Uncovering Pain in Pets: The Subtle Signs That Matter

Posted on by Ellen Yoakum

As many of you may already know, I have two lovely, adorable, incredible senior dogs in my home. Griffey is coming up on his 9th (HOW IS THAT POSSIBLE?!) birthday, and Laika recently turned 12.

In the last couple of years, we’ve been on a journey to assess, measure, and effectively treat any pain from injury or general aging. We’ve built a team of BAMF vets to help us address it from a variety of avenues from nutrition and consumables, to pharmaceuticals, and an evidence based movement plan. Really, I couldn’t be more lucky to have such an incredible team working with us through all of this. 

So, while we’re on our journey, I wanted to consolidate some of the awesome resources that our team has supplied us, share them with our incredible audience. And the place I want to start is…

 

You Aren’t a Bad Pet Parent if You Have a Pet With Pain

There is a particular heartache that comes with suspecting or hearing that you have a pet that is experiencing potential pain. It’s an interesting thing to experience and to watch others experience. When I first identified my pets’ pain, I felt guilt. I felt bad that I didn’t catch it sooner. I felt that I wasn’t “doing enough” to prevent their pain. A better pet parent would have caught it faster, treated it sooner, or prevented it all together. 

And that may all be a normal part of the process. 

But I can tell you, having a pet that is experiencing pain isn’t a measure of how you’re doing as a pet parent. Unfortunately, pain is a normal part of life. It’s something we are all going to experience, and as much as I want to protect my pets, as they age, they are going to hurt sometimes. There is more at play than just my care plan for my pets, including genetics, environmental factors, and more. 

And once I was able to work through my own challenges, I was able to put together the incredible care team to manage their pain as we need. 

 

Physical Health and Behavioral Health Impact One Another

If you’re here, you know fundamentally, we don’t want our critters to hurt, because who wants that? But, on top of that, physical health and behavioral health can’t be parsed; they influence one another in incredible ways. For those of us with the big feels pets, their health and pain can have HUGE impacts on their behavior, progress, and prognosis (more on that later). 

And for those of us with “practically perfect in every way” pets, pain can elicit new behaviors that we find worrisome (also more on that later). 

As Dr. Kelly Ballantyne shared in Episode 106 of Enrichment for the Real World, 

“…we can’t separate behavior from the rest of the body… we can’t just stick them into separate buckets, because as living organisms, all of our systems, including our brain, which is driving behavior – right? – are intertwined. So we can’t just say, oh, this is a behavioral issue, or this is a physical health issue. They’re gonna, they’re gonna be enmeshed. And that’s why it’s so important that we always make sure that physical health needs are being met.”

Pain isn’t always something we can see, especially with chronic pain. It’s something that our pets may compensate for, and it may manifest in ways that make our pet’s behavior feel “unpredictable.” 

Sometimes he growls when I touch his neck, but he’s fine when I put his harness on for a walk. 

Sometimes she runs away when I try to pick her up, but she sits on my lap all the time. 

Sometimes they skip breakfast. 

Physical health, including pain, adds a layer of challenge to our pet’s plan. For a more comprehensive overview of pain and its impacts on behavior, I highly recommend reading this article, Could Pain Be the Hidden Cause of Your Pet’s Behavior Issues? By Dr. Kelly Ballantyne

 

Acute vs. Chronic Pain

Acute pain happens abruptly with a specific onset. We’re usually pretty good at noticing this. It is things like yelping, whimpering, limping, pain grimacing, wincing, hunching over. Most of us have seen this: our dog takes a corner too quickly and wipes out. Our cat doesn’t quite make the jump and it takes a couple minutes to shake it off. Our pet gets a splinter or a burr caught between their paw pads. 

But as Dr. Micaela Young discussed in Episode 46, chronic pain is a whole different beast. 

“Chronic pain waxes and wanes. Chronic pain has a delay after exercise where it gets flared up. You know, usually the effects of chronic pain are behavioral and the animal has time to learn how to compensate so that limp is not going to be near as pronounced as if it had just happened. And it affects the decisions that they make, and it affects their emotional interpretation of other things that are happening around them. And none of those things fall under our typical way that we recognize pain.”

Chronic pain is harder to recognize, assess, and monitor overall.

