Pain and dog behaviour: a complicated relationship!

Pain and dog behaviour are more closely related than we would think.

Is your dog suddenly grumpy around people or other dogs? Are they showing reluctance to go for walks or to be manipulated?  Do they seem to be clingy and constantly asking for attention? Does it seem like they can’t focus, no matter what you are asking them to do ?

Pain could be one of the reasons behind their behavioural problems.

Dogs are natural masters at hiding their pain, and for a good reason : an injured or sick animal in the wild makes them a very easy target for predators.

If our domestic dogs are very different and evolved versions of their ancestors, masking signs of pain is a skill they have inherited from them! The most common sign of pain in dogs is a change in behaviour. They might not tell you directly they are suffering, but if listened to ,their behaviour can be very telling. Pain and dog behaviour are two notions that should be considered together instead of seen as two different aspects of their well-being.

Behaviour does not lie, and every behaviour happens for a reason, up to us dog health and behaviour professionals to find what it is to be able to help them.

Studies have shown that up to 80 % of the “ unwanted behaviour” in dogs were explained by them being in some degree of pain.

If historically, pain and behaviour issues in domestic dogs have mainly been treated separately, more and more studies have highlighted the impact pain can have on a dog’s behaviour. Before being able to talk about the role pain can play in challenging behaviour, it’s important to define the terms used in this article a bit more precisely.

1 – A few definitions

The definition of behavioural problems is actually quite subjective and involves some recognition of the behaviour by dog parents. The definition includes behaviour that are perceived as annoying.

Behavioural problems are also behaviour that can turn out to be dangerous for people, for other animals, or to the dogs themselves. Behavioural problems can appear as a consequence of a health issue, and can also be natural/ normal behaviour that are considered as a problem for the humans sharing their life ( such as resource guarding, competition based aggression, etc). Finally, directly or indirectly,  behavioural problems can deteriorate the dog’s welfare.

• Different forms of pain exist :

Acute pain is a pain that has just come on, or only has been present for a small short amount of time. It is frequently appearing as the result of an illness, injury or surgery. The pain usually ends after the underlying cause is treated or has been resolved.

Chronic pain is a long standing pain that persists beyond the usual recovery period or occurs along with a chronic health condition ( arthritis for example). Chronic pain can be on and off or continuous.

Acute pain is usually more intense and will in most cases generates a noticeable change in the dog’s behaviour.

The behavioural manifestation of pain can be highlighted by either :

• The loss of normal behaviour : decreased ambulation or activity, reluctance to interactions with other animals or humans, decreased appetite and decreased resting behaviours.
• The development of new and abnormal behaviour : aggressive, anxious or fear based reactions, inappropriate elimination, vocalisations, restlessness, hiding, repetitive behaviours.

Every dog will react differently to pain, and a lot of factors are leading to one individual’s reaction : their history, the pre existence of behavioural issues, genetics, experiences during all different development phases, etc..

Common behaviour problems lead to emotional suffering, frequent rehoming and sadly, sometimes euthanasia in dogs. Those challenging behaviours are the result of an innocent misinterpretation, miscommunication, and  sometimes a lack of collaboration between health and behaviour professionals.

Health ( and pain) is responsible for way more behavioural issues than we would think. We often assume that the dog is “ fine” since there is no obvious sign of pain, and that is an honest mistake. The subject of pain and dog behaviour particularly important to me since it’s hitting very close to home, for both personal and professional reasons.

My own little dog Croquette has Chiari like malformation. Chiari like malformation is a brain malformation that generates neuropathic pains, extreme touch and noise sensitivity, scratching around neck/shoulders area and many associated symptoms. I have been suspecting it for quite a while now, but only got a proper diagnosis through an MRI very recently. His fears have been quite a challenge to manage, and now that I know more about his condition, a lot of his behaviour make so much more sense.

Now I know that he doesn’t stop all the time on the way back from the park because he doesn’t want to go home, but because he is probably sore and tired. No wonders he hides under the bed before going on walks, when the click of his harness being put on is so unpleasant for his very sensitive ears.

Finally, the fact that he avoids people that show signs of wanting to touch him at all costs, despite being super friendly the first year of his life seems quite normal now that I know that his condition makes every form of touch on his back/neck area painful for him. In his case, the relation between pain and dog behaviour is more than obvious.

