How can I tell if my pet is in pain?
🐾 Part 1 of Our Pain Awareness Series
This is the first in our ongoing series exploring how to recognize, understand, and manage pain in pets. Stay tuned for more posts focused on the science of pain, real client stories, treatment options, and practical tips to improve your in personal situation.
Pain. We as a species seem to have an innate understanding of what the concept of pain is in ourselves, but the waters become quite muddy when we try to recognize pain in other species.
When we humans are experiencing pain, we know, beyond the shadow of a doubt, what “pain” feels like. It can range from a mildly unpleasant sensation, to an excruciating, debilitating emotional, physical, and psychological sensation, and anything in between.
When I worked as an emergency clinician, this exact conversation happened at least once a day:
Pet owner: He’s limping, but he’s not in any pain.
Me: Why do you think he’s not in any pain?
Pet owner: Well, he’s not crying out in pain. He’s just limping.
When I was in veterinary school, I fell off the top of a 6 foot wall running in an adventure race, and I landed wrong on my knee. It HURT! I limped along the last mile of the race, smiling on the outside, cursing loudly on the inside. After crossing the finish line, I palpated my own knee and could already feel a substantial amount of swelling. I took anti-inflammatory medications. I applied alternating ice and heat. I bathed in Epsom salt. I never once cried out in pain as a result of that injury. When the pain persisted for a couple weeks, I visited an Orthopedic doctor. My Doctor asked me to describe the character of the pain, to which I replied that it was a mostly dull, aching pain with occasional shots of sharp pain coming from the lateral aspect of my knee. This description helped him come up with a list of possibilities, and he ordered some imaging to get to the bottom of it.
I communicated my pain to my doctor using my words. Obviously dogs and cats can’t do that, so we humans have to rely on other clues that our pets give us to show us that they’re experiencing pain.
But first, I’m going to back up a little bit…
What is pain?
Merriam-Webster defines pain as “a localized or generalized unpleasant bodily sensation or complex of sensations that causes mild to severe physical discomfort and emotional distress and typically results from bodily disorder (such as injury or disease).”
From a biological standpoint, the sensation of pain is actually the result of a complex, multi-level signaling pathway. This is an extremely simplified rundown: sensory nerve endings that are highly specialized to detect potentially harmful stimuli are called nociceptors.
Nociceptors “fire” and start this pain signaling pathway when they detect a stimulus that is noxious enough that it could potentially cause bodily harm (such as extreme heat that causes burns, extreme sharpness that slices through skin and muscle, etc.).
When these specialized nerve endings “fire,” they send a signal up specialized peripheral nerves to the spinal cord.
The signal travels up the spinal cord to the brain, where that signal is processed as pain, and the brain says “OUCH!”
Why does pain exist?
Pain is necessary! It sucks, but it’s necessary. We all know that without our brain saying OUCH, we could potentially rest our hand over the top of a sharp knife and slice our fingers right off. In this situation, acute pain protects our bodies by sending a clear, immediate signal that something’s wrong. Chronic pain...is a different beast. It is not beneficial to our bodies or our pets’ bodies. We’ll talk more about chronic pain in another post.
Despite pain being necessary to help us prevent life-threatening injuries to ourselves, that doesn’t mean that feeling pain is without consequences. When a body experiences pain, there are measurable effects on other important body systems, such as the heart and blood vessels, the hormone system, the immune system, and the musculoskeletal system. If this pain goes untreated, not only are we contributing to that creature’s emotional distress, but we are applying stress that can cause damage to these vital organ systems in the body.
So now that we have a basic understanding of what pain is and the importance of treating pain, we have to figure out how to identify it in our four-legged friends.
How an animal reacts to pain will vary based on the severity of pain they are experiencing, how stoic of an individual they are, and their species.
Pets will convey the message to their human caretakers that they are experiencing pain through their behaviors. Some of these behavior changes are more obvious (especially with severe pain), while others tend to be much more subtle--animals truly are masterful at hiding their pain, even from us. In the wild, their survival depends on it.
How can your pet’s behavior tell you that they’re in pain?
Important Points:
For many of the behaviors on this list, “pain” is just one possible cause.
If your pet is exhibiting ANY of these behavior changes, the best thing you can do for them is schedule a visit with your veterinarian.
