

Pain and behavior:

Being in pain sucks. It makes us cranky, unhappy, and changes how we move through our days. The same goes for dogs.

Pain has an unquestionable impact on behavior, so much so that a study by Mills et al., 2020 identified pain as a factor in 28% to 82% of problem behavior cases. Imagine that. In the 100 cases of people seeking help for problem behavior, pain played a direct or indirect role in as many as 82% of them.

Put simply, pain often manifests as behavior problems. A Review of Medical Conditions and Behavioral Problems in Dogs and Cats found that “the most common sign of pain in animals is a change in behavior.” (Camps et al. 2019)

With this in mind, let’s look at signs of pain in dog and how to identify them.

Behavior changes to look for:

The first and most important mindset shift we need to make if we haven’t already is to become more curious about our dogs’ behavior.

Instead of the usual “how do I fix this?” or “how can I get my dog to stop doing this?” we need to ask ourselves, why is my dog doing this?

All behavior serves an important function for the individual, even behaviors we find annoying or troublesome. It doesn’t mean you can’t work to shape your dog’s behavior, but it does mean you should try to assess its function before you work to change it.

Here are just a few examples of behaviors that can be caused or exacerbated by pain:

Distance increasing behaviors, such as barking, lunging, growling, and even biting. These can manifest as behaviors we label as “reactive,” as well as resource guarding, touch sensitivity, aggression towards other dogs
Sound sensitivity, including excessive barking at sounds or escape avoidance behavior when hearing sounds
Handling sensitivity, including aversion to harnesses, grooming, or medical care
Refusing to go on walks, stopping or stalling on walks
Restlessness or ”hyperactivity”
Jumping and mouthing, as well as other behaviors we label as “over arousal”
Leash biting
Pulling on leash
Opting out of training

As you can see, these are very common behaviors people seek training help for. Yes, these can be a function of something other than discomfort, but the fact that these behaviors can be caused or exacerbated by pain underscores how important it is to treat our dogs’ behavior with care and curiosity.

I’ve worked with plenty of dogs whose pain-related behaviors were written off as a product of adolescence, lack of training, or stubbornness. The authors of the Pain and Problem Behavior in Cats and Dogs make a specific reference to the latter as it relates to pain:

“Perhaps the most common secondary sign that appears to resolve with the treatment of pain relates to various behaviors that, prior to the use of analgesia, were being interpreted by the owner as some form of stubbornness.” (Mills et al. 2020)

Changes in behavior:

This can encompass new behaviors, or increase and decrease in the frequency, intensity or duration of existing behaviors.

For example, increase in the intensity of barking or decreases in the duration of sleep can point to underlying discomfort.

Similarly, how a dog moves through their daily environment tells a big story.

Does the dog:

Hesitate to go up or down the stairs
Have trouble riding in the car, including avoiding getting into the car
Change sleeping spots too often, or conversely, no longer using specific resting spots
Avoid areas in the house, including certain rooms or surfaces
Skip meals or is a “picky eater”
Have trouble getting on and off furniture
Frequently slip or trip in the home and over thresholds

Some of these changes can be slight and appear over time and thus be tough to notice. People are especially inclined to refer to older dogs exhibiting some of these signs as “slowing down” not realizing that the behaviors they’re seeing are actually indicative of underlying pain, not age alone.

Gait and postural signs of discomfort:

How dogs hold their bodies (posture) and how they move (gait) can point to areas of compensation and adaptations.

Limping is one example of weight shifting, but there are other, more subtle examples as well.

A dog who places on leg away from the body may be shifting weight off that leg. What may appear as just a weird standing position can be an indication of discomfort. If this is happening on a regular basis, it tells us the dog is consistently taking weight off a particular limb.

Dogs who have musculoskeletal conditions that lead to osteoarthritis will often shift weight to help relieve or stabilize weak, unstable, or painful joints and muscles. It’s important not to chalk these postural adaptations to “oh that’s just how he stands” and remain curious and observant.

Additionally, these adaptations and compensations can become secondary sources of pain and discomfort. A dog who shifts even a small percentage of body weight from one limb to another can start to have pain in the limb that’s taking on the extra weight. It’s not unusual for dogs with hind end instability, for example, to have pain in their forelimbs and shoulders.

Gait can also tell us quite a bit about how comfortable a dog is when moving. Which gait a dog chooses, when, and if they’re able to use a particular gait can point to pain.

When we take all of these elements together, we can see a broader picture of a dog’s mobility and comfort.

Why we miss signs of pain:

Pain is missed because we don’t always know which signs to look for and because dogs in pain can still be active and playful. Countless dogs living with chronic pain run, jump, and play on a daily basis. When we see active dogs it can be hard to imagine that they’re experiencing discomfort.

Most notably, however, we don’t recognize pain because we’re conditioned to treat dog behavior as a matter of personal convenience, and by effect, obedience or lack thereof. When dogs exhibit behavior problems, we immediately reach for training solutions.

What’s worse, many training tools, including those used as walking equipment, can in and of themselves cause pain or make underlying discomfort worse. Yet, we rarely pause to consider their impact on dogs’ health, because we’re too focused on getting behavioral compliance.

Moving away from this mindset can help us be more observant, compassionate, and curious. We’ll be more likely to note changes in behavior, posture, and mobility and get dogs the help they need sooner rather than later.

To learn more about how health impacts behavior, including how to better recognize signs of discomfort, support your dog, and access additional resources, join my Substack community, The Whole Picture.

If you suspect your dog might be experiencing discomfort and would like a personalized consultation and assessment, you can book my Behavior and Health Assessment.

Signs of pain in dogs: How discomfort impacts behavior and wellbeing