Dogs in Pain Part 1: It can be Surprisingly Hard to Tell When Your Dog is in Pain!

Some signs of pain in dogs are so subtle that it’s easy for owners to miss, including dull eyes, withdrawn behaviour and suppressed appetite, among others.

Back and myofascial pain in dogs is widespread, and horribly underdiagnosed. (Myofascia are the connective tissues that surround, support and interpenetrate the muscles. These connective tissues are richly innervated with sensory nerves, and can hold pain and tension patterns.) Around 90% of the dogs I assess with the Whole Energy Body Balance method have significant pain, and at least half of these have what I’d call severe pain.

And here’s the thing that never ceases to surprise me. More than half of the people who own these dogs are surprised when I tell them that their dogs have pain. They think that nothing is wrong with their dogs. (And they are often upset to find out that they have missed this silent suffering.)

Why is this? Why is it that so many dogs live in chronic pain and seem to their pet parents to be just fine?

I believe that the main reason is that dogs usually don’t communicate that they are suffering pain ‘verbally’. And that is the primary way us humans do! We have a built in bias that tells us that if our dogs are silent, then they must not be in pain. And this is simply not true…

In my 20 years of experience as a vet, I have learned that dogs will nearly always cry out with pain only when the pain is acute and severe, or chronic and excruciating. Dogs will sometimes scream at the moment they tear a cruciate ligament, for instance, or when they run into a tree while playing, or if they are bitten by another dog. And old dogs with very painful conditions will often start to groan or moan when this becomes overwhelming.

Understanding How Your Dog Communicates Pain

Unusual body carriage, gait or posture are other subtle signs that your dog may be in pain.

To always know when your dog is hurting, you’ll need to learn how to read ‘dog-talk’, which is a silent, physical, body-language. It can be very subtle, too, so you’ll need to be sensitive and aware. If you get any sort of feeling that ‘something simply isn’t quite right’ with your dog, make sure you get them checked by a vet—and if the vet can’t find anything, don’t be shy to get several second opinions, and maybe also an assessment by a skilled dog body-worker or physiotherapist.

I have assessed multiple dogs who have been to the vet and been given the all clear, only to find that they have severe back or myofascial pain that has been missed by the vet. Please note that I never was taught how to assess properly for this sort of pain when I was training as a vet—it’s something I have had to teach myself over the years.

Before we dig into signs of pain to be aware of, it’s also important to understand that chronic pain can develop very slowly (arthritis is a good example of this). The changes in how your dog moves, or gets up and down, stiffness and so on, can develop so slowly that it’s very easy to miss them. It’s not normal for any dog to be slow and stiff in getting up and down or moving around, and it’s an important sign of pain.

Here’s a recent video I made about how to tell when your pet is in pain. It reinforces the list below of signs that your dog might be in pain.

Here’s What You Need to Look For

Ok, I’m going to start with the more obvious signs—ones that are more likely to be present with a sudden, acute onset of pain. Then I’ll move on to talk about ones that are a bit subtler and more likely to be a feature with chronic pain. You can download a PDF of these signs and symptoms of pain for printing.

Sudden or Acute Onset of Pain

This Chihuahua is in pain from a neck injury. Tense face muscles and dilated pupils are often signs of severe pain.

• Sudden yelping or crying out while being active or playing: Yes, I know vocalisation is often absent with pain, but if your dog does scream or yell out, take it very seriously!
• Increased heart rate and respiration rate: If your dog is tense, panting, and their heart is racing, there’s a good chance that this may be due to pain. Especially if they are reluctant or unable to move about or to get up and down. And especially if it’s not hot and there are no stressful stimuli.
• Tense face muscles, wide open ‘hard’ eyes, dilated pupils: This is present with nearly all severe pain, chronic or acute. It’s actually a bit more of a hallmark in the chronic pain picture. The dog’s face under their eyes, along the cheeks, around the lips, will be tight and constricted, and may even be bunched up or ridged with tension.
• Trembling, circling: If your dog has the trembling shivers and shakes, and if they circle for ages before lying down, this can also be a sign that they are uncomfortable, and that it hurts them to get down onto the ground to lie down.
• Unusual body carriage, gait or postures: If your dog is holding any part of their body in an unusual or guarded posture, and if their gait is restricted or hampered in any way, this is often a sign of pain. Any change in how your dog moves—stiff gait, awkward movement, slow and stiff to get up and down, all should be investigated carefully!
• Limping: It’s an obvious one, but important. Be aware that front leg lameness is sometimes caused by neck pain, too.

