How To Tell if Your Dog Is in Pain

By Jacqueline Boyd

If you live with a pet, you might feel like you can almost read each other’s minds.

You might even have experienced your pet responding to your emotional state. Animals seem to have impressive skills at detecting our state of health too.

However, new research suggests that many dog owners are not skilled in recognising pain in their pets as they might like to think. This could have significant consequences for the behaviour, health and welfare of our pets.

As a migraineur, I am amazed at how my dogs cope with me when a migraine hits. They seem to recognise the pain, distress and incapcacity that comes along with a migraine and respond with more gentle interactions than usual. I hope that when the situation is reversed and they are unwell or in pain, that I too can recognise it.

So, how can you recognise if your pet is in pain and what should you do if you think they are?

Signs of Pain

It is easy to assume that an animal in pain will make some noise about it and show obvious physical signs. This might be the case if they are in acute pain as the result of severe injury for example. However, animals often disguise pain as a survival mechanism, and many signs of pain show only as subtle changes in behaviour.

Humans do seem to be able to recognise basic animal emotional states such as anger, fear or joy, through facial and body expressions. But we are less good at linking these cues to more complex emotional states including pain, anxiety and frustration.

The recently published study assessed how good people are at recognising signs of pain in dogs. This was carried out via an online questionnaire completed by 530 dog-owners and 117 non-owners. 

Participants were given a list of 17 types of dog behaviour. They were asked to rank how likely  the behaviour types indicated their dog was in pain, based on their prior knowledge and experience. In reality, all 17 types of behaviour listed suggest a dog is in pain.

The signs of pain provided included obvious behavioural changes such as hesitant paw lifting, reduced play behaviour and changes in personality. Participants were good at recognising these prominent behaviour changes were linked with pain. 

However, they didn’t realise more subtle indicators such as yawning, lip and nose licking and changes in facial expressions including looking away and increased blinking. These are all warnings that a dog may be suffering.

Notably, participants without dogs were actually more likely to recognise that freezing or turning the head or body away are associated with pain than dog owners. This suggests that dog owners may become complacent in their observations of their dog’s behaviour.

The Link Between Pain and Behaviour

The study participants were also asked to assess the potential relevance of pain in three written canine behaviour cases. The participants were not told this, but two were suffering from painful conditions, one outwardly obvious, and one more subtle. The third case was not linked to a painful condition.

Dog owners noted that pain was likely in the case with obvious signs of movement problems – hopping and lifting of legs. This was higher for dog owners than non-owners. In the case where pain signs were more subtle (night restlessness and “shadowing” family members), there was no difference in the ability of dog-owners and non-owners to identify the behaviour as signs of pain.

However, the dog owners with previous experience of pets with a painful condition seemed to be better at recognising signs of suffering. This applied to overt changes in movement as well as body language. This suggests that prior experience can be valuable in developing skills when its comes to pet behaviour.

What is interesting from this study is that there were some discrete differences between dog-owners and non-owners in recognising signs of pain. However, owning a dog was no guarantee that someone would be better able to identify subtle pain indicators.

Previous studies have shown animal species may show pain in different ways. For example rabbits often freeze, which might be considered a fearful response. Facial grimace scales are also increasingly being used to assess pain for a range of species including cats and horses. These assessment tools track minute muscular movements in the face such as tightening eyes.

What To Do If Your Pet Is in Pain

Recognising signs of pain in your pet is critical so you can respond quickly. This may also help reduce the risk of dog bites, which are often linked to the dog struggling with chronic pain.

Pain can lead to increased noise reactivity too, where dogs flinch or bark loudly in response to sudden, unusual or loud noises.

If you suspect your pet might be in pain because of a sudden change in their behaviour or movement, seek veterinary advice. Soreness can manifest outwardly such as lameness, lethargy or a lack of desire to exercise or play, but it can be easy to miss more subtle signs such as altered blinking, momentary pauses or freezing.

