One of the questions I get asked most as a veterinarian is, “how do I know if my dog is in pain?” Much like a pediatrician who relies on non-verbal clues to indicate a patient’s health status, veterinarians become acutely aware of both mental and physical pain by observing a dog’s body and behavior. Common conditions include arthritis pain in senior pets, gastrointestinal pain in puppies who have ingested a toy, or the mental pain of separation anxiety in a dog who had been previously neglected. Pain is a complex topic, but we know “mammals share the same nervous system, neurochemicals, perceptions, and emotions, all of which are integrated into the experience of pain”, says Marc Bekoff, evolutionary biologist and author.

Understanding a Pet’s Pain Scales

Because when we know better, we do better, and scientists including veterinarians have developed various pain scales for animals. Using these scales to quantify pain in conjunction with a physical examination and observation, we can address pain with a combination of medications, laser therapy, massage, acupuncture, and emotional support among many modalities. Dog owners can perform a physical assessment and reference these scales to determine whether their pet is in pain and needs medical attention. On a scale of 0-5, anything above a 1 justifies more than a “wait and see” approach, and you should schedule a visit with your vet.

How to Examine Your Pet

Examination of your pet should include a “nose to toes” approach, and I recommend performing one regularly. Because pets have different levels of pain tolerance, reactions to pain, and temperaments, know your dog’s baseline, or “normal”.  Do they regularly react when you touch their feet? If the answer is yes, pulling away a foot during an exam may not be a good pain indicator for your pet.

1. Start at your pet’s nose and make sure there is no drainage or change in shape.
2. The same should hold true for the eyes which should be clear and bright with no squinting.
3. Ears should also be clean and free from discharge and odor.
4. A dog’s mouth shouldn’t have a foul smell (know your pet’s normal smell) indicative of periodontal disease (ouch to tooth pain!) and the gums should be bubblegum pink.
5. Manipulation of the limbs, neck, and spine should not illicit a response and your dog should bear weight equally on all four feet.
6. When putting pressure on the belly, wincing or arching of the back can indicate pain.
7. Check the pads on your dog’s feet – Scrapes and cuts are common in these areas and animals typically will endure the physical pain of walking on the foot to the emotional pain of not going on their regular walk.

Not all lumps and bumps are painful but bring any new masses to your veterinarian’s attention. If you have a stethoscope, know your dog’s resting heart rate. A persistent elevation may be due to discomfort. Likewise, panting or an increased respiratory rate is common among dog’s in pain.

Know a Pet’s Behavioral Cues

Behavioral clues that your pet may be in pain include anything outside of their normal.

• Is your dog’s appetite decreased?
• Do they seem restless or have difficulty sitting or standing?
• Do they no longer jump on the bed or are they sluggish on walks?

Not all dogs will whimper, cry, or groan when they are hurting, though some, like huskies and other opinionated breeds, do. Similarly, I’ve observed dogs bearing full weight on a fractured bone, only responding to direct manipulation of the area while others continue to have phantom pain or anticipatory stress walking on a completely healed leg.

Excessive biting or grooming of a painful area is another sign your dog may need medical attention. More subtle clues can be physically distancing them from others, lack of interest in their surroundings, signs of aggressive behavior, or a “worried” facial expression with droopy ears, arched brows, and darting eye movements. A hunched posture, tense body position, or a “praying” pose with the rear in the air and front legs extended are often seen in dogs with belly discomfort.

Know that you are not alone when supporting your best friend. Asking neighbors who might not see your dog everyday for their opinion on your dog’s body condition or movements. Sometimes, we normalize our own pet’s condition because we are constantly interacting! Your veterinarian can also provide with resources to identify and address painful conditions. Because pain can become a vicious cycle if not treated, be your dog’s best advocate and speak for them when they can’t.

1 https://www.nationalgeographic.com/news/2016/12/animals-science-medical-pain/

2 https://www.veterinarypracticenews.com/download-these-pain-scales/