More Subtle Signs of Pain in Dogs

Self-isolation from other dogs and people is often a subtle sign of pain.

• Becoming withdrawn, not themselves, not playing any more: This one can be subtle, and it can change slowly, too. You might have to think back months or years to get a handle on if your dog is showing this subtler expression of silent pain.
• Localised excessive grooming or biting or chewing at a certain place on their body: Dogs will sometimes chew holes right through their skin in response to pain.
• Any change in behaviour—grumpy, aggression that’s out of character: If your dog suddenly starts growling and snapping at other dogs or humans (especially kids, who dogs often find disturbingly unpredictable) for no apparent reason, pain is often the reason for this behaviour.
• Any change (reduction) in ability to jump off and on couches, into cars etc.: Even if your dog is getting older, if they can no longer jump on the couch or into the car, you need to investigate this, and to find out if there is pain behind the change.
• Any change in tail position—guarded tail, not wagging, etc.: A dog’s tail is very expressive, and should be active and lively. If your dog’s tail is held still and guarded, they may have put their tail out (which can be very, very painful), or they may have some other injury or disease that is hurting them.
• Not shaking from head right through to the end of the tail: A classic sign that your dog has back pain! And one that is all too often missed. A wave of shaking should pass right along the spine, from nose to tail.
• Abnormal head and ear carriage. Splinting of the neck, holding the head lower than usual, ears tense and tight, up high on the head: If your dog has neck pain, they will tend to try not to move their head and neck at all.
• Dull eyes, withdrawn, not engaged: This is more common with chronic pain, as it takes a lot of your dog’s energy to cope with living with long-term pain. Pain can lead to depression.
• Flinching when touched or avoiding touch, doesn’t want to be held or picked up, if severe crying out or moaning when picked up: This is a more obvious one, but it can be subtle, too, as sometimes dogs will quietly position themselves so you only pat their comfortable areas.
• Isolating themselves from other dogs and/or people: If your dog used to be social and now is avoiding other dogs, growling at them to warn them off, or has become a ‘couch potato’ who doesn’t want to do anything much at all (not keen on walks etc.), pain may be the cause.
• Supressed appetite, or seems hungry but then won’t eat: If your dog has back pain, bending down to eat may hurt. This can be another sign to watch out for! (You can raise their bowl to help alleviate the pain.)
• Feeling like there’s ‘something not quite right’ with your dog, but you can’t work out what it is, and sometimes vets can’t find a cause either. Listen to this: It’s the last sign, but one of the most important. You know your dog, and if something is not right, but a reason can’t be found, pain may very well be the cause. Again—seek multiple opinions from different practitioners, as it can easily be missed, even by vets.

You know your dog. If something seems “off” or not quite right – seek opinions from several practitioners until you get to the bottom of it.

So there you have it! Please read the signs again carefully, or even print them out and memorise them, as doing so may save your dog a lot of silent suffering. You can download a PDF of these signs and symptoms of pain for printing. In Dogs in Pain Part 2, I discuss treatment options for pain—both natural and conventional.

Image attribution
Antonino Visalli on Unsplash, Manuel Fedele on Unsplash, rihaij/Pixabay, Suti Stock Photo/Shutterstock.com, leungchopan/Shutterstock.com.

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Edward Bassingthwaighte, BVSc

Holistic Home Visit Vet at The Healing Vet

Dr. Edward Bassingthwaighte is a home visit veterinarian in Uki, New South Wales, Australia. He graduated from the University of Queensland in 1995, and spent a short time being kicked by dairy cows before he decided that large animal work was not his cup of tea. He has worked in small animal practice since 2000.

Many clients remark that Dr Edward has a way with animals quite unlike any other vet they have ever seen. Pets who are normally fearful, or who would never approach a stranger are drawn to him. He has an intuitive ability to connect with and understand animals.

Apart from being a vet, Dr Edward is a singer/songwriter, loves gardening, and likes to paint. He is owned by Pearl (a very graceful, willfully disobedient Whippet), Mitzi (an out of control Shitzu/Silky cross), and Parvati and fred (2 lovely cats).

Latest posts by Edward Bassingthwaighte, BVSc (see all)

• Dogs in Pain Part 2: Treating the Pain—What are Your Options? - August 24, 2018
• Dogs in Pain Part 1: It can be Surprisingly Hard to Tell When Your Dog is in Pain! - July 8, 2018
• Back Pain is a Severely Underdiagnosed Problem in Dogs - April 16, 2018