Recognising pain in dogs: the subtle signs owners miss

Unlike humans, dogs cannot say "it hurts here." Their evolutionary heritage as prey animals means showing vulnerability can be dangerous, so many dogs mask discomfort with remarkable success. By the time an owner notices obvious lameness or yelping, the underlying problem is often well established. Learning to read early, subtle signals is one of the most valuable skills a dog owner can develop.

The International Veterinary Academy of Pain Management (IVAPM) and veterinary pain specialists have developed validated tools — including the Glasgow Composite Measure Pain Scale — to help clinicians assess pain. The same behavioural cues these tools measure can help owners notice change at home.

Pain in dogs falls broadly into two types: acute (sudden-onset, often from injury or surgery) and chronic (persistent, often from conditions like osteoarthritis, dental disease, or cancer). Chronic pain is the more commonly missed type, because its signs emerge gradually and owners may attribute them to "just getting old."

Behavioural changes that signal pain

Changes in personality and routine are often the first clues. A dog in pain may become quieter, less interactive or more irritable than usual — occasionally snapping at people they would normally welcome. They may retreat to a quiet corner, be reluctant to be touched in certain areas, or show out-of-character aggression when handled.

• Reduced interest in play, walks or activities the dog normally enjoys
• Sleeping more than usual, or conversely seeming restless and unable to settle
• Changes in posture: hunching, tucked abdomen, weight shifted off one limb
• Reluctance to jump on or off furniture, climb stairs, or get into the car
• Decreased appetite or dropping food (dental pain)
• Excessive licking, chewing or guarding of a body part
• Altered facial expression: furrowed brow, tightened muscles around the eyes, ears pulled back

Physical signs

• Lameness or stiffness, especially after rest or first thing in the morning
• Muscle loss (atrophy) over a limb or the topline — often visible in chronic orthopaedic pain
• Increased respiratory rate or shallow breathing at rest
• Trembling or shaking unrelated to cold or fear
• Vocalisation: whimpering, groaning when moving, or yelping when touched
• Swelling, heat or visible wound

Dental pain: the most commonly missed source

Veterinary dentists estimate that the majority of dogs over three years of age have some degree of periodontal disease, yet most show no dramatic symptoms at home. Signs that dental pain may be present include dropping food, chewing on one side of the mouth, pawing at the face, reluctance to accept hard chews or toys they previously enjoyed, and bad breath. A thorough oral exam under anaesthesia is the only way to fully assess dental health.

Pain assessment tools you can use at home

Several validated owner-reported outcome measures exist for specific conditions. The Canine Brief Pain Inventory (CBPI) and Helsinki Chronic Pain Index (HCPI) allow owners to score their dog's pain and mobility over time. These are particularly useful for tracking response to treatment in dogs with diagnosed osteoarthritis. Ask your vet for the appropriate tool for your dog's condition.

What to tell your vet

The more specific your observations, the better. Note when the changes started, whether they are constant or come and go, what makes them better or worse (e.g. worse after exercise or after rest), and any other signs you have noticed. Short video clips taken at home are extremely useful — dogs often move and behave differently in the consulting room.