On a more professional point of view, as a dog behaviourist, I meet dogs with behavioural problems on a daily basis, and I have come across so many situations when the behaviour solutions and training protocols only take the dog so far, and they keeps showing “ unexplained” and unwanted behaviour despite all the efforts that are made by their humans.

After more thorough investigations, pain was assessed in most of those. The treatment of both pain and dog behaviour in all those cases allowed the dogs to feel better.

2- The impact of pain and dog behaviour through negative associations with the environment

To be able to fully understand the relation between pain and dog behaviour, I think it is very important to have a clear idea of the way dogs form associations between different events and situations.

If dogs don’t have memories the way we do, their brain forms associations. Those associations can be positive or negative. Here are a few example of those associations :

• Positive : Family friends always brings treats with them when visiting, to give some to the dog. Those friends ‘s presence is very quickly associated with a pleasant feeling : receiving his favourite treats. If repeated a few times, the dog is showing signs of happiness/excitement when he sees them coming because a positive association has formed in his brain between those persons being there and getting treats.

• Negative : A dog has a pain in his back that comes and goes. During a walk at the park, another dog comes to play with him. The first dog is very excited, and starts playing. Then his back suddenly hurts. It is quite likely he will associate the pain to something in his environment : it could be playing with the dog, the dog’s presence, someone who is present when it happens, or even being in the park. If that situation is repeated a few times, the dog could start being reluctant to go to that specific place, to play with that dog, with every dog, or even being around a dog.

The tricky thing is that sometimes they will form an association with something totally unrelated to the negative feeling. Here is an example of an unfortunate association between an event and the environment :

A new puppy is brought home after just being adopted. The lady who picked him up opens the door so the puppy can enter the house. Her husband is in the kitchen, waiting to greet the adorable new pup. As soon as the pup enters the kitchen, he sees the husband, while a broom stick falls next to him, and he gets very scared. He was after that very scared of the husband who was the first thing he saw when he walked into the room, while the broom fell next to him, and associated him with something scary.

 Sometimes, it is all it takes for a dog to be afraid of a certain person/situation/place, and feeling pain works the same way. It can trigger reactivity, fear, aggressivity, and even lead a dog to be very anxious in their environment.

3- The behavioural manifestations of pain.

Every individual is different, and every dog will behave differently when in pain. These individual differences in the expression of their behaviour could be due to many factors: genetics, pre-natal manipulation of the dam, experiences of the animal during the different developmental stages, experiences during adulthood, etc…

Despite those differences, are a few signs that could help you noticing when they might not feel their best

• Vocalisations
• Change of facial expressions
• Regression in toilet training
• Change in posture : head carried lower, tail down, hopping on 3 legs, praying position ( their rear end up in the air while their front legs and head are lowered onto the floor)
• Motor issues : limping, difficulties to get up, to get up and down stairs, etc…
• Nibbling or scratching of a specific area
• Unconventional sitting or lying posture
• Interruptions to gait/and sudden freezing
• Unusual/hesitant defecation and urination behaviour
• Social manifestations : lethargy, anorexia, change in sleep cycles, absence of self- grooming, excessive licking, reluctance to being touched, grumpiness around other dogs, OCD, aggressivity, etc…

It is usually easier to spot acute pain in dogs, since its intensity is most of the time higher and will trigger a change in the dog’s behaviour.

It then gets a bit tricker to spot when the pain has been there the dog’s whole life, or for a long period of time. They have successfully proven that they are adaptation masters and they learn how to live with the pain. The coping mechanisms are very different too depending on the individuals, but there are a few signs that could alert you :

• Grumpiness around other dogs/persons
• Reluctance to be touched and manipulated
• Aggressivity
• Excessive and out of context panting
• Restlessness and excessive sniffing
• Attention seeking behaviours
• Separation related behaviour ( that happen only when you are not present)
• Poor tolerance to frustration and difficulties to focus

Pain and aggressivity

Most of the time aggressivity in a dog in pain will be a defensive reaction to avoid the physical contact that may cause more pain : reluctance to being brushed/groomed, to being lifted, reluctance to play with other dogs, etc… If a dog has experienced pain in a specific context, it is quite likely they will try to avoid the same situation in the future. The avoidance can be expressed many ways, and aggressivity can be one of them.

