The Other End of the Leash

Patricia McConnell, Ph.D., a Certified Applied Animal Behaviorist, has made a lifelong commitment to improving the relationship between people and animals.

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Welcome to an ongoing inquiry about the behavior of people and dogs.
Blog Home >> Animals and the People Who Love Them >> Accepting That Your Dog Might Be In Pain

Accepting That Your Dog Might Be In Pain

August 18, 2015 >> 77 Comments

Years ago I saw a client whose dog, let’s call him Charlie, entered the room with a neck twisted slightly to the side. It wasn’t extreme, but it was obvious, if you paid attention to the way the dog moved. The owners had brought the dog in because after six years of being a docile and loving dog, he had become aggressive in a variety of contexts. Except after we talked it became clear that there was always a consistent trigger–any time someone, anyone, reached toward Charlie’s collar he growled or lunged forward, teeth flashing. The week before he had finally connected, biting a friend who had reached toward his collar to attach the leash.

Charlie had been left in the car while we talked, and predictably, when the owners began to attach the leash to his collar he lunged forward, ears flat, eyes round. They literally couldn’t get him out of the car until I went to get a slip lead, which we looped around his neck with our hands well out of range. I noticed his neck as we all walked back into the office, and asked if they had seen their veterinarian recently because I suspected that Charlie was in pain.

“Oh no, he’s fine!” they answered. “He eats like a horse and loves to play fetch. We get tired before he does. Really, he couldn’t be in any pain, and besides, we recently took him into the vet clinic for his annual physical and the vet said he was doing great.

“Well, here’s why I asked,” I said. “First of all, if a dog becomes aggressive after having been friendly and docile for its entire life, usually something is going on, often related to the dog’s health. Second, every time Charlie growled or attempted to bite, someone was reaching toward him. The circumstances that you noted may have varied–in the car, in the kitchen, when you tried to get him to come away from the window–but in every case, someone reached toward Charlie right before he began to growl. Third, look at how he is holding his head. Do you see how it’s titled to the right?” Charlie’s owners shook their heads again. “No, I’m sure he’s fine. Really.”

I mention this case because lately I have been wondering why it seems so common for people to dismiss the idea that their dog might be in pain. A good friend got me thinking about it when she stopped by with her adorable, elderly dog. Her vet had suggested that the dog’s weak hind end might be related to arthritis, and to try giving the dog an anti-inflammatory and pain killer to see if it helped. Her first reaction was to dismiss the suggestion that her dog was in pain (although after we talked she called her vet clinic right away).

She is not alone. An experienced veterinarian told me that about 25% of clients who bring in a limping dog say “I don’t think he’s in any pain.” “Well then,” the vet asks, “why would he be limping if he’s not?” I asked a second veterinarian, who also does acupuncture and treats a lot of cancer patients, if she had also experienced owners denying that their dog could be in pain. It seems she’s had a similar experience: She reported that clients often asked if their dog was in pain, but then tended to discount it if she answered that the dog might indeed be in pain. In addition, she found on follow ups that people often stopped giving their dog pain killers very soon after even a major surgery, one that would have their owners moaning for days without medication.

None of us need convincing that pain is important. Besides being at best unpleasant and at worst horrible, pain in companion animals can be an unacknowledged cause of behavior problems, including aggression. Given that most people who take their dog to a vet or behaviorist have no problem believing that animals can feel pain, my question for you is this: Why is it so common for people to dismiss the idea that their pet is in pain? Of course, animals can’t use language to tell us that their stomach aches or their paw hurts, and the symptoms of pain are highly variable. But humans too can be in a lot of pain and say nothing about it and show no visible signs of it to others.

I have no good answers to why it is so common for people to deny that their beloved dog might be in pain. Certainly, in a general sense, our species is adept at denial.  Perhaps we deny pain in pets because our animals can’t complain out loud about it? Because we have such a strong dividing line between “human” and “animal?” Because we tend to discount our own pain often? (Raise your hand if you’ve tried to ignore a pain for a long period of time, then finally found relief and thought “Why did I wait so long to deal with this?! I’d write more on this, but both of my hands are raised up in the air….) Here’s an engaging post, “Denying Denial”,  by Kirby Farrel that might explain why we are so good at it: He argues that it’s a useful way of coping, and sometimes has its benefits.

And so, dear reader, I toss this question out to you. Why it is that behaviorists and veterinarians find that owners are often resistant to believing that their pet is in pain? I await your wisdom.

MEANWHILE, back on the farm: I’m calling this The Summer of Everything. Move the business office. Redecorate the living room. Build a bedroom on top of the hill. Take the gardens to another level. Finish the memoir. Busy yes, but lots good.  And, soon… Spain! I am beyond excited to go to Spain, in less than a month from now. Por favor, ven y saludar en Madrid los días 19 y 20 de septiembre!

Speaking of knowing what’s going on inside your dog–here’s Maggie after a long play session with Willie. You can see she’s very hot by the length and curl in her tongue. She tends to heat up fast, so we watch her carefully, but at the same time we need and want to increase her heat tolerance a bit. So we’re always walking a balance with her, not letting her get too hot without over protecting her and making her even less heat tolerant. I suspect she’s a tad uncomfortable right now, and wouldn’t push her any farther than this. But she is getting more heat tolerant as we work on it, which is important here when it can be so hot and humid in summer.

Maggie tongue

 

 

 

 

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Comments

  1. LisaW says

    August 18, 2015 at 10:04 am

    This is such an important topic. One of my dogs is as her vet says: “A great dog but not put together very well.” Her joints are her weak spot, and after almost 2 years rehabbing her torn CCL, which healed amazingly well, she started limping on the opposite leg. I was convinced it was her other CCL, but after much rest and many exams and writing down her symptoms and timing, and process of elimination, our vet decided it was most likely her hip (she has hip dysplasia) and a soft tissue injury. She’s slowly improving. We’ve all learned to pay closer attention to her signals, and she has actually gotten much better at limiting herself. She gives us many more signs that she’s ready to rest (this from a dog that lives to run and chase balls and jump and twirl). It is a balance – what she needs and loves to do versus possible after effects. Swimming is our current activity of choice, and we’ve been engaging her mind even more than we had been. I do not hesitate to give her pain meds and/or NSAIDs when needed.

    She has taught us to be much more aware of how her body moves and how she is acting and adjust accordingly. I know her “normal” gait with my eyes closed. I even check her tongue from time to time, if there is a hint of purple, it’s time to slow her down (tongues should be a nice, red/pink color like Maggie’s; darker pink or purplish is an indication of pain and stress).

    With her initial CCL injury, there were different opinions on her diagnosis and treatment plan. It was difficult to sort through and took a lot of energy and persistence to come up with a plan and a vet that would work with us on improving the whole dog not her injury in isolation and not jump to surgery immediately. I wasn’t in denial so much as in a mass of confusion.

    I think sometimes denial or slow action is based in fear. It can be a rabbit hole of research and doctor visits and costly specialists. The devil you know . . .

  2. Abby says

    August 18, 2015 at 10:18 am

    Having a dog in pain is hard even when you admit the problem. I’m so grateful now that my dog’s pain issues are managed I have found the book canine massage for the athlete in every dog. I find the massage sessions relieve pain and indicate if new pains are a problem. Most enjoyable for both of us it provides a different aspect to bonding/playing.

    http://www.holistictouchtherapy.com/books-and-dvds.html

  3. jen says

    August 18, 2015 at 10:35 am

    I wonder if it’s a defensive, ego thing. That we as the dog’s guardian would “certainly know if our dog is in pain” and yet if it is, we’ve completely failed at what we’re supposed to be doing. Admitting that the dog is in pain is admitting that you haven’t done your job properly…so it’s better to deny it.??

  4. Jesse S says

    August 18, 2015 at 10:41 am

    I think we attribute dogs as tough. They can handle a lot more pain and discomfort than we can, or so we say. It becomes easy to pass these things off when we dismiss them as tough. I also think in terms of pain medication cost plays into it. If we write off their pain and discomfort we can make it easier to ignore the costs of medication. We have a dog that is about to turn 11 years old and now has some strong hip joint and arthritis pain. We always knew the day would come when he would have issues. He is a weird mixed breed and his long body muscular and short legs have always put stress on his body. But that didn’t make the vet bill and the monthly cost of medication any easier to swallow. It costs hundreds of dollars to give what essentially amounts to a large dose of advil. It has made a big difference in his life though. He still doesn’t move like he used to but , you can tell his is no longer in pain. However; this is a big cost we have to deal with when I just lost my job and have a baby on the way. If we were to dismiss his pain because he doesn’t illicit a lot of response then I would have to give up other things for his medication. I don’t think people do it maliciously but, they might push aside what they are really facing to avoid the bigger question of can I afford this.

  5. Jenny Lujan says

    August 18, 2015 at 10:43 am

    My beloved great Dane, Kady, during the last couple of weeks of her life, began to nip at staff at day care when they tried to move her to help her to the bathroom, etc. And this was with her receiving almost maximum amounts of pain medications. It got to the point that one time when trying to help her go to bathroom at home, she nipped me enough to leave a bruise. When I called her name immediately afterwards, she immediately “came back” to me and realized it was me. Two days later, after collapsing in the yard, she looked at me and I knew she was telling me she was ready to go and I told her I heard her and it was ok. And a day later, after a wonderful time together for the morning and early afternoon, she was helped to pass on with her favorite vet and me.
    I absolutely believe that pain medication, if warranted, is necessary. When a sweet dog such as my Kady resorted to nipping even me to express her pain, I had to honor that. I believed that I would not be taking care of her if I hadn’t included pain management in her treatment plan.
    And now, my three legged Greyhound receives mild pain medication and regular acupuncture to help with his back pain and long-term stress on his body from missing a leg since he was 3 months old (he’s 7.5 years old now).
    Thank you so much for bringing up this important topic.

  6. Betsy Calkins says

    August 18, 2015 at 10:46 am

    Oh Trisha…thank you so much for this. I have at least two clients now who dismiss me every time I mention that their dog may be in pain…and one dog has several broken teeth from trying to escape from his crate. (Before they hired me). I suspect that some of the denial is fear of the unknown (how can you prove pain?) and some of the denial is fear of the unknown cost. But now that I’ve read this, I will keep at it, for the sake of their dogs.

    Happy travels to you.

  7. Monika & Sam says

    August 18, 2015 at 10:59 am

    My sense is people deny it because they only associate noises like yelps to indicate pain. Dogs are stoic especially in that regard and we erroneously believe life’s creatures associate to the world around them the same way we do. Pawsome topic. I hope more people look deeper at their pets and expand a small world vision to include all possibilities about what’s going on within and outside of them.

  8. widogmom says

    August 18, 2015 at 11:03 am

    I think one of the reasons people are in denial about their pet’s pain is that many folks (especially men; don’t get mad, guys, it just means you’re do-ers and you’re trying to help) tend to be frustrated by/not want to hear about problems they feel they can’t fix. Up until recently, pain management has lagged behind the rest of the veterinary (and medical) industry; for many years I felt helpless to do anything about our dog’s pain.

