Untreated Types of Pain in Dogs

Untreated Types of Pain in Dogs


By Dr. Karen Shaw Becker and comments by Diane Weinmann

The practice of scoring pain is almost exclusively a human medicine tool. A doctor or nurse asks a patient to rate the pain he or she is experiencing with a number, for example, 0 to 10, with 0 indicating no pain, and 10 signifying excruciating pain.

Sadly, the veterinary community has been slow to follow suit. In fact, I regularly have pet parents tell me their vets won’t administer pain medications after surgeries or accidents, even when the client demands them. It breaks my heart that so many animals suffer needlessly, and it infuriates me that doctors who take an oath to relieve suffering fail to do so.

Assessing Pain in Canine Patients

In veterinary medicine, our canine patients can’t tell us in words how much they’re hurting, so pain scoring must be done primarily through observation. It can be used not only with dogs who’ve had surgery, but also any pet dealing with an injury or illness. Since every animal is an individual with a specific pain threshold, to use pain scoring effectively, we must observe the dog before painkillers are given and before any procedure is attempted, no matter how minor (e.g., a blood draw).

We also need to apply some science to the art of observation when determining a dog’s pain score. We need to know average pain levels for the condition the animal has or the surgery about to be performed, and factor those into the equation. This is necessary because many dogs are stoic even when in significant pain.

Pet Pain Scales

Pain scales such as Colorado State University’s (CSU) below are intended for use by veterinarians and their staffs, but they can also be helpful for pet parents who want to learn what signs to look for to determine if their dog might be in pain.1

Pain score: 0 No pain present. The patient is happy, acts normally, moves comfortably, has a normal appetite and (if applicable) does not bother the surgery site. TPR (temperature) is normal.
Pain score: 1 Mild pain present. This is usually displayed by a slight limp, difficulty getting up or down or a slight increase in TPR. The patient is eating, tail wagging and not depressed.
Pain score: 2 Moderate pain present. The patient shows sensitivity and may lick or chew at the surgical site or wound. The patient may refuse to eat and may seem depressed, and has slow, shallow respirations.
Pain score: 3 Severe pain present. Signs include depression, reluctance to move and sensitivity at the surgical site or wound. The patient will usually not eat, may vocalize and may lie down but not sleep.
Pain score: 4 Excruciating pain present. The patient shows all the signs described with a pain score of 3, in addition to intermittent panting, increased TPR — even at rest — constant vocalizing, profound depression, dilated pupils, aggressiveness and deep breathing.

To view the full detailed CSU pain scales, which include rough drawings of how your dog might appear with a pain score of 0, 1, etc.: Canine Pain Scale.

Signs to Watch for at Home

Determining if your pet is hurting is all about picking up subtle cues. Generally speaking, a cat in pain will make herself scarce, whereas a hurting dog is often a dog with a sad or tense expression. Canines don’t typically whine or cry unless they are in tremendous pain, so here are some other signs to keep an eye out for:2

Lack or loss of appetite Not greeting you as usual
Trembling/shivering Crouching
Not bearing weight on a leg Taking longer than usual to urinate or defecate
Reluctance to climb up or down stairs Excessive panting

What to Do if You Think Your Dog Is in Pain

How your canine companion’s pain is managed depends on what’s causing it, so it’s crucially important to make an appointment with your veterinarian for a thorough exam. Once your vet has evaluated your dog and depending on the root cause of his discomfort, there are a number of integrative therapies that blend nicely to reduce the amount of medications needed to manage pain, including:

There are also some newer therapies I’ve used with good success, including the Assisi Loop, a form of pulsed electromagnetic field therapy. In addition, there are a variety of beneficial supplements you can add to your pet’s diet, again depending on his diagnosis and treatment protocol.

A Type of Pain in Dogs That Often Goes Undiagnosed

Myofascial pain, which is pain in the muscles that results from one or more trigger points, is common in dogs, but because it doesn’t show up on x-rays or other diagnostic tests, it’s often left untreated. The result is that many dogs suffer needlessly with significant, chronic muscle pain.

Trigger points, sometimes described as knots in the muscles, are focal points for inflammation and irritation. They may be in an active or latent phase. In the active phase, a trigger point may be very painful for your pet.

