Recognizing Pain in Dogs: How to Tell Whether Your Dog Is Hurting – and What to Do Now

In brief

There are four things you should know. First: pain is one of the commonly overlooked causes of behavior problems – in the caseloads of several referral behavioral medicine practices, its share ranged from 28 to 82 percent. Second: dog owners reliably recognize obvious pain signs, but they are no better than people without a dog at recognizing subtle ones. Third: the widespread belief that tough working breeds feel or show less pain does not hold up to scrutiny – veterinarians, too, get their breed judgments wrong. And fourth: a change in behavior with no apparent trigger is a reason for a veterinary workup, not for more consistency in training.

And here is some good news that hardly anyone knows: for chronic pain there are validated questionnaires you can fill out yourself. They turn "he seems better today" into a number you can compare over months – exactly what is otherwise missing when a condition creeps up slowly. There is a dedicated chapter on them further down.

Dogs show pain differently than we expect. This article walks through how to recognize the subtle signals, what causes may lie behind them – and where the usual advice columns claim things the research does not support.

👉 The basics of preventive care and health checks for dogs

1. Why pain is so often overlooked

The usual explanation goes like this: dogs hide pain because visible weakness would be dangerous in the wild. That is a plausible story, but it is hard to test – and it leads to an unhelpful conclusion, namely that there is not much to see anyway.

The data point in a different direction: the signals are there – we just don't read them as pain.

A research group at Utrecht University surveyed 530 dog owners and 117 people without a dog online. They were asked to rate how likely 17 behavioral signs were to indicate pain, and to assess three case descriptions (Gardeweg, Picard & van Herwijnen, 2026). All 17 listed signs are in fact possible signs of pain.

Almost everyone got the movement-related signs right. For the case description with the subtle signs – shadow chasing, restlessness at night – there was, by contrast, no difference between people with and without a dog.

What is revealing is how the individual signs were rated. Personality change, hesitantly lifting a paw, fluctuating mood and less play were rated high. Snapping at the air, licking the nose and yawning were rated low.

And one finding that cannot be explained away: two signs were more likely to be recognized as pointing to pain by the people without a dog than by the dog owners – freezing and turning the head or body away. The authors' obvious interpretation: anyone who knows these signals as signs of stress or fear falls back on that explanation and no longer checks the second possibility.

It is also interesting what this was linked to: participants who had experienced pain themselves, or whose dog had already gone through a painful condition, classified the subtle signs correctly more often. So experience goes along with better recognition – but apparently only experience with pain, not with dogs in general.

How far this goes: This was an online survey with written case descriptions, not an assessment of real dogs. Participants were mostly female, the comparison group without a dog was smaller and younger, and many in that group had lived with dogs in the past. That weakens the group comparison – the generally poor recognition of the subtle signs is unaffected by it.

This is an uncomfortable but useful finding. It shifts the task: it is less about coaxing out something a dog is hiding and more about training your own eye.

Two further reasons come on top of this, and they are not in dispute:

Gradual progression. Osteoarthritis, dental disease and similar processes develop over months to years. Compared with yesterday, everything always looks unremarkable – the comparison with two years ago would be the telling one.

Misattribution. Early signs of pain are interpreted as a personality trait, old age, stubbornness or a training problem. Many subtle pain signals also overlap with signs of stress and insecurity – and anyone who already has an explanation for those naturally falls back on it.

2. The breed claim that doesn't hold up

Almost every advice column says that tough working breeds – shepherds, retrievers, hunting dogs – show pain later or handle it better. This assumption is so widespread that it is hardly ever questioned anymore. It has now been studied.

In a US survey, more than 98 percent of the veterinarians surveyed agreed that dog breeds differ in their sensitivity to pain – and their breed ratings largely matched each other. There was no evidence of biological differences behind those ratings.

A follow-up study measured instead of asking: 149 healthy dogs from ten breeds were examined with standardized threshold tests. The result came in two parts (Caddiell et al., 2023):

• There are indeed differences in pain thresholds between breeds.
• But the veterinarians' ratings barely explained these differences. Instead, their ratings were related to how the dogs approached a stranger behaving in an unfriendly way.