Pain can reduce the aggression threshold for a dog showing aggressive behaviour before the onset on pain. In that case, the dog will tend to react quicker and sooner than before being in pain, their “threshold” ( when the threshold is reached, the dog can’t handle the situation anymore and reacts by displaying what we consider to be a “problem behaviour”) will be a lower intensity of exposition to the trigger.

For dogs that were not displaying aggressivity before the onset of pain, the targets were often less specific, consisting of both familiar and unfamiliar individuals (whether they be dogs or humans), and the bites were often of variable severity and typically directed towards the limb extremities of the target (by contrast, dogs not in pain often delivered more severe bites to a wider diversity of body regions, including the face and the torso in addition to limbs).

The bite incidents were also typically short and easy to interrupt. Taken together, these signs are strongly suggestive of the bites being a low level violent threat aimed at saving the animal from further interaction. Most of the time, those dogs will try to avoid the situation that generates the pain with agnostic signals such as licking their lips, turning their head away, ducking away from hands, growling before biting, which is why it is generally very important to learn how to read your dog’s communication and stress signals as early as possible in their life. If those signals are heard, it is very likely the dog won’t need to go as far as biting because it won’t be necessary.

Ignoring the first signs of discomfort could lead the dog to stop warning and going straight for the bite, since they always do what works, and biting usually drives people/ dogs away from them.

Real life case  :

T, a 8 years old german shepperd that has been with her family since being a 10 month old puppy and has always loved getting in the car, that predicts going to the beach. She has never shown any signs of aggressivity during her whole life. They contacted a dog behaviourist because growled at the children a few times and bit one of the parents once. The bite was superficial and she barely broke the skin.

When investigating a bit more, it turned out that the growling and then the biting happened in the same circumstances every time : next to the car, she stopped in front of the open door, and both the children and the adult that was bitten tried to help her getting in the car by attempting to lift her up on the seat. After a vet check, it turned out the dog had a back issue, that explained the reluctance of jumping in the car, and the warning + bite when being lifted. After being on pain treatment for 10 days,  physiotherapy and facilitating the access to the car with a ramp,  all the signs of aggressivity and avoidance disappeared.

H, friendly border collie who has been happily leaving within a family of 4, loves going out for walks on the morning to take the kids to school. She starts being slower during those walks, and then hides when it’s time to leave, then snaps when asked to get up to go for the walk. At the kid’s school, everyone knows her as very friendly. One of the kids from school approaches her to greet her as he usually does. She turns her head away, licks her lips, and try to walk away but she is on a lead.

Her stress signals and attempt to flee are not accounted for, so she ends up biting the kid when he touches her back. This aggression is very out of character, she is taken to the vet’s and diagnosed with arthritis, that explained the slowing down on walks, the requests for space, and the biting when all of that was ignored. Physiotherapy and an adapted treatment helped her feeling like her old self in no time.

Pain and anxious/fearful/ reactive behaviour

Pain can also induce fear. First, pain acts as an unconditional stimulus, which induces a fear response. A dog who in a situation in which they experiences pain,  will try to create associations between the stimulus that causes pain and other neutral stimuli that can literally be anything in the environment at the moment when the pain happens. When the conditional context is present again, the animal may show fear even in the absence of the initial unconditional stimulus.

For a dog with chronic pains, a lot of elements in the environment can start being a source of fear, and that will turn into generalized anxiety because it the pain happens in random moments and it affects the feeling of general safety for the dog.

Reactivity can also be triggered by pain : an episode of pain happens outside when other dogs are in sight, and that can lead to a negative association with dogs in general, with a certain type of dogs, or even with people.

Real life cases :

S. was adopted when he was around 1.5 years old. Ever since arriving in his forever family, he has shown signs of severe anxiety, resource guarding and reactivity towards dogs. A huge behaviour modification work, combined with anti-anxiety medication has helped him feeling more confident, and he tolerates situations that would trigger him before. He often pants without any apparent reason, and still displays dog to dog reactivity, as well as remaining signs of resource guarding in the house.

A 10 days pain trial has been done, and his behaviour towards dogs outdoors changed a few days after being on the pain medication. Reactivity was lessened, and he even displayed playful behaviour towards other dogs.  Resource guarding inside the house also reduced a lot. Investigations are still ongoing to figure out where the pain is coming from.