    One of our dogs (RIP, Miss Kali, O Intense One) had spondylosis (in addition to a seizure disorder; such fun) and was on a hair trigger constantly. Managing her pain & seizures helped, but we didn’t find out about the spondylosis until much later in her life. I wish we could have done more. We have an amazing vet now who is very much a proponent of pain management, especially post-surgically.

    I also agree with Lisa W, too; looking into a potential medical issue can be a huge (and expensive!) can of worms to open, and can be daunting to even the most dedicated and responsible pet owner.

  9. Bits Foerg says

    August 18, 2015 at 11:29 am

    Even worse, when the VET won’t admit the dog is in pain – because it isn’t yelping when manipulated. A student has a 2 year old rescue golden who limps noticeably. On my suggestion, they took the dog to the orthopedic specialist at the university, who says that because there is nothing visible on an X-ray, and the dog doesn’t verbalize when being manipulated, there is nothing wrong and nothing to be done. (If it ain’t a surgical solution, it doesn’t exist…) They are seeking second opinions.

  10. Peggy Lee says

    August 18, 2015 at 11:37 am

    What an important issue! I would have plenty to say if I had the time… I seem to see so many dogs being kept alive with obvious signs of suffering because of owners inability to deal with their own feelings, fears and issues with loss and death. In addition, I suspect I am seen (or would be) as insensitive or less bonded with dogs in advocating for an end to a dog’s suffering.

    When I worked in an animal shelter and assisted with euthanasia, people would sometimes say “Oh, I could never do that. I love animals too much.” To that, I want to distinquish between sentimentality and love. Sentimentality is an opinion or view based on emotion. When we truly love, we do what is in the best interests of the dog/person, etc, even when it’s very very difficult. And yes, I know it isn’t that simple and pain can be difficult to diagnose and it’s never black and white…

  11. Lila says

    August 18, 2015 at 11:41 am

    Badger is just shy of 1.5 years old and he broke his leg badly at 4 months old. He now has a screw and a wire in his elbow and noticeable muscle wasting, reduced range of motion, vargus deformity, and of course a limp.

    I finally am able to afford physical therapy for him, and he’s doing better. One of the things they did was give us an anti-inflammatory, and that made a big difference in how willing he was to use the leg. We just kind of assumed that he was okay and couldn’t be hurting too much, but seeing how much the therapy and medication has helped, I’m ashamed to think about the pain he must have been in even after the splint was off and he was running around again.

    Of course, being a crazy little terrier, the bad leg doesn’t slow him down–he loves to run so much and he’s so happy when he’s zooming around.

    Maybe that’s part of it – working dogs especially will just keep going, even when they’re in pain, so it makes it easier for us to ignore.

  12. Trisha says

    August 18, 2015 at 12:12 pm

    I wanted to add to other comments about the cost of pain management being one reason that people try to dismiss that their pet might be in pain. This is not a minor issue for many. I am lucky now that I can afford most veterinary care for my animals. However, I will never forget having to put my cat down because I simply didn’t have the money for another surgery. I’d maxed out my credit card (it took me 2 years to pay it off) for the first surgery, and although I also didn’t want to put my cat through another trauma when the prognosis wasn’t great, money was an important factor. I’ll never forget it, although now, remembering to be kind to myself, I know that I truly did have no choice. It’s good to know though, that there are things one can do to relieve pain that might not be super expensive. Not my line of expertise though… any thoughts from the rest of you? Quick thoughts include aroma therapy, massage from the owner, Arnica cream and homeopathic medicine (very inexpensive), etc…

  13. Dirk says

    August 18, 2015 at 12:17 pm

    I’m not sure why people tend to deny that their dog is in pain, but it’s likely for a variety of reasons. Fear of the worst, pride, money, etc.

    I would like to add a related thought; on several of the dog related Facebook pages I follow, owners will frequently post symptoms that their dog is experiencing and ask what they should do. Many times it’s beyond obvious they should be on their way to the vet. I can’t recall where I heard or read this but, “A child can verbally tell you when they don’t feel well, but your pet only has physical cues to let you know, and often by the time you figure it out, they are quite ill. Get thee to a vet!”

  14. Martina says

    August 18, 2015 at 12:19 pm

    This evening I was witness to the most fond and gentle play session between my Golden (5 ½ years) and Cavalier (5 ½ months). The other two dogs (Labrador and Cavalier) observed this situation as if in slow motion, as this had never happened before.
    So what had happened that made this change possible?

    About 1 ½ weeks ago I realized that Robby (Golden) was limping on both front legs. He was operated on his elbow (dysplasia) when 7 months old and regularly I asked our vets if he could be in pain – which they always denied.
    He also has some anxiety problems and was submitted to a thorough check by his new vet last autumn to exclude any physical problems. All tests were negative and we started with a homeopathic treatment. Results were slow but important.
    When the cavalier puppy moved in Robby was very soft with him and we thought we were on a good way until the heat came, week after week with temperatures around 35° Celsius (95F) and nights without relief.
    All humans were on edge and dogs too, that’s why I gave no further thought to Robby sometimes being in a bad mood, e.g. not allowing the other dogs near him.

    Until I saw him limping. As this occurred on a weekend, I gave him lots of space and possibility to retreat. The vet tested his mobility and I saw that Robby was in extreme pain during these tests.
    He is now on pain medication plus antibiotics, as there seems to be an infection somewhere. The change was immediate; already the next day his mood had improved and the other dogs could walk past him when he was lying on the floor without any bark attack.

    Yesterday he played with all the others, he was happy about another Golden coming to visit this afternoon and then this play session.
    And here I am wondering – did I miss something? Did I react too late? Has he been in pain all along? I’ve got no idea. But to be on the safe side, we’re also seeing a new physiotherapist this Friday, to make sure that he can move without any problems.

  15. Karen says

    August 18, 2015 at 12:31 pm

    When faced with this conversation, I put forth the thought, when animals in the wild show pain/weakness they are usually targeted for dinner. To survive, they mask this….I believe there was a video of a dog,maybe a lab, that had a painful injury. When the owners came into the room the dog appeared fine. When they left, the dog went to a corner and curled up not moving. When I mention the “dinner in the wild” scenario, owners seem to understand a bit more….as a past vet tech, and now trainer have had many of these talks.

  16. Tressie Dutchyn says

    August 18, 2015 at 12:33 pm

    It’s bad enough when owners don’t acknowledge the pain a dog is in, but its disgraceful when its a vet who has been caring for the dog for several weeks. I recently fostered a dog who had a front leg deformity. When I picked him up from the vet I asked if he was in pain and she said “Oh no – he’s fine.!” Well it didn’t take more than a day or two observing him when I had him home that it was obvious he was in pain. I contacted the vet and to her credit she did send me pain medication – albeit at a very low dose. A couple of months later he was x-rayed by same vet, and found to have severe arthritis in the ‘good leg’ and had attacked the veterinary staff while they were attempting to restrain him for the x-ray and was subsequently euthanized. I am still heartsick about it : (

  17. Karen says

    August 18, 2015 at 12:35 pm

    Also FYI, for pain/inflammation I have had absolutely amazing results from turmeric mixture called golden paste. The info can be found on turmeric users group on Facebook. This group was started by a vet. Both 14yr old dogs are perky puppies again….I can’t speak enough about the results. And I take it too!

  18. Beth F. says

    August 18, 2015 at 12:53 pm

    I have noticed that many general practitioner vets seem to poopoo the idea that a dog with behavioral issues might be in pain, especially if he is not obviously limping. I have a great that but I had to convince him to take xrays and do a deeper than average exam when I was convinced that there was something amiss with my dog that was not entirely behavioral. Turns out that he has a soulless injury and it makes his back hurt quite a bit. Because he is a somewhat fearful dog in the first place it’s easy to assume that it change in his behavior is because of his temperament not because he’s in pain. Putting him on pain meds made a dramatic difference in his fearful behavior.

  19. Beth F. says

    August 18, 2015 at 12:54 pm

    That should say “psoas” not “souless”…thanks auto correct!

  20. Rebecca Golatzki says

    August 18, 2015 at 1:00 pm

    It always amazes me that my clients think as long as their dogs aren’t whimpering or crying they aren’t in pain. I NEVER see dogs do this with chronic pain- it just doesn’t happen. People for the most part are SO much worse than the average dog at learning to read their companions’ body language. I wrote a blogpost on this same subject several years ago- http://www.sheltiedoc.blogspot.com/search/label/pain. My own dog last spring was just “not right”. He was eating, but instead of finishing his food before I made it back to the couch, it was taking him up to 5 minutes to finish- WAY too long for him. And while he was still willing to run in agility and I could see no signs on the course, instead of tearing down the deck stairs in the morning to chase squirrels he was going down, peeing on the closest bush and coming right back up. Physical exam was normal, as was bloodwork, radiographs, and even an ultrasound of his chest and abdomen (yes, I’m a little paranoid). Several WEEKS after I first started noticing something was not right, he sloughed several toenails and started showing the first signs of a disease called lupoid onchyodystrophy, where the nails become dry, twisted and tend to fall off. I’ve never diagnosed a patient with it until the nails were really twisted and grossly abnormal, and I don’t remember ever having a client bring in the dog for that problem, it was always something I pointed out during an exam. Yet, Cory made it clear to me that he was really uncomfortable even in the very early stages and within 48 hours of starting treatment he was 85% back to his normal self and I’ve been able to keep the problem pretty well controlled. I still thought there was something just not right about his appetite though, and after getting him down and going over him with a fine toothed comb I also discovered a ruptured ear drum- he’s never had an ear infection and had no related symptoms other than once a week or so shaking his head and scratching at the ear, but that was the final piece of the puzzle and treating that brought him back to 100% normal (except for some residual hearing loss). He’s my third older dog to rupture an ear drum with no symptoms directly related to the ears. None of these things were going to kill him, but finding and treating them definitely improved his quality of life. But they were also dependent on noticing very subtle symptoms that were difficult to pinpoint. It’s always a hard call to decide when to keep looking and when you are over-interpreting.

  21. Valerie says

    August 18, 2015 at 1:01 pm

    I lost my heart dog, a beautiful Giant Schnauzer, a few months ago. He was a Ferrari of a dog and turned heads his entire life, wherever he went. He had a prance like a Hackney pony, which he got compliments for often. Around the age of 10, his hind leg would drop once in a while mid-prance. It was very hard for me to accept that my magnificent dog was getting older, that he was in pain. I think a lot of dog lovers probably feel similarly. We don’t want to believe that our best friends are hurting. Also, many arthritis meds have nasty side effects that can harm our dogs in other ways, so I tried to hold off on administering them for as long as possible.

    When my dog died of a heart attack, I learned that he had likely been suffering from congestive heart failure. Another possibility was a fast moving form of cancer, but I didn’t have an autopsy done, so there is no way to be sure. When I told my friends of his passing they all said, “Don’t worry, he didn’t suffer.” THAT blew my mind. Congestive heart failure and cancer occur in humans as well, and I doubt anyone would ever say a human with either disease “didn’t suffer.” I was actually tortured for a long time (and often still am) thinking about how much pain he must have been in during the last month of his life. He was so incredibly stoic, a true gentleman until the moment he took his last breath, which made it even harder to accept that he was in pain, much less dying. I miss him and really hope he didn’t suffer too terribly.