In other words: what counts as "high pain tolerance" apparently reflects the dog's behavior in the clinic – how approachable or fearful it seems – more than its actual pain sensitivity. The practical consequence is serious: dogs considered "tough" are at risk of getting too little pain management.

This fits the recommendation in the behavioral medicine literature: abnormalities such as an unusual gait or unexplained behavioral signs should not be dismissed because they are common in a breed (Mills et al., 2020).

For you, this means: "That's just how he is, it's the breed" is not a finding. It is a hypothesis that should be checked.

2a. The age explanation that doesn't hold up either

Besides breed, there is a second explanation that is used even more often and has the same effect: "He's just getting old."

It sounds reasonable because there is something to it. Older dogs really do move differently, sleep more and have less stamina. The problem is not the observation but the conclusion drawn from it – namely that nothing can be done.

In fact, two of the most common causes of what passes for signs of aging in everyday life are treatable: osteoarthritis and dental disease. Both develop over years, both lead to exactly the changes attributed to age – less stamina, less play, more withdrawal, changed eating – and both can be relieved.

In the individual case, you cannot tell the difference from behavior. A dog that no longer jumps onto the couch looks the same whether the cause is declining muscle strength or joint pain. You can't tell them apart by watching, only by having it checked – and, as section 6.3 describes, if necessary by a trial treatment and asking whether anything changes.

A rule of thumb that has proven useful: age explains a gradual change over years. It does not explain why a dog gives up something within weeks that it used to do every day. And if a dog reacts sensitively to touch, becomes restless at night or is suddenly irritable, age alone is not a sufficient explanation but a reason for a workup.

This is the same error in reasoning as with breed, just with a different label. In both cases, an observation is confused with a cause, and in both cases the result is that nobody looks any further.

3. Typical signs

Pain rarely shows itself clearly; it usually appears as a combination of behavior, body language and movement.

3.1 Behavior

• less play, less initiative
• withdrawal, seeking less contact – or, conversely, unusual clinginess
• sensitivity to touch in particular spots
• changed resting behavior: more sleep, or restlessness and frequent shifting of position
• restlessness at night
• changed eating behavior

A classic example: the dog no longer jumps onto the couch or into the car. This is often read as laziness – but joint pain is frequently behind it.

Newly appearing fear or aggressive behavior deserves special attention. The behavioral medicine literature describes a recurring pattern: dogs with chronic musculoskeletal problems are often described as moody or unpredictable; the aggression typically occurs when someone approaches, often while the dog is lying down, and a closer look reveals a general reluctance to move (Mills et al., 2020).

How fear and insecurity show up otherwise is described in our guide to fearful dogs; you can read more about the causes of aggression in Aggression in Dogs: Function, Warning Signals and Bite Risk.

3.2 Body language and face

Facial expression calls for an honest assessment. For cats, horses, sheep, pigs and some laboratory species, there are validated "grimace scales" – standardized scales that make the facial expression of pain measurable. For dogs, no comparably validated instrument exists. The tools validated for dogs are composite behavior-based scales used in veterinary practice.

What this means for you: the frequently mentioned features – squinted eyes, a tense forehead, ears turned back or to the side, an overall stiff expression – are useful clues and match what has been documented in other species. But they are not proof and do not replace an examination. Treat them as one piece of the puzzle alongside behavior and movement.

Posture can also give clues: a hunched back, a tucked tail, conspicuously careful movements, panting without heat or exertion.

And one observation from the study mentioned above that helps in everyday life: it is above all the quiet signs that are overlooked – yawning, licking the nose and lips, turning the head or body away, freezing, increased blinking. These are the same signals many people know purely as signs of stress. They can mean either.

For an overview of body language in general: Dog communication and body language.

3.3 Movement

• stiff or cautious gait
• difficulty getting up, especially after lying down
• hesitating at stairs
• avoiding jumps
• lameness, even if mild or shifting
• tiring on longer walks

4. Common causes

4.1 Joint pain and osteoarthritis

Osteoarthritis is among the most common causes of chronic pain in dogs – other possibilities include dental disease, spinal problems, neurological disorders and cancer. For a sense of scale: one recent review puts the share of affected dogs at 20 to 37 percent. In one study that used a screening checklist for owners, 37.3 percent of the dogs presented for routine preventive care or for lameness received an osteoarthritis diagnosis.