Research indicates that dog owners should be alert to altered sleep patterns, restlessness, clinginess and unusual licking or chewing their body. Even changes in a dog’s ear position, coat quality, texture, or how their coat lies on their skin can indicate underlying discomfort. Reluctance to being touched in specific areas of a dog’s body might also be a sign of discomfort that needs veterinary investigation.

So if you think your dog needs training or a session with a behaviourist because of a gradual or sudden alternation in their behaviour, it’s worth ruling out whether your pooch is acting strangely because they’re in pain first.

Jacqueline Boyd, PhD, is a Canine Consultant and Senior Lecturer in Animal Science at Nottingham Trent University.

This article originally appeared in The Conversation and is republished with permission.

Puppy Medicine

By Jennifer Hochgesang, Guest Columnist  

I was miserable. My trigeminal neuralgia pain from multiple sclerosis was still uncontrolled, leaving me mostly housebound. I had also just been diagnosed with vestibular migraines, which cause vertigo. Sometimes the vertigo was so extreme I was unable to walk, the world moving like a drunken carnival ride that never stopped even when my eyes were closed.  

And while the trigeminal neuralgia (TN) was on the right side of my mouth, I had just gotten ulcers out of nowhere on the left side. Anytime I drank something I felt a blind searing pain that took minutes to subside.

I was just barely pushing through, not sure how much more I could take. But I had an appointment to see a puppy at a nearby animal shelter.

I have had dogs all my life. Each one has been a part of the family and amazing creatures: loving, smart, playful and giving. My last dog, Aequoris, passed away two years ago and her sister Zola a little before that. I needed time before getting another dog. But as I went through this year in the worst pain of my life, I started to slowly think about getting a dog again.

But I had many questions to ask myself: Was I well enough to care for a dog? Could I afford a vet? Would the dog get enough exercise? Did I have help for the times I was too sick to care for it? Were there walking services in my area or boarding services if I had to go to the hospital? Would pet insurance cover those situations? Would my family members want a dog and be willing to help?

Even as I answered all those questions on the way to the shelter, I almost cancelled. I just felt so physically awful and it was hard to think of enjoying a puppy.   

When we got there, they put us in a small room so we could meet the puppy and get to know her a little. She was an 11-week old rescue from a litter of five. They said she was a Spaniel mix, but really they had no idea what breed she was.

When they brought her in, my first thought was that she was pretty funny looking. Then she actually ran up to me and kissed me right on the left side of my mouth, the one that doesn’t have my TN. It was like she knew! I couldn’t believe it!

I held her and smelled that sweet puppy smell. She wasn’t funny looking after all. She was beautiful. She had dots of brown over her eyes, silky black fur down her back, and fawn-like legs with spots everywhere.

We played and I fell in love within seconds. I watched her play, moving like a little infant excited with the world. I laughed as she tried to catch a ball and fell, and was so moved when she came to me for comfort.

Suddenly I realized I wasn’t in as much pain! Holding her, rubbing her soft fur and watching her jump around just did something for me – like it was medicinal. She was helping me. I knew at that moment she would bring that gift to me and in return I would do whatever I could to make sure she was cared for: vet visits, exercise, training and love. I named her Sasha: helper of womankind.

Sasha is now almost six months old. She is crazy smart and learned sit, down, and up in the air the first day. I have also started working with a trainer so she doesn’t touch the right side of my face and set off a TN attack.

I can have Sasha off leash in the backyard and throw the ball for her to catch with my 7-year-old daughter, who thankfully runs like crazy with her.

But she still rings the bell to go outside seven times an hour and tries to eat my socks no matter how many times I say no. She grabs tissues and runs so fast, dodging furniture and ducking under and over until you want to pull your hair out.

But then you leave the room for one second and come back to find her butt wiggling, tail thumping on the floor, and plaintively whinnying, “I’m so happy to see you. I missed you so much.”

Sasha has the sweetest face and when she lays next to you with her head curled in your lap letting you pet her, looking up at you -- it’s just pure love.