Pretty, pretty please, do not EVER give your pet a human pain medication without the guidance of your Veterinarian!
Do not give your pet a pain medication that was prescribed to another pet.
I’ve seen many well-intentioned pet owners cause severe harm to their pets by trying to treat pain on their own without the guidance of a veterinarian.
Changes in vocalization
If your pet is crying, whimpering, or yelping, that’s a likely indicator of pain. A more nuanced version of this is “anticipatory pain.” Sometimes when dogs are experiencing pain, they will cry out or act fearful with seemingly benign stimulants, such as brushing against them unexpectedly, or lifting their feet while putting on a harness.
The actual act of lifting their foot might not hurt, but their underlying pain condition has taught them that normal movements *might* hurt, so they react fearfully, anticipating a pain response.
Special note: Cats will rarely cry out in pain unless that pain is very severe. A cat that is normally vocal, however, may vocalize less frequently, or their meow may get quieter or louder when they are painful. The trick here is to look for changes from your cat’s normal vocalizing behavior. This can be seen in many dogs, as well.
Aggression
There are many, many, many causes of aggression in both dogs and cats, and pain is a big one! Aggression should always be taken very seriously in any animal, and ALWAYS necessitates a trip to your veterinarian to discuss options to keep your pet, other animals, and all people safe. Pain can be a cause of aggression in any animal at any life stage. When I was a general practitioner, I saw a 4 month old Golden Retriever puppy who was brought to me for evaluation after he was seen growling at the older dog in the house. His very astute owner thought this was odd behavior for a Golden of any age, but especially such a young puppy, and this concerned his owner greatly. My exam revealed very painful hips, and after some good pain meds and x-rays, we discovered the poor pup had severe hip dysplasia.
Because that owner picked up on his dog’s pain with such a subtle cue, we were able to get a diagnosis very early in the dog’s life and send him to a surgeon.
He had a successful juvenile surgery that improved the quality of that dog’s entire life! After a pretty quick surgical recovery, he stopped growling at the older dog, and they went on to become good friends!
Changes in eating and/or drinking
Painful pets will often show less enthusiasm for food.
Water consumption may decrease as a result of pain, due to decreased activity levels and slower metabolism, or because they just don’t want to physically move themselves over to the water bowl.
Water consumption may actually increase in some painful pets, for a variety of reasons. I’ve personally seen a few dogs who developed a very dramatic increase in water consumption due to pain, though pain is certainly not the most common cause of increased thirst in cats and dogs.
Changes to grooming behaviors
I’m actually going to separate out dogs and cats here, because grooming behaviors are very different between these two species.
Cats normally groom themselves to keep clean, rid their skin and fur of possible parasites, and keep their coat free of mats. Poor grooming or lack of grooming (undergrooming) is a very common sign of pain in cats, and this may show up as a buildup of dandruff, matting of the fur (which can cause more pain, if severe), and failure to keep themselves clean of urine and feces after using the litter box.
Chewing is not a normal grooming behavior in cats, and may indicate itchiness or pain.
Overgrooming to the point of visible hair loss is also abnormal and may indicate pain, itchiness, or other pathology.
Dogs do not groom themselves in the way that cats do (that’s why we have to do it for them). I frequently hear owners say “oh he’s a very clean dog, he always likes to make sure his paws are clean.” Unfortunately that’s not usually what’s going on. If your dog licks any part of its body often enough for you to take notice, there’s likely a problem there.
Lick staining, which is where the fur turns a rust color from the saliva, can be seen if this goes on long enough.
Dogs may lick due to pain, itchiness, an irritant on their skin, or anxiety.
Changes to toileting behaviors
There are so many reasons why a cat may suddenly stop using his litter box, and a perfectly housetrained dog may suddenly start having accidents inside the house. Pain is a big one! It may hurt the cat’s joints to get himself into the box if he has arthritis, and we know that 90% of cats over the age of 12 have evidence of arthritis on x-ray images.
An important caveat: a pet who has arthritis may or may not be in pain. An x-ray that shows arthritis is not, in itself, proof of pain - it is proof of arthritis.
It may hurt the dog’s body to walk down steps to get outside, or wiggle through a doggie door, or to posture into the normal “dog pooping” position. Male dogs who would normally lift their legs to pee may start squatting like a typical girl dog if they’re in pain.