If pressure is applied, pain may radiate from the trigger point to other areas of your dog’s body, such as down the limbs (this is known as referred pain). He may also have latent trigger points that are sensitive, but not as acutely painful as active trigger points. However, even latent trigger points may lead to problems for your dog, including stiffness and restricted range of motion.

Causes of Myofascial Pain

There are many situations that can lead to this type of muscle pain. Some of them may occur suddenly, such as an injury from an unexpected wrenching movement, a fall or a blow to a muscle. Often, however, the development of such pain, and its related trigger points, is gradual.

Just like in humans, dogs may suffer from muscle pain as a result of overuse or muscle imbalance. For example, if your dog runs along a fence every day or favors a back leg due to arthritis, some muscles are being overused and others underused, leading to muscle imbalance and the development of trigger points.

When the pain and related dysfunction becomes chronic, it’s known as myofascial pain syndrome (MPS). Unfortunately, MPS is rarely mentioned in conventional veterinary schools, so it’s often overlooked and left untreated. As veterinarian Dr. Michael Petty notes in his article for dvm360:

“Myofascial pain syndrome is a difficult-to-diagnose and seldom-treated condition in dogs. This is despite the fact that it’s been a recognized pain issue for more than 400 years and entered mainstream human medicine almost 80 years ago. It’s rarely taught in the university setting and there are no books about it.”3

Potential signs of myofascial pain include weakness, muscle tension and stiffness and lameness, or your dog may jump from pain or twitch if you happen to press on a trigger point. Without treatment, trigger points and myofascial pain can turn into a chronic and worsening condition

Treating Myofascial Pain by Relieving Trigger Points

If you suspect your dog is suffering from myofascial pain, see a holistic veterinarian who is experienced at finding trigger points. Once they’ve been located, there are a couple of options for treatment.

One, which is fairly invasive, is dry needling. This involves using an acupuncture needle that is pushed through your pet’s skin to stimulate the trigger point. This may release the tight muscle bands associated with the trigger point, leading to decreased pain and improved function.

Electro-acupuncture and acupressure may also be helpful for some dogs with myofascial pain. Cold laser therapy and ultrasound therapy may be beneficial for dogs that won’t tolerate acupuncture. Another less invasive option is manual manipulation of trigger points using trigger point massage or trigger point therapy. I have found that recurrent trigger point problems can be a result of an underlying chiropractic issue, so if your pet isn’t getting better, consider getting a chiropractic evaluation.


Real life experience from Diane Weinmann

My dog Neko went crazy because some dogs tried to put their faces through our fence.  After they left he ran laps around our back yard because he was so over wrought.  Did I mention he’s a husky?  So once I got him inside and calmed down he flopped down and refused to move.  I figured he was tired from all the running but he was hurting.  Eventually he got up and was limping then holding his leg up and walking on 3 legs.  He was also whimpering.  I immediately started performing reiki energy healing and healing touch for animals on him.  I put an ice pack on the muscle on his hip/leg area.  I also gave him CBD oil to help with pain as I continued to reiki/HTA him and ice his leg.  It took approximately 6 hours for him to really stop whimping when he moved but with rest and repeated healings he completely recovered.  I could have also performed acupressure but was afraid to inflict pressure on an already sensitive area.  In hindsight, I should of went ahead and provided acupressure in addition to the reiki/HTA energy healing. Ah well, live and learn –it’s not like he won’t do it again..he’s a HUSKY!



Changes in Your Pet’s Behavior As they Age

By Dr. Becker and Diane Weinmanndog with glasses

Most pet parents are aware of the physical changes that can take place as their animal companion gets up in years, but did you know your aging pet’s behavior may also change?

Of course, any variation in your pet’s normal conduct should be discussed with your veterinarian, because dogs and cats often express underlying physical problems through a behavior change. For example, a painful hip or back can result in one or more of the behaviors listed below.

Changes in Your Pet’s Behavior As they Age

  • Aggression

Unfortunately, along with an age-related reduction in hearing, eyesight and sense of smell, your pet may startle more easily, and in some pets this can result in unprovoked aggression.