Typical signs: less stamina, avoiding jumps, stiff movement, licking at particular joints.

Many owners report that problems get worse in cold, wet weather. As far as we know, this has not been properly documented for dogs – treat it as an observation, not a rule.

4.2 Dental pain

Dental disease is among the most common causes of pain and is overlooked particularly often, because most dogs keep eating.

Clues: slow or one-sided chewing, food dropping out of the mouth, marked bad breath, rubbing the muzzle, changed play with chew toys.

4.3 Abdominal pain

A characteristic sign is the so-called prayer position: front end lowered, hindquarters raised. This may be accompanied by loss of appetite, restlessness and repeatedly lying down and getting up again. If there is also vomiting or diarrhea, the dog should be examined promptly.

5. The questionnaires you can fill out yourself

This chapter is the most practically useful part of the article, and it is still largely unknown to many dog owners. For chronic pain in dogs there are validated questionnaires for owners. They are filled out at home, take a few minutes and produce a score.

5.1 Why a number beats an impression

The problem these questionnaires solve was described above: when a condition progresses gradually, the comparison with yesterday always looks unremarkable. On top of that, osteoarthritis in particular fluctuates considerably from day to day – a good day says as little as a bad one.

A questionnaire gets around both. It asks the same things every time, in the same order, with the same gradations. What comes out is not a diagnosis but a reference value – and that makes a trend visible that gets lost in your everyday impression.

The second benefit concerns the veterinary practice. "He's been better since the medication" is information that is hard to work with. "The score has dropped from 28 to 17" is information you can work with.

5.2 Which ones exist

Three instruments are established and were evaluated together in 222 dogs with osteoarthritis (Walton, Cowderoy, Lascelles & Innes, 2013).

LOAD – "Liverpool Osteoarthritis in Dogs". 13 questions about mobility, divided into general everyday situations and situations during exercise, each on a five-point scale.

CBPI – "Canine Brief Pain Inventory". 11 questions, derived from an instrument used in human medicine. It records two things separately: how severe the pain is judged to be and how much it interferes with daily life.

HCPI – "Helsinki Chronic Pain Index". Also an owner questionnaire on chronic problems.

The current clinical guideline points in the same direction: the 2022 AAHA Pain Management Guidelines name the CBPI and LOAD as the most widely used owner questionnaires for dogs. They note that such instruments remain subject to bias, but that because they standardize the questions posed to owners, trends over time can be captured more accurately (Gruen et al., 2022).

5.3 What the evaluation showed

The 2013 study did not just compare the three questionnaires with one another; it also held them up against an objective measurement: a force plate that records how evenly a dog loads its limbs.

The result came in two parts. The three questionnaires agreed well with one another. And the scores were related to the force plate data – but only weakly. The authors recommend LOAD as an instrument suitable for measuring osteoarthritis in dogs and point out that a relationship with force plate data was shown here for the first time.

How far this goes: The weak relationship matters for interpretation. These questionnaires do not measure pain itself but its impact on daily life as seen by the person who knows the dog. That is something different from a physical measurement, and the two do not always come out the same. They were also developed and tested for osteoarthritis and orthopedic problems – they are not intended for dental or abdominal pain.

5.4 How to use them

The questionnaires are freely available and are provided by veterinary professional societies and universities. A fixed routine makes sense:

Once as a baseline, before anything has been done. This first score is the most important one, because everything that follows is measured against it.

Then at fixed intervals – roughly every four to eight weeks, plus before and a few weeks after any change in treatment.

Always under comparable conditions. Not the day after the long outing, and not on the best day of the week, of all days. If you always fill out the questionnaire on the same day of the week, you get the cleanest trends.

A tip that has proven itself in practice: if possible, always have the same person fill out the questionnaire. Different people in a household judge the same situation more or less strictly, and that difference is often larger than the change you are trying to measure.

6. What you can do

6.1 Record your observations

A simple pain diary is the most effective tool you have at home – because it solves exactly the problem described above: it makes gradual changes visible.