  22. Rebecca Golatzki says

    August 18, 2015 at 1:04 pm

    PS Trisha if you haven’t tried increasing the fat level in your heat stress dog’s diet give it a whirl. I did this for one of my dogs who was very prone years ago after going to a sports medicine conference and seeing a presentation on a study done at Eukanuba (don’t know if the paper’s still on their website) that indicated higher fat diets helped with increased heat tolerance (and improved scenting ability among other things). He didn’t have another episode for 7 years until we had to change him to a lower fat diet as a senior when he had some mild pancreatic issues (and this was back when we did a lot of outdoor agility trials in 90+ degree heat).

  23. Ellen Jefferies says

    August 18, 2015 at 1:06 pm

    We have a great dane female, now 15 mos, whose owners left her out at night unconfined and of course she was hit by a care at 4 mos. The owners either wouldn’t or couldn’t pay to repair the shattered femur at the specialty clinic, my vets refused to amputate or put her down and took possession, and I volunteered to pay for the repair and do the rehab after the first two weeks in the hospital. She is still with us and probably always will be. During her first weeks with us, she had terrible diarrhea, otherwise she seemed happy and lively. Seemed like stress was the most likely culprit and pain the most likely stressor. Shattered femurs hurt for ages. It hadn’t ocurred to the vet that she might still be in pain, after all, it was 3 weeks post surgery. Tramadol cured the diarrhea instantly. We use a lot of tramadol with our older dogs. Old age is painful.

    What is so frustrating is that our society’s position vis-a-vis treating pain is at best that it isn’t important and at worst that is sinful. Look at the attitude toward use of narcotics and cannabis, both well recognized pain relievers, but heaven forbid, you might become addicted and pot is just plain bad. They even take this position with patients who are terminal. So why should we be surprised about our denial of our pets’ pain.

  24. Kellen says

    August 18, 2015 at 1:12 pm

    I wonder if it’s just because dog’s show pain differently that humans? We hurt, we complain, and lie down, and don’t want to do anything. The first time my dog got hurt, it took me a little while to realized. She had a cut on her foot, and she would limp, sure, but she would still tear around the dog park at top speed with that limp.
    Possibly because dog’s don’t let pain change their personalities too much, we assume that it must not really be hurting them?

  25. Martha Chiang says

    August 18, 2015 at 1:22 pm

    Trish, thank you so much for this special post–between your remarks and Kirby Farrel’s piece on the paradoxical and essential nature of denial as part of the human experience, you have given me so much to think about. And Kirby’s piece is particularly timely for me today. That said, I was not going to comment further until I read of (and each of you who commented above, I learned so much and I thank you individuality for your remarks) Kady, beloved Great Dane lost recently by Jenny Lujan that I felt compelled to talk about my own Kady, beloved Giant Schnauzer and my heart dog whom I lost suddenly last December 5 to a horrible frontal lobe brain tumor and lung carcinoma–the best and the brightest at CSU have never been able to identify the source as there were questions about her liver as well.

    My Kady (Perfect Kadence) was not just my heart dog but my heart. During her life I suffered from chronic migraines and then one awful day, the medications for migraines led to a fall from our hay stack onto a concrete slab. I lost the use of my hand, my dominant hand, for more than two years and am still fighting to get the use of it back. Because of poor medical care, I developed a chronic neurological condition formerly known as RSD, now known as CRPS (Complex Regional Pain Syndrome). One of the many horrific symptoms is that one feels like on has been set on fire. I could touch nothing at the beginning, no fabric, air moving over my hand hurt and I was bedridden for months and months. My two girls, Kady and her younger half-sister Élan, were my constant companions throughout the worst days and nights, and days that turned into weeks, months than years of extreme and unbearable pain and the first time I had “failed” to recover from an injury. Something I was in denial about–words like “incurable,” “spreads to unaffected limbs, ” etc. I refused to read, refused to accept. Being able to touch, pet, stroke, massage Kady and Élan was my foremost goal and eventually my best hand therapy. Their constant smiles and encouraging eyes inspired me to refuse to accept what so many MDs said was inevitable.

    The light in Kady’s eyes shown uniquely for me in a manner I doubt (but I can hope) I will ever see again in any dog’s eyes. Each day despite my pain my one goal was to make her one greatest joy come true: out of the house into the lovely forest behind our home for her daily walk. No one who could see how much that time, that freedom, that companionship meant to her could deny her. Least of all me. So sometimes half-carried by my wonderful husband, sometimes in so much pain I could barely put one foot in front of the other, we walked and she and I smiled through my pain. And Élan aka our “joy of living” always so happy to go, yet Élan interacts with her world and me and on her walks with tennis balls. One can always find the way to our house through the woods by locating the tennis balls!

    When one day Kady pulled up out of breath during a game of ball at home, I was most concerned. A few hours later, she was ataxic. Our former vet, now known for his bedside manner, blurted out “brain tumor” that day and I denied it Trisha and friends on this journey. “It could not be,” I told him “because we had and MRI” of course that MRI was 7 years prior when her idiopathic seizures presented (her brain tumor was confirmed to be unrelated to her seizure disorder). By way of explanation, in the same room at the same time, my daughter was being given the news that her husband’s Golden Retriever, Sandy, 10 years of age, that her bladder cancer had spread to her lungs so it was not a good day all around.

    Refusing to accept this diagnosis without proof, my husband and I took Kady to a vet in neighboring AZ who has quite the opposite manner and diagnostic protocols to the former vet. We have been loyal to him since he properly diagnosed and arthroscopically repaired Élan’s elbow dysplasia when she was four and a half years old. He spent two and a half hours with us, watching Kady and running diagnostics with us, ran every test in the book (except for taking chest films which, in hind sight he regrets very much and he didn’t offer it to us as an option and we did not know to ask), found her to be 100 percent healthy save for the ataxia. He and we all hoped that her anti-siezure medications had become toxic to her so that changing her medications would, hopefully, help her to be 100 percent in regards to her gait. Because I have to take anti-seizure medications for my CRPS and migraines, I am only too familiar with the side-effects.

    I breathed a huge sigh of relief and emailed her breeder and my small group of dog friends that Kady was fine. But I was wrong. During that office visit and at home, I made a list first in my head and then put it to paper of small things that were not quite right. And I emailed Kady’s neurologist at CSU, this list. The most concerning to me was that I had noticed what I now refer to as “circling to the left,” although at that point in time, circling was an exaggeration. Rather, if she came straight to a door or wall, she would each time turn to the left, never to the right, unless I “aided” her/encouraged her to do so, in which case she could. The neurologist got back to me immediately although it had been 5 or 6 years since we had corresponded. She told me not to be alarmed (too late), but that if there were any way possible we could make the trip there with Kady for an MRI, she wanted to see her and do one as my list of symptoms spelled “frontal brain disease” to her. And she assured me that there are many things besides brain tumors which can cause frontal brain disease, many of which are treatable.

    So to Fort Collins, CO we traveled although as others above echo, on paper, financially, we would ill afford to do so. It did not matter, it was Kady and nothing would stop us from getting an answer and trying to help her. She still looked so wonderful when we arrived at CSU that no one could believe, as the neurologists took her, just as a precaution they explained to us, for chest films. As suggested, we went across the street for a cup of coffee and a bite to eat, but my husband’s cell phone rang before I could sit down and before he could pay the bill. Please come back right now, they said, they had found masses in Kady’s lungs.

    The next decision they presented us with was whether, given the unknown masses, which they would explore and biopsy that afternoon, were we willing to go ahead with the MRI scheduled for the following day. There was no decision in our hearts or minds, we had to know what was going on in Kady’s forebrain as their neurological exam confirmed all of my own observations; her turning to the left was becoming more obvious, she would only drink from the left side of her bowl, and if her paw got turned over she could not right it w/o my help. We would have carried Kady like this the rest of her life, and we did, until the pain finally came. But we did not even get the chance to maintain her quality of life at this level, sadly.

    Each day there the news got progressively worse. Then we were asked to come one more time, Friday, to meet with the oncology and radiation people and the neurology team. I told my husband: this is going to be a better day because Kady has this team, they have been working all week at coming up with a plan for Kady and today is the day we are going to find out what that plan is and get help for Kady. I thought I was done with the flood of tears and hysteria that I had, uncharacteristically shed each of the preceding four days. And I was wrong. Friday’s meetings were perhaps the worst, but we left with Kady on prednisone which was already shrinking the swelling of the tumor, and with a chemotherapy drug (and an education about canine vs. human chemotherapy) and hope. They gave us hope that we would have some amount of quality time with Kady before we lost her to either the tumor or the carcinoma in her lungs.

    Together with a team of neurologists, we had made the decision to try and leave Kady off the anti-seizure drugs (by that time we had through trial and error and many consults taken her off everything) as she had not had a single seizure in over two years at that point. I told the chief neurologist that I would give anything in the world just to have a week more of walks in the forest with Kady, but for myself I wanted and hoped to have a trip w/her to the beach, as she loved water, I grew up on the beach and had each year expressed a desire to take her to the ocean to swim. My husband now said, yes, if at all possible, that is what we will do. We knew our time was short.

    No one knew how short. I asked I imagine a hundred times or more, “is she in any pain?” Pain being my constant companion, pain was NOT going to come to my K. Not if I had breath in my body, is how I told myself and others. Repeatedly I was told that she had no pain. And given what we saw, I saw, I believe them. But pain and quality of life are not the same thing either.

    And Kady and I had only one half of one short walk our first day back before the tumor started to cause seizures such that we had no choice but to place her on a very high dose of anti-seizure drugs. We were between the worst rock and a hard place imaginable, either she was not heavily medicated and we risked losing her to an awful seizure or we medicated her heavily, loved and cared for her until something else came up. We live far from CSU and I drove them nearly mad with my incessant emails about my concerns and Kady’s quality of life issues. We were unprepared for this, completely. A week before we had walked into their teaching hospital with a dog who looked, at first glance, happy and healthy. We were to re-xray her chest in 30 days and assessments would be made about the efficacy of the chemotherapy.

    I/we did not get 30 days. Kady got hot, they cannot tell me why, so hot she could not stand to be in the house, so I sat outside and held her on the very cold ground at times when I thought it not “too cold” for her good, on rugs, mats, with blankets covering her, in a beanbag chair. I know it was an honor to care for her in this manner, but it was not an honor I would wish on anyone. She let me know how happy she was to be with me, to spend this time with me, and friends told me that I would know when it was time to let her go—I asked frantically for fear that she would experience even one moment of pain.

    My wonderful husband was “behind me” on the denial progression and he buried himself in his work, which was all he could do. The other members of my household cared for Sandy, also dying of cancer now, the cancer causing her to have extreme diabetes, and I participated in her care as best as I was able. But I was so struck by the difference between the two cases, Sandy had exhibited symptoms of bladder cancer for well over a year before her diagnosis and now we were months after that and she still had a good quality of life.