The situation will require some sleuthing on your part, potentially with the help of your veterinarian, to understand the specific causes or triggers of the behavior so that a treatment or behavior modification protocol can be implemented. This may require the help of a veterinary behaviorist, and I encourage you to contact one sooner rather than later if your older pet is having episodes of unprovoked aggressive behavior. Aggression can be holistically handled in many ways. Essential oils, bach flower essences and animal communication can help to get to the root of the problem and restore your pet’s good nature.

  • Anxiety

Pets who are anxiety-prone as youngsters and adults (for example, those with noise phobias or separation anxiety) often become more so as they age. Signs of increasing anxiety in your pet can include:

  • Heightened sensitivity and irritability
  • Fear of and/or aggression toward strangers or unfamiliar pets
  • Decreased tolerance for being restrained or even touched
  • Needing to be with you constantly or demanding more attention and increased physical contact
  • Destruction of doorways (typically the ones you leave by) and/or refusing to eat while you’re away

Positive reinforcement training may be helpful in curbing anxiety-related behavior in your pet, and it certainly can’t hurt as long as you don’t get too focused on results. It’s important to realize that just as you’ve dealt with some level of anxiety in your pet for years, you should expect and plan for amplification of those issues as she ages. Bach flower essences or essential oils can help with anxiety. Call Diane Weinmann to obtain a custom treatment bottle to provide peace of mind to your pet.

  • Destructiveness

Sadly, some pets become destructive as they age – a situation that can be quite disturbing for family members. You might lose a cherished belonging or two at this stage of your pet’s life, or she might turn her destructive urges on herself.

Some older pets develop pica (eating non-food objects) for the first time. Others seem driven to lick, suck or chew their own body parts, those of family members, or household objects. Digging and scratching can also become a problem.

Once again, it’s important to talk with your veterinarian about any destructive tendencies your pet develops to rule out an underlying physical cause. Meanwhile, you’ll want to pet-proof your home and belongings, and insure your pet has plenty of appropriate toys to gnaw on, but only when you’re around to supervise. I have not received any animal communication calls due to this issue but if you happen to experience destructiveness with your pet, and the medical side of it has been ruled out, give me a call!

  • Hypersensitivity, Fears, and Phobias

If your senior pet has deteriorating vision or hearing, even his own home can become a frightening place. Pets thrive on routine and consistency, and this goes double for aging companions who are having trouble navigating even familiar terrain.

It’s important at this stage of your pets’s life to keep his environment consistent. Don’t arbitrarily change the location of his food or water bowl, his crate, his bed, or his toys. Try to avoid rearranging the furniture in your home. Mealtimes and potty walks or litter box locations should be consistent from one day to the next, as well as exercise and play time. Pets adore routine!

If your pet is becoming more sensitive to normal household or neighborhood sounds, play background music or keep the TV on to mask noises.

  • Inappropriate Elimination

If your older pet seems to have forgotten his housetraining, there are a number of potential causes, none of which involve deliberate disobedience. The first order of business is to make an appointment with your veterinarian to rule out any underlying disease process. Once that’s done, you’ll need to investigate other possible causes for inappropriate elimination, including decreased mobility, needing to go more often, or less control over his bladder or bowels.

Initial steps you can take to resolve the problem include taking him outside more often to eliminate, and/or introducing/re-introducing him to a crate. It’s also important to recognize the difference between urine dribbling, over which your dog has no control no matter how often he goes outside, and urinating. Cats that eliminate outside the litter box may become more sensitive to the litter being used or may not be able to get to the litter box depending on the location due to physical issues that never existed when they were young. Numerous litter boxes may be appropriate on different floors and even several on one floor if the house is large. Again, once a medical reason has been eliminated from the equation contact an animal communicator to determine where the problem lies.

  • Nighttime Restlessness

Some older pets develop an inability to sleep through the night. I know I have that issue and I am only middle-aged! Age-related issues that can cause this change in your pet’s behavior include loss of vision or hearing that affects sleep quality, the need to relieve himself more often (that’s my issue), or an increased response to noises that never bothered him before.