Write down, with the date: when your dog limps, what getting up looks like, changes in eating, in sleeping, in how it seeks contact. Short phone videos of the gait and of getting up are often more informative for the veterinary assessment than any description.

A tip for evaluating your notes: don't just compare good and bad days, but watch for trends over weeks. With osteoarthritis in particular, the condition fluctuates considerably from day to day – you only see the direction over a longer period.

6.2 Adapt the environment

Non-slip runners on smooth floors, ramps for the car and couch, an orthopedic bed, bowls at a comfortable height, shorter and more frequent walks instead of long distances.

6.3 Have it checked by a veterinarian

With persistent or newly appearing problems, there is no way around this. One point you can raise: the professional literature recommends that, when there is a well-founded suspicion of pain, a trial pain treatment be considered and its effect assessed even if no clear physical cause can be found (Mills et al., 2020). That is a veterinary decision – but it is good to know that "nothing found" does not automatically mean "no pain".

What makes good veterinary care is summarized here.

6.4 Prepare for the appointment

One point that is often underestimated: the clinic is usually not the best place to assess subtle signs of pain. Excitement can mask behavior, and many dogs move differently there than at home. What the dog shows in the exam room is therefore only a snapshot.

What you can bring to make that snapshot bigger:

Videos of getting up, recorded after a longer rest – in the morning or after an afternoon nap. That is exactly when stiffness is most obvious, and exactly when nobody is sitting in the waiting room.

A video of the gait on a straight stretch, filmed from the side and from behind, at a calm pace. Lameness is more noticeable at a trot than at a walk.

The AAHA guidelines also mention this explicitly: when pain comes and goes or only shows up in activities that cannot be reproduced in the clinic, pictures or videos taken by the owner and reviewed by the veterinarian provide useful information (Gruen et al., 2022).

The course over time instead of the moment. A diary or a questionnaire score over several weeks says more than any description of the current day.

Concrete examples instead of judgments. "He stopped jumping into the car about four months ago; before that he did it every day" is usable. "He's somehow gotten slower" hardly is.

And one question worth asking: whether a trial pain treatment makes sense. The next section explains why.

7. Mistakes you should avoid

Never give human painkillers. Active ingredients such as ibuprofen, diclofenac or acetaminophen (paracetamol) can cause serious damage to the gastrointestinal tract, kidneys and liver in dogs. How much is dangerous depends on the drug, the dose and body weight – which is why there is no rule of thumb and no safe amount here. What is given is decided by your veterinarian alone.

Don't wait and see on a hunch. Chronic pain often gets worse unnoticed and can lead to secondary behavior problems.

Don't work on behavior before pain has been ruled out. If a dog suddenly becomes more sensitive, more irritable or more reluctant, training is the second question. The first is whether something hurts.

8. When to see the vet right away

• sudden yelping or crying out
• the dog can no longer get up, or the hind legs give way
• unusually rapid or labored breathing
• very pale or white gums
• a bloated, hard belly
• persistent vomiting with marked weakness

A sudden loss of the ability to walk can point to a herniated disc – time matters here.

9. Pain and behavior: why they belong together

For a dog-training school, this is the real core of the matter.

In an analysis of caseloads from several referral behavioral medicine practices, the share of dogs presented in which a painful condition was involved was conservatively estimated at about one third – across the different practices, the range was 28 to 82 percent (Mills et al., 2020). The authors note that this connection is systematically underreported.

For context: these figures come from referral practices, that is, from a preselected population with pronounced problems. They cannot be transferred to all dogs. But they show the order of magnitude – and they explain why an honest behavioral analysis always begins with the question of whether the body has a say.

This very distinction is why, with behavior problems, we work together with veterinary workups rather than against them. A training plan built on top of pain can at best achieve nothing – at worst it demands of the dog exactly what hurts.

Why pain shows up above all as changed behavior, why an unremarkable exam does not rule it out, and which patterns should prompt a workup is covered in Pain Masking in Dogs: Why Discomfort Is Hard to See.

10. Conclusion

Dogs do show pain – but quietly, and often in signals we read as something else.

The three things that make the difference:

Take change seriously. What counts is not the single oddity but the departure from your dog's normal state.

Be wary of breed explanations. "He's tough" is not a diagnosis and can lead to undertreatment.