    Finally, one night, the cancer started to affect Kady’s abdomen and that was the last night of her life. I wish I could say the local vet’s office helped me wonderfully ease her into the next life, but that would be a lie. Yesterday, when we needed a vet for new family member Giant Schnauzer puppy boy Brio on an emergency basis, I was thrilled to have a good experience at a new small animal practice in town (there were no other options until now). I held my heart and let her go in the back of my Subaru the next afternoon. She was in pain on the last trip in the middle of the night, and she told me so. As I had been telling her all those weeks, it was not about me now, it was about her and I did not want her to suffer because she was trying to stay with me.

    Almost a year later, as I write this, I realize my world is not right yet. Our home is not right yet, nothing has been the same since that week.

    I hope something herein helps someone and/or someone’s beloved pet. This is Kady’s story and I am sticking to it.

    There are so many possible interpretations with regard to the scenario Trisha posits. One kind interpretation may be, with respect to the “immediate denials” as opposed to the “long term denials” others have written about, perhaps, like my husband, a person needs time to digest the information that their companion animal is in pain. Perhaps when the vet first blurts it out, it is a reflexive response.

    Tears prevent anymore from me at the moment.

  26. jewels says

    August 18, 2015 at 1:30 pm

    When reading this I couldn’t help but think of people that use shock collars and other electronic devices on their dogs. Could you really use those on a dog you love if you believed they feel pain at least somewhat the way we do?

  27. Sue Schirmer says

    August 18, 2015 at 1:44 pm

    Thanks for a fascinating post.
    Fascinating as I’ve recently started to look into TTouch for dogs which is a holistic approach of looking at dogs (and other animals) and explicitly recognises the link between posture (and tensions, pain etc carried in the body) and behaviour. By working with the posture through touches and groundwork exercises (and through addressing any pain and tensions, if necessary with vet treatment) it opens up new options for behaviour for the dog.
    Fascinating as well because, as much as we would like to focus on the dog, we can get away from the ‘behaviour’ and psychology of the dog’s owners.

  28. HFR says

    August 18, 2015 at 2:04 pm

    This is such a hard subject. I purposely waited 6 years to get a second dog because I didn’t want 2 old dogs at once. For emotional and financial reasons. Who knew that my older dog would live to 15 (and is still going) and now my second dog is 9.5 and he’s a large dog, so that’s even older for him. Best laid plans…

    The older one is in very good shape as far as her joints are concerned, but cognitively (I think) she is not doing as well. The bad time for her is the night. She paces, pants and whines (she’s always been a whiner, so I’m not sure that’s indicative of anything special). She is clearly in some sort of distress. She’s been doing this for a few years now. When it first started I took her to my regular vet, a neurologist and a third vet who had experience with older dogs. They all said the same thing: All those symptoms could be a sign of some sort of pain, but they could find no source. So the only other conclusion was anxiety. So I give her medications to help with that, and it helps some but she still has good nights and bad. In the middle of the night when she seems most distressed I start to question if she is in pain somehow and I can bring myself to tears thinking about her in pain and me being so powerless to help her. So in this case, who knows? I have tried pain relievers and it doesn’t seem to help, but nothing seems to help. Or maybe she has some kind of pain that those pills weren’t good for. She seems to be happy otherwise, eats well and still goes for long walks with me. One thing that is interesting: Because she doesn’t have joint issues, she seems much younger than she is and I’m more likely to dismiss symptoms than I would if she had trouble getting around.

    My other dog has had 2 CCL surgeries. The first one went well and that seems to be a strong leg. But he contracted MRSA with the second surgery which left him with little cartilage in that knee. He’s had a second, arthroscopic surgery, 8 weeks of PT and regular accupuncture, but I can still tell that knee hurts him even tho no one else can see it. He has no limp, but I just know. When he’s standing still he’ll lean slightly onto his stronger leg and his pace when he walks is off. If I give him a cox inhibitor, he does really well, but do I want to give him one every day? Is that hurting him more? Pain meds have their own side effects, especially when it is a chronic condition and there is no end in site of needing them.

    I think the reasons why we want to think our dogs are not in pain are many: Denial on many levels; it’s an insult to our caregiving; a feeling that your dog would surely let you know if it was in pain, after all, you are best friends, are you not?; financial reasons, etc. I also think there is still that feeling with many people that medications are bad, no matter what they are. I know many people who won’t take pain meds themselves because they think of them as dangerous and evil. So maybe people think they are poisoning their dogs somehow. Our dogs can’t object, so we feel especially cautious.

    BTW, what happened to the dog with the bad neck? Did he ever get treated for it?

    Thanks for bringing this up, Trisha…as usual!!!

  29. Jessica says

    August 18, 2015 at 2:12 pm

    All the answers are very interesting and the topic an important one! I would like to add a thought that maybe the denial can be partially a hidden process, in that people tend to internalize whatever their animal companions might feel…

    Not that anybody would make the consious desicion “I’m just going to let you suffer because I can’t stand your pain!” but to see the whole situation MUCH more positive than observation proves it to be to keep themselves out of harm’s way.

  30. Barb Stanek says

    August 18, 2015 at 2:13 pm

    Oh my goodness. Sometimes I think that if people don’t hear the moans and cries or see the dragging leg, they just can’t process that the animal is in pain.

    I was still working when I fixed both hips and an elbow on my beloved one year old. He led a mostly pain free life for thirteen years. But I was a single person, working full time, happy to pay off the surgery costs to have my dog be as pain free as possible.

    I have met more than one person who says, “My dog has hip dysplasia, but it doesn’t bother him/her.” Sigh. I just don’t know what to say.

  31. Nancy Kraft says

    August 18, 2015 at 2:21 pm

    Sad but oh so true. I just had to release a dog from our therapy team because he lunged and growled at a child. The entire situation was heart breaking. The dog had been a working registered therapy dog for nearly 2 years and was a favorite of the kids. Moments before I had been observing the child with the dog and did not see anything. Several weeks later in checking back with the handler she mentioned that the dog has been battling hot spots in his ears all summer but she hadn’t thought they would be a problem. Now she wondered. I wanted to cry. Had she told me before I would have put the team on leave. The child would have been spared the fright and the dog the pain. How do I get my handlers to see that a dog in pain, stressed or just uncomfortable should never be put in that situation no matter what the schedule says?

  32. Mindy says

    August 18, 2015 at 2:21 pm

    I have to agree with those who say that the denial is a defensive thing, because I believe that most folks are embarrassed that they can’t tell when their dog is in pain. A dear friend’s Golden lost weight and (to me) presented as in pain and decline. I mentioned that they might want to see the vet, only to have them loudly and repeatedly say that their vet had just (a couple of months earlier) declared her in the best condition of any Golden that age (13) he had ever seen. Sadly, she died about three months later of cancer which would have been treatable had they been willing to admit that something was wrong. I think that having me mention that she seemed off embarrassed them, as if I were saying that they were not taking good care of her; they loved her but missed everything she told them about her pain.

  33. Kat says

    August 18, 2015 at 2:29 pm

    I suspect that the fact that dogs are stoic and will continue their normal activities despite quite a lot of pain explains, at least in part, why it is easy for people to deny that their dog is in pain. In the example you shared of the dog with a neck issue the reason the people gave for denying he was in pain was that he would still run, jump, and fetch like a fiend. I know when I’m in pain it is very hard for me to continue strenuous physical activity so if I think of dogs as being essentially like me then a dog that is running, jumping, fetching, etc. must not be in serious pain. Dogs are so much like us in so many ways that I think the general public forgets that they are significantly different in other ways.

    The reminder that aggressive behavior and pain can be closely related is an important one. When we adopted Finna she was a white hot mess. It wasn’t until after knee surgery that I realized how much pain had been contributing to her reactivity. It wasn’t the whole story by any means but it was definitely contributing. Unfortunately, because she had so many many issues and deficits I didn’t realize pain was one of them until she’d finally shredded her ACL to such an extent she wouldn’t put weight on it. This time we know better–of course this time we have the advantage of having seen her when she was pain free. She’s in the process of wrecking her other knee and will probably be having surgery sometime soon after Labor Day. In the meantime we have some pain management in place including my efforts at massage. She LOVES her massage time and it gladdens my heart to be able to do this for her and have her accept it. When she first came to live with us she couldn’t tolerate any type of handling for more than a few seconds at a time and now she wants massage until my hands can’t take anymore. What a long way she has come.

    And a thought for Maggie. Here in the Pacific Northwest where I live we don’t typically get really hot weather so my dogs aren’t especially acclimated to it and this summer’s above average temperatures were hard on Ranger especially. We found that the bandannas filled with cooling gel were very helpful for two and four legs alike.

  34. Lisa says

    August 18, 2015 at 3:25 pm

    Homeopathy isn’t medicine. There is no difference for the dog between doing nothing and giving homeopathic treatment… only a difference in the owner’s intent.

  35. Bruce says

    August 18, 2015 at 4:07 pm

    @jen – “Admitting that the dog is in pain is admitting that you haven’t done your job properly.” I think that is an excellent explanation. People will go to remarkable lengths to preserve a favorable self-image.

    @Peggy Lee – “. . . many dogs being kept alive with obvious signs of suffering because of owners inability to deal with their own feelings, fears and issues with loss and death.” Yes, one of our friends called recently, agonizing about whether to euthanize her dog. Even over the phone it seemed crystal clear that it was time (or past time) to end the dog’s suffering. Unfortunately the owner was not yet ready.

    To be fair, dogs can be hard to read. Some are more stoic, and some more dramatic. One of our dogs would occasionally limp on the “wrong” leg after a mishap, presumably a ploy for attention. When called on his act, he would immediately trot off with no trace of a limp. Sneaky bugger!

  36. Carolyn says

    August 18, 2015 at 5:07 pm

    I am guilty of denial about my girl’s pain. I have two dogs, my Golden girl who is now eleven and my Golden/Sheltie boy who is nine. My boy who is a rescue has always been rather creaky with a front leg that would go out when he overdid it. A few years ago we went through a major investigation with a rehab vet to determine what his issues were and how to work with them. It turns out he has elbow dysplasia (although his elbows were x-rayed when he first started having problems and the orthopods at Michigan State said they were fine) and we tried all sorts of medication combos and he now is on a low dose of prednisone and will be for the rest of his life.

    But the real point of this story is that I started to notice that my girl who got a OFA good on her hips and an OFA normal on her elbows was missing every once in a while in the rear so I took her in and my vet who we love said that she looked rather stiff when she moved. I was like “no she isn’t, she still loves to go out for hours.” And my vet said, we have been focusing so much on the other dog’s lameness that we missed her’s. Well now my girl is on carprofen daily and even then I want to give her a lower dose then is typical for her size because I don’t want to acknowledge that she is aging. I am in denial. But I will up her dosage….this has been a good lesson for me.

  37. LisaW says

    August 18, 2015 at 5:10 pm

    I think we need to be a bit more generous to the people and the circumstances when we are talking about dogs who may be nearing the end of their life. I have had to make that awful decision three times so far and only once was it crystal clear that my dog was done and looked to me for relief from it all. The other two times was a matter of watching and assessing and making sure it wasn’t too soon or too late. Would someone else have made the decision earlier or later? Maybe. Maybe not. Looking in from a distance is not the same as living with and knowing your dog and their pain levels and abilities to cope or not.