Is it a coincidence that in the past five weeks I’ve finally found the food triggers for my trigeminal neuralgia? I’ve stopped eating dairy, citrus, chocolate, caffeine and sugar. My pain has gone down so much. It’s like night and day since I got Sasha. I still need to work with a nutritionist to make sure I’m eating the right foods, but for now this is working for me.

Sasha is still a baby so I haven’t expected her to do much more than be a cute furball. But one day while I was working on my iPad, she came and positioned herself right in my lap. I had to move her over a little so I could work. She still stuck like glue to the left side of my body with her head on my leg or arm throughout the day. I thought she was just tired.

Then slowly my TN pain began to increase, until I had a really awful volley of attacks every few minutes. Sasha moved closer and closer to my face as the pain got worse. During one brutal attack she kissed me on the left side and I was so thankful. She actually understood I was in pain and where it was. She knew when it was getting worse. And all she wanted was to heal and comfort me.  

As I write this, Sasha is sitting right here next to me chewing on a rawhide pretzel. She brought seven toys up on the couch in case she gets bored with the pretzel and wants me to throw something. I take a break from writing to pet her and sometimes she will turn over and give me her belly to rub. Soon she’s going to get up and ring that bell to go outside in the light snow.

She is just the most beautiful thing.

Jennifer Hochgesang lives in Illinois. Jennifer has multiple sclerosis, trigeminal neuralgia and vestibular migraines.

The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represents the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.

Pain Researchers Say Let Sleeping Dogs Lie

By Pat Anson, PNN Editor

Most people with chronic pain recognize the importance of good sleeping habits. A night spent tossing and turning can mean a day full of aches and pains.

For that reason, dog lovers are often told they shouldn’t sleep with their pet. One survey of pet owners found that over half said their dogs tend to wake them at least once during the night. Sleeping with a pet can also be unsanitary and lead to behavioral problems.   

"Typically, people who have pain also have a lot of sleep problems, so usually if they ask their healthcare provider about a pet, they're told to get the pet out of the bedroom. But that standard advice can actually be damaging," says Cary Brown, PhD, a Professor of Rehabilitation Medicine at the University of Alberta.

Brown is co-author of a small study, published in the journal of Social Sciences, in which seven chronic pain patients who slept with their dogs were asked about their pets’ impact on their sleep. Brown said the response was "overwhelmingly positive."

"They liked the physical contact with their dogs—cuddling before bed, and how it distracted them from feeling anxious about being alone at night. They felt more relaxed and safer, so they weren't anxious as they were trying to sleep," said Brown.

"A sense of relaxation and caring are emotions that release positive hormones in our bodies that will help us sleep better."

Having our pets sleep with us can also help ward off loneliness. A dog can take on a significant role for the chronically ill when friends drift away and social circles shrink.

“I’ve got my buddy and I’ve got my companion hanging out with me and I don’t get that loneliness,” one patient said.

“I always have got somebody to cuddle and make me feel loved when I am lonely and in pain and when I am trying to sleep,” said another.

Researchers say doctors need to have deeper conversations with their patients before suggesting that a pet sleep somewhere else.

"When you ask people to remove an animal they are in the habit of co-sleeping with, it could have consequences the health-care provider hasn't considered," Brown said. "For some people with chronic pain, their relationship with their pet could be the only one they have and the comfort that dog or cat produces would be lost."

For some patients, it’s also a reciprocal relationship. They try to help their dogs sleep and comfort them when they have pain.

“She [the dog] has days when she experiences lots of pain, I make myself get down on the floor at her level …. I will sit with her and talk with her and very softly, very calmly, I make a point of massaging her ever so gently,” one woman said. “I find this brings down her heart rate, she’s not in pain, the pain is starting to go down. I can physically see the changes in her and eventually she nods off to sleep.”

Although dogs have been living with people for thousands of years – and often sleeping with them – surprisingly little is known about the emotional and physical benefits of sharing a bed.

“This small study shines a light on this important and yet neglected area of research. It reveals that for these participants their dog appears to enhance their sleep in many ways. Further research is warranted to explore more fully the ways in which pet dogs influence sleep for people with chronic pain,” said Brown.