Potential Signs of Pain

Alright, let’s get int some potential signs of pain. I pulled from a variety of resources (all shared below). This is not a comprehensive list, but somewhere to get started. Signs of pain can include:

  • Pets that respond by growling, snapping, swatting, or biting when they are approached while they are resting (you can read about how we learned about Griffey’s spinal narrowing here)
  • Big behavior changes in a socially mature, adult animal 
  • Noise sensitivity/phobia starting later in life 
  • Aversion or avoidance to handling, especially from a preferred person or to things that were successful in the past
  • Hunched posture, or low head carriage 
  • Bunny hopping gate 
  • Self-isolation 
  • Hesitation or winding up before jumping onto something 
  • Hesitation or avoidance of things that were previously fun, preferred activities, or highly practiced 
  • Difficulty maintaining speed on walks 
  • Difficulty settling or getting comfortable 
  • Disrupted sleep 
  • Changes in daily patterns
  • Excessive licking 
  • Hyperactivity
  • Ingestion of inappropriate items 
  • House soiling

And, as a reminder, this isn’t a comprehensive list, which brings us to…

 

How I Knew Griffey Was in Pain

I’ve talked about this before on the podcast, so I’ll keep this relatively brief. Our first sign was back in 2018/2019 when I woke up, standing on the other side of the room because Griffey was growling in his sleep. This was the first time we’d seen or heard him growl and we knew something was wrong. 

We got him into the vet and found the beginning stages of spinal narrowing and related challenges. We managed that for years with an exercise plan, diet changes, and home modifications, and went on our merry way. 

Jump ahead to 2023, and we started to see some behavior changes creep in, and while the list looks long and clear, it would be one or two things a couple times a week:

  • Increased sound sensitivity with more intense responses, and slower recovery time
  • Pawing of only the right side of his face from above his right eye, to his commissure 
  • Increase in frenetic play 
  • Increased growling and aggression when rolling around on the couch or when on his back (which he was doing to himself) 
  • Increased reactivity to the presence of other humans and dogs 
  • A rapid breakdown of his oral medication administration behavior 
  • A rapid breakdown of his paw-handling behaviors 
  • More “negotiation” in his training sessions, he’d offer alternatives to the things we had previously done frequently 
  • Ineffective treat pairing with the sound of the bug zapper (sound sensitivity)
  • Increased water consumption and urination

I took some data, which I talked more about here, so that I could bring these observations to our vet team to start our investigation.

Med Trial

With the help of his team, we were able to approach this from multiple angles and both rule out and rule in different diagnoses. But, unlike some other health conditions, we couldn’t rely on imaging and labs to tell us we were moving in the right direction. Instead, we needed to rely on changes in his behavior. Here’s an update email I sent his team after the first round of medication trials (of which there were many): 

Hi, team!

Wanted to shoot over updates from the med trials with Griffey.

An observation I’ve made, and I have no clue if this means anything to y’all, but in the last two weeks, I’ve seen piloerection only on his tail for about an inch, roughly 2 inches away from the base of his tail. It looks like a balloon animal tail. This isn’t preceded by a reliable antecedent or time of day.

Onto the meds:

We started with the 1 tab 2x daily on Monday, Feb 12 (9 days ago). Since then we’ve seen:

  • Only two instances of right face-only paw rubbing compared to 3-5x/week previously.
  • His jumpiness to the bug zapper has decreased INCREDIBLY and has continued to fade. 

The baseline response was full body startle, flinch, jump, and 3-5 feet of bolting before orienting toward me. This was with many, many, many months of zap = tasty treat.

Friday of last week (3 full days of med), we saw that his response was still big, full body jump and flinch, but immediate orientation to me.

By Sunday of this week (6 full days of med), we saw he was no longer leaving the ground, but a would offer a smile and wiggle when the zapper went off.

By yesterday (a little over a week), we saw that there was little to no flinching and immediate orientation to me with a smile and a wiggle.

  • Huge reduction in meltdowns to the sound of dogs next door and trucks.

The baseline, when he’d hear dogs outside, or trucks, we’d get an immediate rapid shriek with a 2-3 minute meltdown before he was able to re-engage with us. This would happen 2-4x/day.

We’ve only had 2-3 meltdowns total since starting the meds, and they were all super reasonable. 