    Right now our other dog, who is almost 12 and has virtually no hips, is looking at two back-to-back surgeries — one to clean and remove some teeth and the other to remove two lumps from her side (most likely benign going by two aspirations and tests of the fluids drawn). We have managed her pain and her exercise and her craziness all her life. The thought of putting her through several hours of surgery and the aftermath worries me terribly — how will she be able to handle it and at what cost to the quality of her life? I want to make sure I am making my decision based on what is best for her both long and short term. It could look to a casual observer that I am stalling or denying that she is in pain. It’s much more complicated and nuanced than that. My ego was left outside the door many years ago when it comes to making these hard decisions for my dogs.

  38. J. Becker says

    August 18, 2015 at 5:34 pm

    To jewels:
    We use an electronic fence for our 2 dogs (one Goldendoodle, one Lab/Golden mix) and here’s why. If the dogs turn around as soon as they hear the warning tone, nobody gets shocked. Even if they did, it wouldn’t hurt nearly as bad as being hit by a car on the nearby busy street. We can’t put in a regular fence here; the bedrock is too close to the surface. A fencing company we called shortly after we moved in returned our deposit. We already had 2 dogs, although different dogs, when we bought our home.
    Our guys get the run of over an acre of a heavily wooded lot. They have an electronic door (no shocks, it opens when it senses a little doodad on their collar) to go & come as they please without running their people ragged.
    Both of them are fairly territorial, barking at whoever comes up their driveway. The Doodle had a strong prey drive when she was young, and there were enough squirrels, chipmunks and really dumb baby moles inside the permitted area to keep her happy. Fortunately she’s not into hunting at 6.
    I mention this because I don’t think this kind of fence would work with sight hounds who’d run right on through it after prey. It works for us, and we are not evil people.

  39. Elizabeth says

    August 18, 2015 at 6:34 pm

    Interesting topic, my other favourite animal blogger posted on the same topic recently: http://pawcurious.com/2015/08/stop-saying-your-pet-doesnt-hurt/ Our bullmastiff is a very stoical girl, so we have to watch her carefully for signs of pain – she had two ruptured ACLs and limped only a tiny bit – it was the falling when she tried to get up that alerted us – not normal behaviour for a 14 month old dog. (She’s had TPLOs on both and is fine now).

    How can you tell when a dog is really in danger of overheating? Rosa does everything with such gusto it’s hard to tell if she’s panting hard from the heat or from running around after our other dog…

  40. Tired Caregiver says

    August 18, 2015 at 6:46 pm

    I know that with my cat, dealing with pain can be very frustrating both from a diagnostic and treatment standpoint. A number of months ago Jonas suddenly went down in the rear…he had a pulse in his rear legs and had appropriate withdraw to pain, but he wasn’t able to move them. I rushed him to the emergency vet. Within an hour he was standing again, but for the next three months he was lethargic, not seeking attention, and generally just not himself. It was very obvious to *me* that he was in pain, but I’ve basically made a life of staring at this cat 24/7. I think for a less obsessive owner it wouldn’t have been so clear because he wasn’t vocalizing or lashing out when touched. He was just…sad. All the time. I really starting to worry I was going to have to make some hard choices. He was getting some quality of life back with daily doses of buprenorphine, but I was resisting adding an NSAID because of the side effects. Though obviously if it came down to it, I would give him an NSAID before considering euthanizing.

    Throughout the course of this, we were doing everything we could think of to pinpoint the root cause of his symptoms and to make him more comfortable. On the treatment side, we did acupuncture (which did NOT go well), laser therapy (he loves it!), supplements, Adequan, and physical therapy. We saw a physical rehab specialist, a internal med specialist, a cardiologist, and a neurologist (and of course he had many, many visits with his regular vet.) We did all manner of blood work, multiple sets of x-rays, a full cardio work-up, and an MRI of his spine. The MRI did show some bulging of some discs, but not enough to compress the spinal cord and not enough to warrant surgery. Thsheer severity of his symptoms just wasn’t matching up with some mild disc changes. He was barely walking and sometimes needed to be held up in the litter box, and was started to lose interest in food (Jonas ate a full dinner just hours after recovering from a cardiac arrest…not eating is a HUGE screaming neon sign that something is wrong with him.)

    A few weeks ago I noticed he was sometimes protruding the very tip of his tongue more than cats typically do. Examining him orally meant sedation, which we try hard to avoid with him, but I was very worried about a possible oral mass. So his regular vet sedated him and talked me into doing a fast dental. She pulled one tooth…

    …and Jonas was back to his usual bratty self within a few days. He’s eating great again, torturing his sister, begging for treats, following my every step, biting my face at 6am, and insisting I stop play GTA5 to pet him every 15 minutes. NONE of his vets have any real explanation. Our best guess is that he does have some back pain, and in combination with the pain in his tooth it was enough to tip him over the edge to where he just felt miserable all the time. We’re continuing his physical therapy, supplements, and laser therapy, but right now he’s not on any pain meds. I don’t *think* he’s in pain, but I can’t say for sure and I hate that there really isn’t a safe long-term option I can give him ‘just in case’.

    So I think there can be a combination of factors. I think blog helps illustrate that people often misread the cues of their pets, and I think that exceeds to spotting pain just as much. There’s also the ego factor that others have mentioned…owners may resent and resist being told by someone in authority that they’ve missed something. And yes, unfortunately there is a cost factor. We did every test possible on Jonas that didn’t involve cutting him open, and STILL couldn’t find anything definitive we could point at and say ‘this is what we need to fix.’ In the end, it turned out to be something no one expected.

    Then again…that’s how Jonas rolls. I think most pets probably aren’t quite as mystifying. 😉

  41. Sasha says

    August 18, 2015 at 8:06 pm

    I can add that after taking care of our English Setter the last 5 years of her life, I can understand not necessarily denying the pain but treating later than was best for her. Some of this stemmed from being so obsessive and paranoid about her being in pain I would take her in at the slightest twitch, limp or behavioral issue, only to be told by the vet they couldn’t find anything wrong. There are so many times I saw subtle symptoms months before the vets could diagnose anything and other times when nothing was ever diagnosed. Those times when nothing could be diagnosed added up over the years and made me doubt myself when taking the pups in, sometimes to the point of not taking them in because I would think the vet would look at me like a hypochondriac parent.

    Our Golden, for months before he died from splenic hemangiosarcoma, would groan when lying down – which we attributed to old age. I grunt when I get off the couch. He also jumped out of the car once during that time and whined so we took him in. The vet focused on his front limbs and couldn’t find any pain. In retrospect he could have been in pain in his core from jumping down but we didn’t know. It was so frustrating and heartbreaking to not know if and where they hurt.

    I’ve long had a fantasy to try to work with someone like Ken Ramirez to train dogs a more cognitively complex set of behaviors that allow a dog to communicate a location of pain on their body. I imagine some system of teaching a dog to communicate yes or no and to communicate the concept of sensations, i.e. heat and cold and pain and pleasure. How to teach that without inflicting pain always stumps me though. God I wish they could talk.

  42. Antonia says

    August 18, 2015 at 8:52 pm

    I think that often people aren’t able to distance themselves enough from their close emotional bond with their dog to be able to see what might be obvious to an unattached person. We all know how easy it is to see the issues other people need to change, problems obvious in other people’s children and I think our fur babies fall into the same category sometimes. We learned a very hard lesson of how much pain an animal can be in with our 4 year old Kangal dog that we lost to cancer at age 4. He was a very stoic working dog. When he broke his leg at 1 1/2 years of age, he never made a peep, needed no tranquilizers to take his x-rays or to set the leg. At age two he developed a systemic fungal infection endemic to the southwest, Valley Fever. The only sign he ever gave was that he was more grumpy than was usual for him with our puppy. By the time he was diagnosed, the VF was pretty advanced and he had to be in pain. The only sign that was obvious when he came down with cancer was the he stopped barking at night. Soon he developed a cough and pneumonia. He seemed to be a little better after a course of antibiotics but rapidly deteriorated. A scan to see if the pneumonia had come back revealed the massive tumor filling his chest and pressing on his lungs and trachea. There was nothing we could do at that point. Within two weeks I let him go and broke my heart over the loss of the best dog I have ever had, my true heart dog. This experience with the incredible pain tolerance of dogs and how sick they can be has made me hypersensitive to examining my current dogs for signs that they might be manifesting. I believe this is what allowed me to observe something “odd” about the gait of one of my young dogs. No one else could see it but I knew he wasn’t right. Our vet trusts me and this feeling led to an early diagnosis of CHD that allowed us to get him on treatment before he developed other problems. This dog was bitten by a Mojave rattlesnake this past week. He developed some slightly odd behaviors that made me uncomfortable and I asked our vet to look at him again later that morning. Turns out he was developing neurological issues and required multiple rounds of antivenin to save him. The venom of this snake causes massive pain for the victim. The only sign he gave me was to growl at me very softly when I walked near him. A sign for me that his pain was off the charts. He has never growled at anyone in his life. I’ve read that it pays to observe your dog fairly often when it does not know you are watching. Many dogs will hide pain when their people are around and show more signs when they are alone of think they are unobserved.

  43. Pam says

    August 18, 2015 at 9:17 pm

    My dear beloved lab, Sam was 17 when i started giving him oral pain meds and we added pain patches of fentanyl until he died at almost 19. He let me know when he was in pain and the doctor confirmed with xray. He panted, paced, and became annoying, when otherwise he wasn’t. As he neared the end, his meds wore off too soon and had to have higher doses, again, same signs. Dogs do feel pain and do tell, it is our job as owners/family to pay attention.

  44. Catherine says

    August 19, 2015 at 12:13 am

    Thank you for this article, and the comments have been illuminating as well. Did Charlie ever get treated? I’m sure everyone is wondering what his outcome was.

  45. Joanne says

    August 19, 2015 at 12:33 am

    This article is amazing and so true. I will say that MANY owners that I know do have the smarts and even take the dog to a vet. However, I think that there are many vets out there that don’t listen to the subtleties of the dog OR the pet owner that maybe can’t describe details but just know that the dog “isn’t acting right”. I see it all the time where I live, but the most notable case was where I was called in to assess the behavior of a 6 year old Vizsla.

    He was mopey, depressed and after 4 visits to the vet, diagnosed with a stubborn UTI. Upon meeting me at the door wiggly and happy, it wasn’t 5 minutes before he just looked exhausted and needed to lay down. Talking with the foster home, he did initially get better with meds but then worse and nothing was helping. After a long case history hearing he had trouble not only urinating but defecating as well and seeing it in person, I showed them how his third eyelids were up and very red. He also showed pain in his abdomen just from walking so I asked if I could examine him. I told them I’m no vet, but I wanted to take a look. With nothing more than a slight touch to his stomach, he yelped in pain and jumped away.

    I told them he needed to see a new vet and reported back to the rescue that I couldn’t do a proper behavioral assessment as I felt the dog was very ill. They trusted me and took him to the rescue’s trusted vet 3 hours away. It was found he had a giant mass in his stomach. Unfortunately this guy was given the best care for 2 weeks but ended up in so much pain it was best to let him go.

    So while there are many capable and amazing vets out there, I do think it’s very worthy to note that there are just as many that do not listen, do not do a proper exam (as any vet could have simply felt his abdomen and seen the dramatic response that was way more than any UTI) and are just quick to dispense antibiotics or pain meds without truly diagnosing the problem.