Rule things out first, then train. When fear, irritability or reluctance appear for the first time, the body should be checked first.

If you know your dog and write down changes instead of explaining them away, you will recognize pain much earlier – and that is the point where there is the most to gain.

Key takeaways on recognizing pain in dogs

The signals are there – they are just read differently. Almost everyone recognizes movement-related signs; for the case description with subtle signs, there was no difference between people with and without a dog. Freezing and turning away were even more likely to be recognized as pointing to pain by people without a dog (Gardeweg et al., 2026). The task is to train your own eye, not to coax something out of the dog.

"Tough" is not a trait but an impression. More than 98 percent of the veterinarians surveyed believe in breed differences in pain sensitivity. Measured differences do exist – but the ratings barely explained them; they depended on how approachable a dog seemed in the clinic (Caddiell et al., 2023).

Pain is often behind behavior problems. In the caseloads of referral behavioral medicine practices, its share ranged from 28 to 82 percent (Mills et al., 2020) – figures from a preselected population, but clear in their order of magnitude.

There are validated questionnaires for use at home. LOAD, CBPI and HCPI were tested against force plate data in 222 dogs; LOAD is recommended (Walton et al., 2013). They measure the impact on daily life, not the pain itself – and they were developed for osteoarthritis, not for pain in general.

For facial expression, dogs lack a validated instrument. Validated scales exist for cats, horses and other species, but not for dogs. The features mentioned are useful clues, not proof.

The quiet signs overlap with stress signs. Yawning, licking the nose, turning away, freezing, blinking – anyone who already has an explanation for these naturally falls back on it and overlooks the second possibility.

Comparing over weeks beats comparing with yesterday. Gradual changes never stand out in a day-to-day comparison. A diary, videos and a repeatedly completed questionnaire solve exactly this problem.

Rule things out first, then train. When fear, irritability or reluctance appear for the first time, the body should be checked first. A training plan built on top of pain demands of the dog, in the worst case, exactly what hurts.

References

• Gruen, M. E., Lascelles, B. D. X., Colleran, E., Gottlieb, A., Johnson, J., Lotsikas, P., Marcellin-Little, D., & Wright, B. (2022). 2022 AAHA pain management guidelines for dogs and cats. Journal of the American Animal Hospital Association, 58(2), 55–76. https://doi.org/10.5326/JAAHA-MS-7292
• Caddiell, R. M. P., Cunningham, R. M., White, P. A., Lascelles, B. D. X., & Gruen, M. E. (2023). Pain sensitivity differs between dog breeds but not in the way veterinarians believe. Frontiers in Pain Research, 4, Article 1165340. https://doi.org/10.3389/fpain.2023.1165340
• Walton, M. B., Cowderoy, E., Lascelles, D., & Innes, J. F. (2013). Evaluation of construct and criterion validity for the "Liverpool Osteoarthritis in Dogs" (LOAD) clinical metrology instrument and comparison to two other instruments. PLoS ONE, 8(3), e58125. https://doi.org/10.1371/journal.pone.0058125
• Mills, D. S., Demontigny-Bédard, I., Gruen, M., Klinck, M. P., McPeake, K. J., Barcelos, A. M., Hewison, L., Van Haevermaet, H., Denenberg, S., Hauser, H., Koch, C., Ballantyne, K., Wilson, C., Mathkari, C. V., Pounder, J., Garcia, E., Darder, P., Fatjó, J., & Levine, E. (2020). Pain and problem behavior in cats and dogs. Animals, 10(2), Article 318. https://doi.org/10.3390/ani10020318

Gardeweg, S. M. A., Picard, D. E., & van Herwijnen, I. R. (2026). The abilities in dog pain sign recognition as assessed by presenting seventeen listed dog behavioural signs and three case descriptions to dog owners and non-dog owners. PLoS ONE, 21(4), e0344512. https://doi.org/10.1371/journal.pone.0344512

Note: This article does not replace a veterinary examination, diagnosis or treatment. If you suspect your dog is in pain, contact your veterinarian; if you see any of the emergency signs listed above, contact an emergency veterinary service immediately.

Frequently asked questions about recognizing pain in dogs

How to interpret subtle signs correctly and when you should act