 

How I Monitor His Pain Daily 

Now, a year or so later, we’ve found an incredibly effective pain management plan for him, that ebbs and flows with his needs, and has helped him in so many ways. Not only physically, but also behaviorally, and he’s even made new friends that he trusts to do weird things (like laser treatments while he wears cool sunglasses)! But, we also know that his challenges will change with time, and we will need to continue to adjust as he ages and his conditions change.

Part of his pain management is ebbing and flowing with how his body feels on any given day. We worked with our vet team to both identify and assess the validity of these measures for him. I want to be abundantly clear: I had the contacts and resources to obtain assessment and monitoring from multiple vets. The indicators we track will not be exactly the same for other dogs, and/or may indicate something different in a different individual.

 We’ve observed and identified, that on ouchy days Griffey will: 

  1. Have the above mentioned piloerection, increasing in frequency and duration
  2. Consume large amounts of water at once
  3. Take the stairs one leg at a time with very wide stance in the back 
  4. Carry his hind legs further under his stomach, with what looks like muscular atrophy in his hind end 
  5. Have more frequent, more intense, and longer bouts of reactivity to loud sounds outside and the bug zapper 
  6. Show more hard eye and whale eye when resting and someone moves near him 
  7. Play more frenetically with less diversity in offerings
  8. He will avoid exercises or take food more sharkily when doing things he can do skillfully 
  9. Do quick checks toward his right side

Knowing all of this, my partner and I are able to objectively manage his pain on a day to day basis. We’re able to provide his care team with quick, concise updates so that they can help us make adjustments as we need, and we’re able to fold in more folx to our care team. 

 

How I Knew Laika Was in Pain 

Laika is my Mary Poppins dog. If we held a ruler up to her, it would say “practically perfect in every way”. And part of that includes being an incredibly healthy, well-structured dog naturally. We have needed very little intervention or support throughout her life and that is a tremendous privilege. But recently, as she’s aged, we’ve started to notice some things, and in particular, the last few months. We started to see: 

  • Unpredictable bouts of shivering 
  • Self-isolation, particularly when Griffey is rowdy 
  • Hiding on our laps when things hit the side of the house, or Griffey playing with a toy 
  • Stiffening and side eye toward Griffey if he walks too closely when she’s resting 
  • Disinterest in playing with Griffey or toys 
  • Disinterest in shredding cardboard 
  • Occasionally skipping breakfast 
  • Occasionally carrying self with a hunched posture 
  • Disinterest in fitness training 
  • Shortening of walks or exercise

And again, these things were happening at most once a week, usually closer to once a month, so independently they could be really easy to write off.

 

Monitoring and Improvements

But we got her in to see our incredible rehabilitation vet for some movement assessment, and a plan for the next steps. With the adjustments we made at the rehab vet a couple of weeks ago including medication changes, updating Laika’s fitness and mobility routine, and adding in targeted treatment at the clinic, we’re already seeing improvements like: 

  1. Interest in activities that previously brought her joy. She’s been shredding almost daily. One day, she spent 3 hours shredding little boxes into teeny tiny pieces.
  2. 4 days this week she’s initiated play with Griffey, and pounced, laughed, and made merry for long bouts of play 
  3. She’s been seeking out and chasing toys again
  4. She’s excited to see her harness again 
  5. She’s going out of her way to walk over the cavalettis (exercise equipment) I have set up on the back deck
  6. Decrease in unpredictable bouts of shivering, self-isolation, and hiding

As I’m writing this, we’re right in the middle, so unlike with Griffey, I don’t have as nice a bow to put on the story. But I’m sure I’ll be back with an update!

 

What Does Pain Tracking Mean for Enrichment?

Remember, enrichment is meeting an animal’s needs. It is helping them to perform species-typical behaviors in healthy, safe, and appropriate ways. Just like you might set yourself up differently to sit at your computer if you had say a neck injury or a migraine, enrichment can be delivered differently for a pet with pain. Here are some examples: 

  • Put the dog beds on the floor instead of on the couch so they don’t have to jump up and down
  • Feed primarily off of plates or bowls to easily monitor food intake, eating speed, and to make sure that the food is presented in a way that is safe for their current pain points
  • Leverage different variants of their medication protocols 

And it means they get to tell us no. They get to opt out of activities. They get to have more agency and control. Because it sucks to hurt. Giving them more agency and control is a small thing I can do to make a hard time a little easier. 

 

Now What? 

Happy Training! 

Ellen

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