    Just like so many humans that do not have the knowledge to advocate for themselves, I think the pet owner population is even less in those that seek education and therefore blindly trust their vets to make the best decision for their dogs.

  46. Joanne says

    August 19, 2015 at 12:52 am

    PS… I know there are lots of natural product out there and while I haven’t tried them all, I have tried many. I have found none to work as well as System Saver for dogs with arthritis, degenerative conditions and just plain old age. http://systemsaver.net/public/

    Suzanne Clothier turned me on to the product and I swear by it now. It’s a hidden gem that many have never heard of. It not only repairs damage but inhibits future destruction. My 9 1/2 year old BC had CCL surgery on both knees and 4 years later, x-rays show absolutely no arthritis in the knee. My degenerative spinal disease girl would have been gone years prior without this product and my 13 year old mixed breed has folks asking me over and over again how old my puppy is. It’s a truly amazing product.

  47. Frances says

    August 19, 2015 at 4:48 am

    I have learned, through hard lessons, to look at overall behaviour and not just “obvious” signs of pain, but even then the slow progression of some forms can make them difficult to see. It took visiting friends pointing out that Pippin’s reluctance to jump and climb was very similar to the behaviour of their elderly, arthritic cat to make me realise that he was not just slowing down with age. Now I know that if he does not come out to greet the car when I get home there may be a problem, and start looking for it. When Sophy slipped a disc the immediate pain was obvious – screaming, shaking, rigid, tail down agony. Within seconds she seemed to be back to herself, and if I had not seen the really obvious pain I might not have noticed the little tells over the following hours – the reluctance to jump, the tiny stumble on the stairs, etc – that had me Googling and then at the vet ASAP. And then there is adrenaline – how many of us have seen a dog apparently unable to move stage a miraculous “recovery” when the postman is at the door to be barked at, or a squirrel crosses the lawn? But I am still rather surprised that people would prefer to think that their pet had suddenly developed some serious behavioural problem than that the poor creature might simply be in pain.

    Martha – I hope your own health is improving, and that some day soon you look into a dog’s eyes and feel the first stirrings of that same wonderful connection you had with Kady.

  48. Mireille says

    August 19, 2015 at 5:08 am

    I am actually quite suprised that is is difficult to convince owners to consider the possibility that their dog might be in pain. I am only a dog owner, not a trainer so I do not have to convince other people.
    I do know that I find it difficult to see if dogs are in pain. Even with my own dogs. I remember once reading about sled dogs “if your best dog stops pulling he is in pain” and I know that helped with Janouk. Usually when he quit he had something like a small tear in his pad. Put ointment on it and he started working again. Then I knew my guess was right. But I also learned the hard way froom him how easy it is to miss pain. He was still walking and running, but when we got to new pups in the house when he was 10+ he seemed a bit subdued. I know I felt guilty about the youngsters being too much for him. I made time for extr aquality time with him. When he started going of his food, I know there was something seriously wrong. The first vet thought he had back-ache but the NSAIDS only made him worse. X-rays of his abdomen showed “something” in his stomach/gut, the second vet thought it was a ‘pseudo-obstruction’, possibly some rubbish he ate? He was still eating and passing stools, so we decided to wait and gave him something to relieve stomach cramps, which made him feel better. We were going away for a couple of days, and the vet said “You go, it is not that serious” but when we left him at our dog sitter, he retreated to his crate and stopped eating completely. He took him to our vet who did an emergency surgery and found a tumor in the gut with three holes in it. His gastric juices were leaking into his abdomen. The -very experienced – vet had never seen something like this. He must have been in terrible pain for weeks. STill eating just to please me. Looking back at photographs I now see it: he has a somewhat tight look and inward turned. This is his last picture, only days before his death: https://photos.google.com/photo/AF1QipMRkVoE06ocO4vwV6JMn4xWlU0XmGM4Dx-T512M
    I still feel sad and guilty for not recognizing his pain.

  49. Jane says

    August 19, 2015 at 6:33 am

    HFR, Did any of your vets consider Canine Cognitive Dysfunction (dog dementia) as an explanation for your older dog’s symptoms? I’ve had 2 senior dogs who had similar symptoms – difficulty sleeping at night, anxiety, wandering/ pacing aimlessly, panting. These symptoms would appear only at night time. Something similar happens to elderly people with dementia (sundowning syndrome) evidently due to changes in the brain.

  50. HFR says

    August 19, 2015 at 7:14 am

    Jane, yes, I think we’re assuming that that is what she has, but no one seems to recommend the medication that is currently available for it (I forgot the name of it). Did you try anything that worked for your dogs? I’m open to all suggestions! Thanks!

  51. Bruce says

    August 19, 2015 at 8:36 am

    Lisa, if I implied that I was judging how others make end-of-life decisions for their pets, then I communicated poorly. Let me explain with a story.

    One of my favorite dogs ever was a scruffy 35-pound Shepherd-Collie mix of some sort. He was a stray, maybe 3 years old when we met in an open field. He made friends with my dog and happily followed us home. I became quite fond of him in the week it took to track down his owners. I was looking for a second dog at the time and his owners, who had also found him as a stray, were having problems with him and gladly accepted my offer to keep him. After deworming and a little training, he was a devoted and delightful companion for the next 12 years.

    The last few years of his life included a life-threatening blood disorder, a week in canine critical care, diabetes, insulin shots, and a slow but inexorable decline. Each time we began to discuss euthanasia he made a miraculous recovery. We started calling him our 9-lives dog, regularly quoting the Monty Python “not quite dead yet” sketch. When his time finally arrived, we waited too long. One of my greatest regrets is that I did not act sooner to spare him what was surely a miserable penultimate day.

    We have had dogs that gave crystal-clear signs when their time had come. The 16-year old food hound who turned down two meals in a row, and then turned down a bowl of beef Stroganoff. The 19-year old Schipperke who became scared and confused because she could no longer see, hear, or think clearly. The stoic 13-year old Labrador who could no longer rise, even at dinner time.

    Even when our dogs are young and healthy, we start thinking about end of life decisions for each of them. What signs would signal low quality of life for each dog? Which dogs are “softer” and best suited for earlier endpoints, and which dogs power through life’s challenges via sheer stubborn determination and force of will?

    Thinking about death while our dogs are bursting with life probably sounds morbid, but we do have the great responsibility to make life and death decisions for our companion animals. Lacking the ability to do a Vulcan mind meld with our dogs (” On a scale of 1 to 10, how would you describe your pain?”), we all do the best we can.

    I still wish I had a do-over with my scruffy stray. He deserved better from me.

  52. Marjorie says

    August 19, 2015 at 10:08 am

    Great topic! I think there are many reasons. I find there are still many people out there who “love” their dogs, but still don’t really clue into their being sentient beings that have emotions and feel pain (How else can you explain those people who insist on dragging a dog along on a jog in the middle of a 80+ degree day). I think there are those individuals who want to run their agenda and routine regardless of how their dog might be feeling. Society has this notion of “no pain no gain” attitude when it comes to exercise. How many times have I seen dogs in obvious discomfort at the park being walked from one end to the next and back again when they shouldn’t be. Perhaps we should be blaming the dog (just kidding) for being so loyal and wanting to please us and for following along and not just shutting down and refusing to budge.

    I also think there are those who are driven by fear in that they are afraid to face the issue of their dog being in pain because then they will have to do something about it and they may be afraid of where that will take them both/either financially and potentially the possibility of loosing their dog. It causes them to face their dogs mortality. Lets face it, there are many, many dogs out there that fill a huge emotional void for their people and some people may just not be able to face the consequences of recognizing their dogs pain.

    In talking about recognizing dogs pain, I think we also need to talk about emotional/psychological pain as well. How many dogs are forced to live with another dog/s that they don’t like and perhaps for good reason fear. How many dogs are forced to participate in dog sports/shows/events that actually cause them stress, discomfort and fear. How many dogs are forced to either spend the day alone or attend a crowded daycare when they really don’t want to. Seems to be much to consider in regards to your good question.

  53. Melissa L. says

    August 19, 2015 at 10:16 am

    I had no idea that my last dog was experiencing pain until the vet on a home visit told me that she thought Shadow was in pain. I was shocked that I wouldn’t recognize it, and it took me a couple of days to realize that the vet was right and we needed to treat the pain. As Shadow got (even) older, I counted on our acupuncture vet to help me keep track of her pain, as it is very easy in an old dog for something to become the “new normal” as she slowly declines. My current dog has cancer and has been on pain meds for it since I got her. A few weeks ago I noticed changes in her behavior and took her in for a check-up. Sure enough, the cancer had metastasized into her lungs. So we have upped her dosage of pain meds as well as adding a new one.
    In terms of pain medications, I have not had good luck with NSAIDS (Rimadyl, Deramaxx, Metacam) for either dog. Both dogs threw up on them and they didn’t seem to do a good job of managing the pain. For cancer, I have had good luck with pregabalin (Lyrica) but switched to the substitute gabapentin (Neurontin) as a cheaper and easier to obtain alternative. Good old opiates (oxycodone) worked best for my elderly dog whose pain was primarily arthritic, along with acupuncture for both dogs. I am on the cusp of using oxycodone again for my current dog but will wait until after I see the acupuncture vet at the end of this week.

  54. Janice says

    August 19, 2015 at 10:25 am

    Wow … such an important topic as evidenced by the numerous and lengthy replies. Thank you for starting this discussion. I have no idea why pet owners would deny that their animals might be experiencing pain as that someone could even think that never entered my mind! I am a physical therapist (for humans) by profession so know well the value and importance of pain medication. The information I wish to contribute comes from studies in geriatric medicine. People with dementia unable to speak about their pain will “inform” via behavior change often aggression or anxiety. Timely administration of pain medication makes all the difference.
    Our 12 yr old golden lab gets Metacam with breakfast and Gabapentin with breakfast and dinner. He is not an unhappy dog ?and we always watch for his way of informing us about his ails.

  55. jackied says

    August 19, 2015 at 11:56 am

    I think a lot of it is because you often have to be very observant to work out your animal is in pain, because they are naturally stoic. Even vets can be skeptical in the face of an owner who keeps coming back with a dog that they say ‘isn’t right’ but can’t pin it down. I am persistent, and even so it can take several visits to work out exactly what is causing my dog to be slightly more subdued than usual, and whether it is pain or some other illness ( this month it is lower back pain!)

    Incidentally, my vets are very keen on the importance of pain relief, and open to the possibility of it being the root of behavioural issues.

    Another reason is a kind of transference thing. My mother was very reluctant to get her stiff labrador onto sufficient pain relief. Firstly, she wouldn’t believe me when I said her delight in chasing squirrels didn’t mean that she wasn’t in pain. Secondly, she admitted to me eventually that because SHE was used to being in constant pain from her back she rather discounted pain as being a significant issue. Of course, when she did finally agree to using pain relief and the dog suddenly got a new lease of life it became obvious that she should have done it much sooner :/

  56. jackied says

    August 19, 2015 at 12:05 pm

    Oh and another stoic anecdote – my spaniel cut her paw badly enough to need stitches, and didn’t limp at all! I only realised when I saw her licking the wound several hours after our walk.

