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Recognizing Pain in Dogs and Cats

September 25, 2019

As our pets are routinely living into their teens, it is inevitable that we start to see some age-related problems crop up. Conditions that cause pain, such as arthritis, chronic tendonitis, soft tissue or slip and fall injuries are common in our aging pets. It can be surprisingly difficult to recognize signs of pain in dogs and cats as they are “programmed” to appear as normal as possible; this is a holdover from their wild ancestors for whom appearing weak or vulnerable could be a death sentence. Overt crying or whining is uncommon.

It can also be difficult to differentiate signs of pain from other aging changes (for example, diminished sight or hearing, or decreased strength) or other diseases. In general, many of the behaviors we attribute to “slowing down” or “getting older” may actually be caused by pain. We have a variety of good options for managing pain in cats and dogs, but the first sign is recognizing that it is there.

For dogs, keep an eye out for the following signs if they are changes from your dog’s norm (for example, for a dog who always hated going up and down stairs, that particular sign isn’t as significant as for a dog who has always bounded up and down the stairs):

  • Decreased appetite or unwilling to bend down to eat or drink from bowls.
  • Limping or holding a leg up; shifting weight between legs.
  • Gait seems “off,” possibly without being able to pin down to a particular leg or problem. This may include short choppy leg movements, excessive swaying/swinging from side to side, or head bobbing up and down when walking or trotting (to name just a few).
  • Decreased interest in or objection to previously enjoyed activities, not only exercise (walks, fetch) but also things like being brushed, petted, or playing/wrestling with either people or other pets in the household.
  • Difficulty or increased effort changing from one position (standing, sitting, lying down) to another or sitting or lying in strange positions.
  • Restlessness or frequently readjusting position when resting.
  • Difficulty going up and/or down stairs.
  • Difficulty jumping (on people or furniture, or into the car).
  • Self-isolation, sleeping more, decreased interest in interacting with family OR the opposite – extreme clinginess or constant attention seeking in a previously more independent individual.
  • Suddenly obsessively licking a particular limb or joint.
In this picture, my dog Maisy is sitting in a very abnormal (for her) posture. This was taken after she had been diagnosed with a torn ligament in her knee, before she’d had surgery.

Cats can be particularly hard to evaluate because they are SO good at hiding signs of illness and pain. All of the above items may apply, but be particularly alert for:

  • Decreased grooming: Mats, accumulated undercoat, dandruff or greasiness in a previously fastidious cat.
  • Not jumping up on previously favorite perching or resting areas.
  • Irritability or reactivity to being touched, petted, or brushed in a cat who has previously liked (or at least tolerated) these activities. May be reactive enough to bite or swat.
  • Overgrooming – pulling out hair or otherwise excessively grooming a particular joint or spot on the body.
  • Changes in litter box use; accidents outside the box may be near the box or on a separate floor of the home from the box.
  • Self-isolation, “smaller world” – not coming upstairs or downstairs to interact with family as much, keeping to themselves more, sleeping more.
Near the end of his life, my cat Solo didn’t groom as well as he used to. In his case, it was due to other health problems including diabetes and he didn’t have any other signs or physical exam findings that made me concerned about pain.

Obviously many of these signs can be caused by things other than pain, which is why it is important that individual signs be interpreted in context and that your pet be evaluated with a good history and physical exam if you see concerning symptoms. We may also recommend diagnostics to rule out other problems before proceeding with talking about pain management. If you are concerned about any symptoms your pet is exhibiting, please call the clinic to set up an appointment.

Karen Christopherson DVM CVA

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