All pets, including senior and geriatric pets, need age- and condition-appropriate exercise each day. If your pet gets some exercise already, try increasing the time he spends playing or taking walks. If he doesn’t get much exercise, start safely increasing his daily activity level. The goal is to tire him out physically so he’ll be more likely to sleep at night. With cats, play with them using a new toy will usually stimulate movement.

If your dog needs midnight trips outside to relieve himself but is otherwise healthy (as confirmed by your vet), he may be taking in too much water before bed. Try removing his water bowl after dinner, and insure he gets an opportunity to relieve himself right before you retire for the night.

Let your pet sleep in your bedroom. Sleeping near his humans should help ease any anxiety that is contributing to his nighttime restlessness. If you allow your pet on your bed with you, you may want to supply a ramp or stairs for them to safely get on and off the bed.

  • Obsessive-Compulsiveness

These are behaviors your pet may perform over and over, for no apparent reason. They can include constant licking (usually of a particular body part like a paw), which can result in hot spots. Other O-C behaviors include repetitive tail chasing, spinning, jumping, pacing, “air biting,” and staring blankly into space.

If a thorough workup by your veterinarian shows no medical cause for your pets’s obsessive behavior, she may be doing it to relieve feelings of anxiety or conflict. One way to try to break the cycle is to simply stop her as soon as she begins the behavior, by speaking calmly to her and petting or massaging her.

If the obsessive behavior is potentially dangerous or harmful and you don’t feel you can manage it on your own, talk with your holistic veterinarian or a veterinary behaviorist or an animal communicator.

  • Vocalizingcat lounging



Excessive vocalizing is more common in older cats than dogs, but if your dog is growing more “talkative,” it can be unsettling because as her guardian, you want desperately to understand what she needs from you.

An increase in vocalizing can be caused by the disorientation that comes with a decline in cognitive function. It can also mean your pet isn’t hearing or seeing things as well as she once did, or that she’s in pain.

If your veterinarian has ruled out an underlying medical condition, try training your pet to respond to a gentle verbal cue such as “Quiet” or “Shhh”, and reward her lavishly for her efforts. However, keep in mind it’s possible she doesn’t realize she’s making noise, in which case she’s not likely to learn a verbal command to be quiet. If that’s the case, you’ll just need to distract her when she vocalizes by speaking quietly and reassuringly to her. Another option would be to call me, Diane Weinmann to communicate with your pet to discover what the issue my be.

Suggestions to Enhance Your Older Pet’s Quality of Life

  • Address subtle changes when you first notice them, talk to your holistic vet or Diane Weinmann about homeopathic remedies, bach flower essences, essential oils, herbs or nutraceuticals that may be appropriate for your pets’s symptoms.
  • Treat-release and puzzle toys provide fun and mental stimulation.
  • Walks instead of jogs. Tug games instead of chase games. New toys for cats.
  • Ramps so they can still get into the car or up on the bed or their favorite chair.
  • Adequate social interaction with other pets and people, but take care not to over stimulate your pet – short periods of exercise and playtime in controlled situations are best for older animals.
  • If your pet has problems hearing or seeing, use odor cues like essential oil diffusers or other aromatherapy products to help him find his way around.
  • Guide your pet with clear cues and easy-to-follow instructions, especially if they are showing signs of mental decline.
  • When you talk to your pet, keep your voice quiet, calm and kind. No shouting.
  • Keep your pet at a healthy size – overweight animals are at significant increased risk for disease as they age.
  • Provide extra warmth on cold days.  Soft pillows and beds, blankets to snuggle in plus to wear outside along with rain gear if appropriate.  Arthritis acts up in the damp and cold weather. Allow pets to bask in sun as it warms their aging bones.
  • Maintain your pets’s dental health.
  • Feed an anti-inflammatory, nutritionally balanced, species-appropriate diet, which is the foundation of good health and a long life for pets of any age. Contact your vet to obtain ideas on which brands would work best for your pet. Also you can contact someone certified in canine nutrition like Diane Weinmann.
  • Lots of good old fashioned quality time together, talking, cuddling, brushing them or just letting them sit on your lap or next to you will help your pet feel cherished and loved as they can no longer do the physical things that they used to. It helps them feel like they are still valuable so tell them your troubles and you will be surprised how better you both will feel.
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