  57. Trisha says

    August 19, 2015 at 12:07 pm

    HFR: The name of the medication often used for canine cognitive dysfunction is Anipryl®. I’d talk to your vet about it for sure; I don’t know many friends or clients who have tried it, but it is definitely worth a conversation with your vet.

  58. Trisha says

    August 19, 2015 at 12:15 pm

    I wanted to add my voice to the important comments that ask us all to be compassionate toward those who don’t, or can’t, acknowledge that their dog is in pain. I’ve thought so much about this issue since first looking into it, and realized that there have been times that I too have probably not asked soon enough if one of my dogs, or a client’s dog, was in pain. I’ve heard, privately, from several highly experienced professionals (vets and trainers both) who told me stories of how they still feel badly that they too didn’t think of pain as a factor in an animal’s behavior at first. I agree that there are many reasons that we don’t think of pain as an issue in our pets, the comments here have done a wonderful job describing them. But I also think that we don’t think about pain being a factor in people either. Maybe the woman who was crabby at the check out counter had a painful hip? Perhaps the guy who cut you off while driving home had spent all day masking the pain in his shoulder? It is true that we humans can talk about our pain, but we often don’t. I’m not saying we should, life would get a tad boring if all we talked about was how our foot hurts. (Did I mention that my foot hurts right now? No? Well, let me tell you all about it…). But it seems it is human nature to often make negative attributions to others (she’s rude, he’s a jerk, the dog is “aggressive”) when so often ‘bad’ behavior is the expression of some kind of pain.

  59. Trisha says

    August 19, 2015 at 12:17 pm

    Thanks, by the way, for the comment about a diet with high fat content potentially helping dogs tolerate heat stress. Maggie is indeed on a relatively high fat diet, and gets coconut oil added to her dinner every night. Helping? Don’t know, but boy is her coat gorgeous!

  60. Blueberry's human says

    August 19, 2015 at 1:53 pm

    I don’t understand it either. I remember meeting a potential foster dog that was extremely obese and an older fella. I watched as he did this weird little dance and then after about 5 minutes, finally began to poop. It was obvious to me that he was in pain but the rescue lady discounted it and said he was fine. I mean, I get that our dogs are often less whiny about their pain than we humans – but that’s no excuse to believe they are not in pain when all the signs are there. I think I am more aware of my own dog’s pain since I have hip and back issues as well. I notice when the weather is funky – my pain will flare up and so I watch her more carefully and manage it with medication accordingly (she’s also on daily supplements). It’s also funny that your clients would rather have had their dog have an actual behavorial issue rather than a simple physical one that could no doubt provide quick relief (and a mood improvement) with the proper vet care!

  61. Susan says

    August 19, 2015 at 9:45 pm

    I think sometimes if an owner has punished their dog for “misbehavior” the thought of it being possibly caused by pain is rejected out of guilt. it seems also difficult for people to wrap their minds around the fact that a commonly seen behavior that is caused by lack of training, or temperament, or whatever could show up in an identical fashion though caused by pain.

  62. Rebecca Rice says

    August 20, 2015 at 1:34 am

    Here’s my comments. Not a vet or trainer, but have had to deal with pain issues in my pets. First, some pets are very stoic. My first greyhound wound up breaking her leg, and let her physical therapist do the “drawer test” where they pull the leg into a full extension and the only indication that she gave that it was painful was raising her head a little off the mat to look at her. It was a day or two later at my regular vet where we did some x-rays and realized that the femur was broken length wise, and I got the dreaded diagnosis of osteosarcoma. So, it is sometimes hard to tell because the dog is so good at hiding the signs.

    Then, you get into the question of whether the signs you do see are pain signals, or behavioral. I found a miniature rat terrier (Pixie) as a 3-5 year old stray, and adopted her after her owners failed to claim her. This dog was mostly nice, but a little bit snappy and very space-possessive. She didn’t like the other pets (a dog and two cats, at the time) getting too close to her and would snap at them if they did. And she showed a really weird trait at training class. She is a wildly food-motivated dog, but after about 45 minutes at class, she would suddenly act like food was poison, backing away from treats that she was happily eating at the start of class and showing stress signals: rapidly blinking eyes, panting, avoidance behavior, hiding. It was driving me and my trainer crazy trying to figure out. I had her in to the vet to get some other strange behavior on walks checked out, and learned that she had severely luxating patellas in both legs. After surgery to fix those (thank god for insurance!), her personality has done a 180. She’s now a bright, cheerful, happy little pup, as opposed to the grumpy old dog she was when I first got her. But I had no previous baseline to go off of. If the source of that pain would have been more difficult to pinpoint, it would be relatively easy to just assume that that was her base personality, especially with her being a terrier, and that the snapping was due to being territorial as opposed to my current belief that she was just desperately trying to keep from having to deal with the pain from being bumped.

    My current greyhound is another, very recent example. She is a very shy dog, with generalized anxiety, and likes to hide out in her safe spot. I’ve known for a while now that it seemed like she had been coming out less. I also have felt that she’s “not walking right”. However, I couldn’t really describe what was off. And, of course, when you take a shy dog to the vet, the last thing that she wants to do is walk down a hallway in anything approaching a normal gait! Most often, she winds up being pulled with her legs braced, or picked up (partly or wholly) to get her to move, if that seems less stressful. So I would take her in, we’d do some tests, things would come back normal, we’d go back home until I just felt things were off enough to go back. I finally took her to a specialist, who said that she has extremely tight iliopsoas (ses?), and then to a physical therapist, who agrees but says that that, and the extremely tight hip flexors, and the contralateral neck pain, are all because of lower back pain. She’s now on gabapentin, rimadyl, and a muscle relaxer, and the change in her personality is amazing! She’s back to being social, and even chattered at me this morning, which I haven’t heard from her in months. But it was so incredibly easy to put it all down to “something must be stressing her out”, rather than think of physical pain being the cause. Especially since this has been coming on slowly for months, and there were no really obvious signs… no limping, yelping, snapping, or anything like that. And she would still occasionally go racing around her yard, so how bad could it be?

    I do think that sometimes we lie to ourselves just because we don’t want to face the truth of a situation. If we acknowledge that our pet is in pain, especially from something like arthritis or cancer, we have to also acknowledge that they are getting older, and we may soon be faced with making quality of life decisions. It’s easier in those situations to concentrate on the good days that they have, and downplay the bad, because we don’t like to contemplate the fact that we are going to outlive our devoted companion. On the other hand, I will demand pain relief for them after surgeries and dentals, because that is a temporary short term situation and doesn’t have as much emotional baggage wrapped up with it.

    Cost is also a factor. Pixie’s knee surgeries cost me over $6,000 altogether. I make good money, and could afford to do one without impacting my finances too much. But even I was fretting as I waited to hear back from the insurance company on whether they would cover these or not, because it was going to really be stretching if I had to cover both. I have never actually added up the cost of treating Trinkett’s osteosarcoma, but I know it was somewhere in the 12-20K range, depending on how much of her other symptoms I was treating were actually caused by the cancer instead of the reasons I had thought. And Katie’s physical therapy for the hip issues is going to run 1300, of which I am going to have to pay 429, with insurance covering the rest. If you can’t afford to do that, it’s a lot easier to convince yourself that your dog is not in pain, rather than having to look at them and say “I know you are in a lot of pain, but there is just no way I can spend 6K to fix you.” (Can I mention again just how much I love having pet insurance? I am sure that the company hates me, but it does make things much easier to deal with.)

    And finally, there are still some owners and vets who subscribe to the “pain will keep them from overdoing things” school of thought. If you are told that your dog needs to be kept calm and quiet for 6 weeks while X heals, there can be concern that if you give them pain meds, they will feel better, and then they will want to do more, so it will be harder to keep them quiet. Not using pain meds would then, in this thought process, allow the pain to provide valuable feedback to the dog so that they don’t try to do more than they are physically capable of.

  63. Rebecca Rice says

    August 20, 2015 at 1:36 am

    PS: Is there a way of navigating to unread comments? Sometimes, I don’t have time to read all the comments at once, and in a long thread like this, it’s easy to forget where you stopped.

  64. LisaW says

    August 20, 2015 at 4:54 am

    Bruce, my comment wasn’t directed at anyone in particular. Simply wanting to add that things aren’t always as they seem even when we think we know the circumstances. Thanks for sharing the scruffy dog story. I have one of my own that still makes me wince more than five years later.

    Trisha, you are so right when you say we don’t consider our own or others pain as much as we might. Right now our family consists of a 12-year-old dog with no hips and other health issues, a five-ish-year-old dog with bad joints and soft tissue issues, my husband who was recently diagnosed with a rare neurological, auto-immune disease that destroys the myelin sheath around the nerves and affects balance and strength, and me with a hip that is about to be replaced after waiting too long. We’ve learned to adjust our attitudes, expectations, and responses — mostly for the better. It also has made us more empathetic and calmer in an odd way. (I might have a little more work to do in some areas 🙂

    A few weeks ago we decided to load up the dogs and go to the woods, take a little walk and have a picnic. It had been many moons since we’d all done this together. The four of us were ambling down a logging road, and my husband started to laugh. He was picturing what this rag-tag group each with a hitch-in-their-giddy-up must look like from behind. A cross between Walter Brennan and the horse in Cat Ballou. It was a wonderful day.

  65. HFR says

    August 20, 2015 at 6:32 am

    Here’s a kind of creepy thought. Dogs are stoic because in the wild if they show signs of pain they may either be left behind, attacked by members of the pack or subject to becoming prey. Well, if they show pain in human society, they may be subject to, at the least, going to the vet (not a fun place for a dog) and, at the worst, being euthanized since it’s considered humane to put a dog down if they are in pain. And how many dogs are dumped at the shelter because they have health issues that the owners can’t/won’t take care of. I know, I know, dogs don’t know that, but it’s interesting to think that in a dog’s life showing pain, whether in the wild or in the home, is usually not a good action to take.

  66. Mittsy says

    August 20, 2015 at 9:51 am

    I’m really glad you posted this. I spend a lot of time at our veterinary practice talking to people about pain in their cats and dogs. I think, as others have mentioned, that people assume animals will vocalize while in pain, and so being quiet means the patient is fine. One of our doctors has a great story he tells about a farmer he knows, who walked across his property every day, taking time to lean on just about every piece of equipment as he went. And then he finally had his hip replaced. That discussion helps some people make the connection: people don’t always vocalize when we’re in pain (walking through the grocery store, limping, saying “ouch, ouch ouch”?), and so animals can be in pain without vocalizing.

    Another conversation I have frequently is with giving pain medications. I never write “as needed” on prescription bottles anymore, because I’m fairly certain the owner will stop giving the meds after 1-2 doses. Instead, I indicate the minimum number of days the medication should be given, and then I talk to the client about the properties of anti-inflammatory medications and why it’s important to stay ahead of post-surgical pain, including to prevent complications like licking/scratching at surgical sites due to discomfort. I also do follow up calls to make sure the meds are still being given. That’s a lot of work to make sure someone gives pain meds, but I’ve found that it’s necessary!