Changes in gait and mobility
Changes to mobility is a big indicator of pain in cats! Not crawling as high up on their cat tree as they used to? Not able to jump up onto the furniture like they used to? Going up the stairs more slowly? Visibly limping? These could all be due to pain.
Limping always means pain in dogs (I mean, in cats, too, but no cat owner ever questions to me whether or not their limping cat is in pain). Questions I commonly receive immediately after saying this to dog owners:
Q: Can’t a limp just be mechanical and not painful?
A: OK, ok… Very rarely, animals may limp due to a non-painful, mechanical problem--I’m thinking of a little Yorkie with a Medial Patellar Luxation, MPL, who skips every now and then when she’s running because she’s trying to get her kneecap back in place where it belongs, but sometimes MPLs are painful. A dog may have a joint surgically fused and limp as a result of the loss of that joint’s range of motion. But these are unique circumstances.
Q: My dog is limping, but she still wants to play and be active, so she can’t be that painful.
A: When I was an emergency clinician, I saw a labrador who had a barbed fishhook through his tongue. He was tail wagging (whole body wagging, actually), very happy, he tried to dig through the trash, and he tried to lick everybody he came into contact with. With the same tongue that had a fishhook in it. Labradors… And looking at our own species, we all have that friend who is SO excited for the concert, it doesn’t matter if they just sprained their ankle and it’s black and blue and twice the size it should be, they’ll limp their way to their seat and have the best time they can at that concert. With a sore ankle.
Q: If the pain isn’t that bad, isn’t it better not to treat it?
A: Well, no. I feel that all pain should be treated (after all, your friend with the sprained ankle would have had more fun at that concert if she wasn’t in pain). The type of treatment warranted is definitely different for different types of pain. A mild MPL should be treated with rehabilitation therapy, as that may reduce the chances of it becoming more severe over time, whereas a severely painful bone tumor is going to require many different types of therapy (called a “multimodal pain management strategy”) to maintain an acceptable level of pain control. Stay tuned for more on the different types of pain and how (and why!) they are treated in a future post in our pain series.
Changes in posture
Cats and dogs will often arch their backs when they’re in pain. I don’t mean in a quick stretch (“cat stretch” is a normal behavior, and very good for the back muscles and spine), but rather, when they walk around and maintain this posture for more than a few seconds.
Dogs will sometimes sit in a “play bow” type of position when they have abdominal pain, where they’re standing up on their back legs, but have their elbows and chest on the floor. Again, we’re not talking about the play bow stretch that they hold for a few seconds--we’re talking about maintaining this position for noticeable amounts of time. That’s abnormal.
Other behavior changes
This is a list of some of the other behaviors that don’t fit nicely into another category, and may indicate that your pet is painful.
Panting when not exercising or hot
Not greeting you at the door when that’s something they would normally do, or just generally being more antisocial than normal
Greeting you at the door when that’s NOT something they would normally do, or generally being more clingy than normal
Hiding
Becoming “obstinate” or “stubborn” and not following normal cues/commands that they know well
Shaking/shivering
Restlessness and inability to settle or get comfortable
Changes to purring--cats may purr less, or more, if they are in pain (contrary to popular belief, purring is not always a sign of comfort)
Constipation (ok, this isn’t a behavior, but it can be a sign or result of pain, especially in cats or dogs with back pain)
🩺 When Should You Call Your Vet?
If your pet is showing any of the pain-related behaviors mentioned above, your first call should always be to your primary care veterinarian — especially if the signs are sudden, severe, or your pet seems distressed. Acute pain situations like broken bones, seizures, vomiting, abdominal pain, or sudden mobility changes are emergencies that need prompt attention from your regular veterinary team.
However, if your pet is stable and you're worried about chronic pain, or if you've been trying to manage their discomfort but things just don’t seem to be improving — that’s exactly where we come in.
At Ruff Day Vet, we specialize in identifying, understanding, and treating persistent or complex pain conditions. We bring advanced rehabilitation tools, compassionate expertise, and a deep focus on improving quality of life — for both your pet and your family.
🔗 Concerned your pet is in pain?
Let’s help your pet feel better — together.