 My dog Croquette has always been quite fearful and can even be considered generally anxious. For a long time, I thought the conditions of breeding, being kept in a 2 meters square kennel and never being taken out of it until he was 2 month old was explaining it.

It probably did affect his ability to cope with new things, but the fact that he started showing signs of neuropathic pains at the age of 6 month is also playing a good part in his general behaviour/ anxiety. As a dog behaviourist, I spent almost 2 years trying to gently get him used to many stimuli in his environment, and got some good progress for some aspect of it, but at some point, we were stuck, and no wonders he can’t relax more when pain happens when he least expects it, even during pleasant moments for him. Every  part of his behaviour problems, from his fear of people to excessive licking his paws.

Feeding and behaviour

What dogs eat, how much and when can also affect their behaviour quite a lot. Imagine, the feeling you have after a heavy Christmas meal, or after eating in a all you can eat buffet. How do you feel? You are very likely a bit nauseous, bloated, tired, uncomfortable, too full, etc… Or let’s say you have some food intolerance, but still eats them because you really like them. You probably won’t feel your best for the few hours that follow your meal.

On the contrary, if you’re visiting your mom who’s on a diet and serves you a really light meal when you are starving, you’ll feel frustrated, on edge, and quite likely to be less tolerant to many life situations that you would normally be okay with, right?

And let’s imagine those situation keep happening every day over a few years. Or you can’t go to the toilet when you want. Or someone forces you to do a physical activity when all you really want is getting some sleep.

And imagine if eating is your only pleasure in life, you don’t have anything else to do with your days.

What kind of behaviours would you display?

Our dogs are the same. Far from me the idea to humanize them, they are a different species, but simply because they can’t talk doesn’t mean they are always feeling at their best. Food is a really important aspect of their life, and as much as they can be happy to eat, it can also bring them very different forms of discomfort, from being bloated, to being frustrated because they are very hungry and someone is trying to make them sit for a long time before being allowed to eat.

Real life case :

B, 2 years old male working dog has been adopted for 2 month. His humans asked for help after 2 weeks of signs of resource guarding towards strangers coming in the house and lead reactivity towards dogs outside.

During the consultation, smelly fart are mentioned as a detail, since he has been on a temporary food, while waiting for his regular one to be delivered. When asking a bit more questions, it turned out that B had tendencies to resource guard but it became worse at the same time the food that upset his tummy was brought in. A behaviour protocol was still necessary to help B feeling more confident around new people, but being back on his usual food also played a part in his well-being.

Behaviour and health are closely intricated, and if something is wrong health wise, it is very likely the dog’s behaviour will be impacted. Their behaviour are their always way to let us know something is going on. Remember, they can’t talk, or even understand what is happening.

To conclude, if something doesn’t seem right with your dog, if their behaviour have suddenly changed, or if they are displaying reactions that seem out of character for them, don’t feel bad asking for a second, third or fourth medical opinion. Working with a qualified dog behaviourist can also be a great help if you are having trouble understanding their behaviour. Advocate for them, they can’t speak, and you are their voices. Feel free to reach out, I can help you :https://dog-training.ie/dog-behaviour-consultations/

If you are not too sure about the origin of the behaviour, seek the advice of a qualified dog behaviourist, who will refer you to your vets if necessary.

Sources :

https://www.zoetispetcare.com/blog/article/chronic-acute-pain-dogs

https://www.hopkinsmedicine.org/health/conditions-and-diseases/chronic-pain

A Review of Medical Conditions and Behavioral Problems in Dogs and Cats; Tomàs Camps, Marta Amat and Xavier Manteca, Published: 12 December 2019

Pain and Problem Behavior in Cats and Dogs; Daniel S. Mills, Isabelle Demontigny-Bédard, Margaret Gruen, Mary P. Klinck, Kevin J. McPeake, Ana Maria Barcelos, Lynn Hewison, Himara Van Haeverma, Sagi Denenberg, Hagar Hauser, Colleen Koch, Kelly Ballantyne, Colleen Wilson, Chirantana V Mathkari, Julia Pounder,Elena Garcia, Patrícia Darder, Jaume Fatjón, Emily Levine; Published: 18 February 2020

Why don’t you listen? A story about how to recognize when dogs are in pain; Canine Arthritis Management, 2021