    Finally, when our doctors do physical exams on potentially painful patients, they ask me to assist with those exams, so that (as a behavioral specialist) I can help determine good ways to handle the patient, and read body language as the exam proceeds. I give a running commentary as the doctor proceeds (“mouth relaxed, eyes soft, pupils just dilated, mouth closed and tightened, eyes pinched, mouth relaxed again, eyes soft again…” and so on). As I mention body language that may indicate pain, the doctor verbally notes where on the body that occurred. I find that the clients are then much more aware of what we’re picking up on, and that their dog may be giving more subtle signs of discomfort than they expected.

    Those are the steps we take, but I still sometimes struggle to get through to people. I do wonder if it is denial, especially if it’s pain that the client cannot afford to treat or feels responsible for.

  67. Laura says

    August 20, 2015 at 9:59 am

    Wow, what comments,
    I agree with everyone here who said that the dog’s pain could be well hidden and also that people sometimes want to deny it. I had a coworker tell me once about what symptoms his elderly cat was showing. We both knew that the cat was close to the end, but I suggested anyway that he might be in pain. I really didn’t think anything of it, perhaps thinking, if I did, that pain meds might make the kitty more comfortable. My coworker’s response was to snap back at me, “why do you have to be so negative about my cat?” I realize that he was in a lot of emotional pain about his cat and probably couldn’t bare to think his friend was in more physical pain than he already was from old age. I understood the response and felt sad for my coworker. When Marlin was first dignosed with cancer, he was in a lot of pain, not eating, hiding in his bed all the time. I remember giving him his nightly pill to shrink the tumor. I would sit beside him as I gave him the pill and would cry as he coughed weakly and then swallowed. I promised him it wouldn’t be much longer, because I couldn’t stand to see him in this much pain if this was all there was left for him. That first week, I honestly thought we would lose him, but the meds kicked in and he became a happy dog for those last two months, playing again and chewing on his toys, but I know what it is like to have your heart broken over watching a beloved pet suffer like that.
    With Torpedo, his pain signals were more subtle. He was going through physical therapy to help with a lame left leg and though he would be fine after PT, the next morning he would hide in his crate and refuse to come down for breakfast. I immediately called his therapist and asked if he could be in pain from the day before. She said he certainly could and gave me some pain meds to give him. After giving him the meds he felt much better, zooming down for breakfast like his old self. At the school where I’ve received my dogs, they teach us to look for pain. When we groom our dogs, about every other day if needed, we’re taught to check them over, just to make sure they’re all right. We are told that dogs are excellent at hiding pain and were given the example of a handler who’s dog worked an entire afternoon with a piece of glass in her foot. No one noticed until that evening when the handler was grooming her. The dog gave no signs, not a limp or a whimper. It’s why I don’t dismiss weird behaviors in my dog and why I don’t hesitate to bring him into the vet if he’s “not right.” Heck, I even called the vet two weeks ago because Seamus was scratching more than usual and I thought it could be a thyroid problem. turns out, after a nice bath, his skin felt better and it had just been bad allergies, like we’re all experiencing up here, but I was ready to help him if he needed it. I also think, as others have said, that it’s important to have vets who listen to you. My vets are wonderful. They don’t care if I want to bring Seamus in and always encourage me to do so if I think there’s something up. They know what kind of physical condition he has to be in to do his job and so they want to make sure he’s in the best shape he can be. that being said, I think people are right to cut vets, and ourselves, a little slack when it comes to pain symptoms. Sometimes, yup, it’s just hard to tell what’s pain and what’s a behavior issue. Great post Tricia and yeah, what ever did happen to that dog with the neck pain? Poor baby!

  68. Rebecca Rice says

    August 20, 2015 at 1:43 pm

    Just another example of dog stoicism:

    I had my first greyhound, Trinkett, at a groomer to get her nails trimmed. Since she was a bigger dog, and the shop was small, we did that on the concrete outside the door. Trink, as always, was her sweet patient self, letting each paw be picked up, nails clipped, put back down, holding rock-steady still. It wasn’t until we were done and were going inside to pay that we saw the pools of blood under nails where several had been quicked. The groomer apologized, went to get the QuikStop, and life went on. But, as she said, there hadn’t been any indication that the dog had been quicked.. not a whimper, yelp, or flinch, which I knew since I had been there the whole time. If there had been, she wouldn’t have cut the rest as short, and things would have worked out better all around.

  69. Frances says

    August 21, 2015 at 5:38 am

    Well, after reading all the comments, and thinking for a while about how I whizz Sophy to the osteopath at the first sign of discomfort, and Pippin-cat to the vet if he misses more than one meal, etc, etc, I finally got round to making a GP appointment for my own hip pain, and now have exercises and other recommendations for dealing with the bursitis that has been bothering me on and off for years… And the really daft thing is that in the UK human health care is free, and animal health care is not, so I was probably only held back by an almost unconscious and definitely irrational anxiety that I might get a diagnosis I didn’t want to hear. I fear that we really are not very rational creatures, no matter how much we pretend to be (and thank you all – it seems most of my problem should resolve with stretching and Pilates!).

  70. Jaye Mier says

    August 21, 2015 at 7:10 am

    HFR…we used a product called Senilife when our Robbie started showing symptoms of Canine Cognitive Disfunction. It worked quite well for him and more quickly than we expected. His night pacing stopped, sleep patterns improved, as did his willingness to interact with us and give and accept affection. Another unexpected benefit was a fairly drastic change in some of his life-long phobias. This fear of thunderstorms dwindled as did his fear of opening the oven door. This surprised my vet as much as us. You might want to look into it.

  71. HFR says

    August 21, 2015 at 2:20 pm

    @Jaye Mier: Thanks, I will definitely look into that, it sounds promising. And thanks, Trisha, for reminding me of the name of the prescription drug. Unfortunately, most of the vets I talk to aren’t very supportive of it, but I may try it eventually. I actually changed the timing of her tranquilizer and that seems to have helped a bit for now anyway. Thanks again!!

  72. Rebecca Rice says

    August 22, 2015 at 10:24 am

    I have been thinking about this some more, and think that denying your dog is in pain may also be a bit of a defense mechanism, especially when you are faced with making a very hard decision. Take my example of Pixie and her knee surgeries. You have just been told that your dog needs surgery, and there is no way that you can afford it. What can you do? Decide to rehome a dog that you have had for years, that is very loved, and at least acts like she is feeling fine a lot of the time, in the hopes that someone else is willing to pay for that surgery? But what if they don’t? You’ll never know. Acknowledge that the dog is in pain, but you can’t afford to treat it, so euthanize a dog that spends a lot of time acting like she is fine? Or, tell yourself that she doesn’t act like she’s in pain, so it’s probably really not that bad, and just go on with things the best that you can? Sometimes, I think the denial is a way to make our decisions more acceptable to us.

  73. Nic1 says

    August 23, 2015 at 4:01 am

    I think denial is probably a defence mechanism to protect us from pain or shame. Problems can occur when we try to rationalise our denial in the face of alternative evidence, a bit like Rebecca’s example above. It can then become cognitive dissonance, or warped logic. Sometimes I wonder if the pace of our modern lives makes some people think that illness and pain has become something of an inconvenience? Therefore, if we pretend it isn’t happening, life doesn’t get too disrupted. Stoicism in the face of difficulty is admirable, but just because our dogs don’t complain doesn’t mean they are ‘coping’ with it.

    ‘The research literature is quite clear in showing that pain, especially if it is experienced over a long duration of time, can actually be hazardous to a dog’s health. The reason is that pain is a stressor, and in response to stress the body begins to release a set of stress-related hormones. These affect virtually every system in the body, altering the rate of metabolism, causing neurological responses, causing the heart, thymus glands, adrenal glands and the immune system to go into a high state of activity. If this situation continues long enough these organs may actually become dysfunctional. In addition the tension that the state of pain related stress induces can decrease the animal’s appetite, cause muscle fatigue and tissue breakdown, and also rob the dog of needed, healing, sleep. In the end the dog is exhausted as well as distressed, and this reduces the body’s ability to heal.’

    https://www.psychologytoday.com/blog/canine-corner/201109/do-dogs-feel-pain-the-same-way-humans-do

    Some research from a group at your University Trisha indicates that dogs need early intervention as the treatment of pain itself can be healing, reducing the stress that can prolong the recovery of any illness or injury. I can’t see a study citation though.

    However, we can’t change anything about how people choose to think about things. All we can do is offer support, empathy and compassion and hope that others extend the same to us. We all deny stuff for all sorts of reasons and it does seem to be part of our complex human nature.

  74. Rebecca Rice says

    August 23, 2015 at 1:18 pm

    As long as we are talking about dogs and pain, do you think that dogs can also suffer from some of the other types of neurological issues that we do? I am “lucky” enough to suffer from aura migraines (aka ocular migraines), where I get the visual aura and extreme sensitivity to touch, heat, and cold, but not the typical headache pain that people think of when they think migraine. I also have tension headaches that tend to manifest as extreme panic attacks, where the only thing I can really feel is this intense need to get away from where ever it is that I am. I am a sane, intelligent woman, and fully capable of understanding that these are medical issues, and that they will go away in a while if I can just bear with it (which I normally do by finding some place and curling up and sleeping). But it is scary when your vision suddenly goes wonky, and half the world turns into nothing but zigzagging streaks of light. Or to have this sudden overwhelming sense of dread, like something is screaming at you “get away, get away1”, which has been bad enough to make me leave meetings and go pace in the hall until I can calm down and go back in. I can’t imagine what a dog would do if something similar happens to them.

  75. Lacey says

    August 23, 2015 at 5:43 pm

    Thank you, Nic1.

  76. Peri says

    August 26, 2015 at 11:37 am

    The older I get, the better I get at recognizing the “source” of my bad days. More often than not, my physical health and condition is a major contributing factor to my attitude. My dogs of my middle/older age are benefitting from the experiences I am having with my own aging body. Like Bruce, I wish I could have some of the others “back”. I could do better now.

  77. Heather Martin says

    October 23, 2018 at 4:04 am

    Our dog is on pain killers as he seems to have an unidentified restriction in his movements which seemed relieved by pain killers. We all (including our vet) discovered that Metacam seemed to allow him to move without an occasional ‘yelp’. Following castration he seemed to be in pain when he got up or sat down. We never discovered why, exactly, he was in pain. He is a rescue dog so we know nothing of his past, except that he was kept in a stable for a kennel. He was not properly socialised and this has left its own problems. My reluctance to give the pain killer, or up the dose, was not because I did not think he might be in pain but because, as with all pain killers, and other medication, the chances of him becoming immune to the effects and having to receive higher and higher doses, was possible. Taking pain killers, even for myself, has its own problems and we wanted to ascertain that he definitely needed the pain killer, and what dosage to administer. He is still on Metacam, and we try to give the amount that he seems to need, but it is quite difficult to handle something that is not immediately recognisable. Good luck to all those handling their dogs medical issues.

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Patricia B. McConnell, PhD, CAAB Emeritus is an applied animal behaviorist who has been working with, studying, and writing about dogs for over twenty-five years. She encourages your participation, believing that your voice adds greatly to its value. She enjoys reading every comment, and adds her own responses when she can.

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