Dog Pain Scale: How to Assess Canine Pain

POV: Your normally boisterous dog is lying on the ground with droopy ears and a worried expression on his face. When you touch certain places on his body, he whimpers and pulls away.

If your dog is exhibiting any of these behaviors, it’s possible he’s experiencing pain. 

But signs of pain in dogs are not always obvious. Sometimes dogs in pain may only appear slightly unsettled or distracted. This is where a dog pain scale — a tool to assess how much pain your dog is in — may come in handy. However, canine pain scales can be difficult to use without professional help, so proper assessment should always be performed by a veterinarian or other expert.

Why Dog Pain is So Hard to Measure

Dogs are masters at hiding their pain, and the roots of this ability may be evolutionary. 

Dr. Erin Katribe, medical director at Best Friends Animal Society, an animal welfare organization in the U.S., says dogs developed the ability to hide pain “prior to domestication when signs of illness or injury out in the wild could lead to predation.”

“For this reason, though, sometimes pain or illness isn’t obviously detectable by owners or veterinarians until the condition has progressed,” says Dr. Katribe. “Many times, conditions that seem to have a sudden onset have actually been brewing for some time. This can often be surprising to pet owners, however, when their pet is diagnosed.”

Dr. Katherine Earl, a staff veterinarian and pain management director at DoveLewis Veterinary Emergency & Specialty Hospital in Portland, Oregon, says dogs may even try to mask their discomfort in an effort to please their pet parents, and may continue partaking in activities like ball chasing or going on runs. Dr. Earl says it’s also difficult to detect dog pain because since they may “demonstrate pain behaviors that are different than what we can relate to from our own experience.”

In general, there are two types of pain your dog can experience: acute pain and chronic pain.

“Acute pain is associated with a trauma or injury such as a wound where the pain is expected to resolve in an appropriate time frame,” says Dr. Earl. “Chronic pain is pain that is severe enough or constant enough to not resolve and become a disease in and of itself.”

If acute pain is left untreated, it may eventually turn into chronic pain, says Dr. Katribe. With this in mind, it’s important to take your dog to the veterinary clinic if you suspect your dog may be experiencing any kind of discomfort. A veterinarian or other professional may then use a pain scale to assess your dog’s condition. These scales can help catch pain issues early, which will allow you to quickly find a treatment plan that will help your dog enjoy a better quality of life.

What is a Dog Pain Scale?

A canine pain scale is a tool used to assess a dog’s level of pain and how to help them. There are several types of dog pain scales, including the Colorado State Acute Pain Scale, Glasgow Composite Measure Pain Scale, and even the BEAP Pain Scale for Dogs developed by BluePearl Pet Hospital. There are also questionnaires designed to assess chronic pain and quality of life in dogs. 

While each pain scale is different, Dr. Katribe says most use behavior indicators, such as posture, vocalization, and movement, to assess the scale of a dog’s pain. The higher the score, the greater pain your dog is likely experiencing. 

How to Use the Dog Pain Scale to Assess Your Pet

According to Dr. Earl, the majority of validated pain scales for dogs are “not meant for pet parents due to their complexity.” Additionally, many dog pain scales measure responses to palpation — that is, what happens when you touch your dog’s body — which Dr. Earl says pet parents shouldn’t attempt “as it could provoke your dog and is best handled by a veterinary professional.”

However, pet parents can still draw on the information in canine pain scale to recognize behavioral changes that might indicate pain.

For instance, according to the Colorado State Acute Pain Scale, a dog that is groaning or screaming when left alone, biting or chewing at their wound, or unresponsive to their surroundings, is likely experiencing moderate to severe pain — the highest amount of pain on the scale. On the other hand, a dog that seems content, but slightly unsettled or restless may be experiencing mild pain. 

Dr. Katribe says that while dog pain scales tend to be used more in veterinary clinics and shelter environments, there are certain situations in which pet parents can utilize them.

“Pain scales may allow pet owners to identify subtle signs of pain or to identify signs of pain earlier,” says Dr. Katribe. “They may also be useful for pet parents to use while their pet is undergoing treatment for pain, to assess their pet’s response to that therapy.  For example, if a pet has undergone a surgical procedure and is on pain medication post-operatively, an owner can use a pain scale to determine if the pain management approach is effective, or if their dog may need an alternative approach.”

According to Dr. Earl, there are telltale signs that a dog is experiencing pain:

• Standing in one place and not lying down
• Repeatedly doing a “play bow” position without playing
• Pacing and refusing to lay down
• Changes in normal behavior: hiding, being aggressive, refusing favorite treats or activities
• Vocalizing/groaning when picked up, moving, or spontaneously

“To detect pain in a dog, there are no specific materials but your observation,” says Dr. Earl. “If your dog is in an unusual position (say a play bow that does not stop), shaking for no reason, acting lethargic, refusing to eat or hiding — these all can be signs of pain especially if there is no other context for it. Generally, if you observe an obvious site of trauma — a visible wound or laceration, squinty eye — it is best to not handle that part as a dog who is in pain has the potential to bite or exhibit aggression that is only secondary to fear.”

Dr. Earl says it’s also important to maintain a calm demeanor when approaching a dog experiencing pain so you don’t provoke anxiety in the dog.

Dr. Katribe advises pet parents to keep records of their observations — and even to capture footage with their phone camera — to later share with their veterinarian. 

“Recording video of suspected indicators of pain can help with the discussion,” says Dr. Katribe. “Many dogs will mask signs of mild to moderate pain when in the stressful veterinary clinic setting, so video from the less-stressful home environment will help give your vet an accurate picture of what’s going on at home.”

However, if you see your dog dealing with a sudden onset of pain, possibly after getting injured, you need to whisk your dog to a veterinary clinic.

“The more severe the pain or clinical signs, the more urgent and serious this could be and the faster the pet should be seen,” says Dr. Katribe. “If an appointment at your regular veterinarian isn’t possible, consider seeking care at an emergency facility.”

Pain Relief for Dogs and Recovery Tips

Luckily for our canine friends, acute and chronic pain can usually be treated through medication, therapy, or other management steps.

“Acute pain can be treated with both injectable and oral medications to decrease both the pain and inflammation that may be contributing to the discomfort,” says Dr. Earl. “Chronic pain such as arthritis is harder to treat with just medications and typically needs more physical modalities to help control pain and improve quality of life such as acupuncture, physiotherapy, and environmental modification.”

And if a dog is experiencing unbearable pain?

“Severe pain warrants a veterinary visit as soon as possible to discuss pain control options, as well as diagnostic testing to determine the source of the pain, followed by comprehensive treatment,” says Dr. Katribe. 

“As many of us have experienced, pain can be extremely detrimental to welfare and quality of life,” Dr. Katribe adds, “so this should never be ignored in our pets.”