How to tell if your dog is in pain: 18 signs, and what to do next

Your dog is quieter than usual. It takes the stairs slowly, or it does not want to be picked up. You wonder if your dog is in pain. Dogs cannot tell you, and many hide it well. But pain changes how a dog moves, acts and lives, and you know your dog’s normal better than anyone.

This guide lists the signs that vets use, tells you when to call a vet now, and shows you what to write down for the visit.

When to call a vet now

Some pain needs help today, not at the next free appointment. The American Veterinary Medical Association (AVMA) first aid guide covers these emergencies. Call your vet or an emergency clinic at once if your dog:

• is injured, bleeding or bitten, for example after a fall or a fight;
• may have eaten a poison or a medicine;
• has heatstroke, or shows signs of shock;
• has a seizure;
• is choking, or is not breathing.

Also call at once if your dog cries out and cannot stand or walk. If you are not sure, call. The clinic tells you if your dog must come in now.

The AVMA says to call ahead, so the clinic can be ready when you arrive. The AVMA also warns that pain and fear can make even a gentle dog bite. Do not hug an injured dog. Keep your face away from its mouth. Ask someone to help you move it.

How to tell if your dog is in pain: 18 signs vets list

The Cornell University Riney Canine Health Center groups the signs of pain into four kinds of change. Signs differ with breed, age and the dog. Look for a change from your dog’s normal.

Changes in movement

1. An unusual posture: an arched back, a low head, or the tail held in an odd way.
2. Sitting or lying down more often than before.
3. Limping, or not putting weight on one leg.
4. Stiffness, or trouble getting up after rest.
5. Trouble with stairs, the car, or the sofa.

Changes in activity

6. Restlessness: pacing, or not able to settle.
7. Lethargy: unusually tired, or not willing to move.
8. Slower walks, or no interest in play or exercise.

Changes in behaviour

9. Whimpering, yelping or groaning.
10. Hiding, or avoiding people and other pets.
11. More need for attention than usual.
12. A bad reaction to touch, from a dog that liked to be held.
13. Licking or chewing one area of the body again and again.
14. Snapping or growling, which is not like your dog.
15. Heavy panting at rest.
16. A changed face: flattened ears, a tense look, or glazed eyes.

Changes in daily habits

17. Less interest in food.
18. Poor sleep or more sleep, or accidents in the house.

One sign alone does not prove pain. But a new sign that stays, or several signs together, is a reason to see your vet.

Why dogs hide pain, and why it matters

Cornell says that pain-related changes often develop slowly. That is why the person who sees the dog every day is the best person to notice them. Cornell also says that fear in the clinic can hide pain behaviour. Your dog may walk well on the clinic floor and limp at home.

Pain can also look like a behaviour problem. In a 2020 review, Daniel Mills and other behaviour experts looked at 100 recent dog cases from their clinics. They estimate that about a third of dogs referred for problem behaviour have some form of painful condition. In some case groups, the figure may be nearly 80%. Painful joints were common, but so were painful gut and skin conditions. If your dog suddenly growls, stops liking a walk, or has new house accidents, ask your vet to check for pain first. Our guides on why a dog is reactive on the leash and why a dog licks its paws explain more.

Acute pain and chronic pain

Cornell describes two kinds of pain:

• Acute pain comes from an injury, surgery, infection or inflammation. It can last a few hours or several days. It usually responds well to treatment from your vet.
• Chronic pain stays after the tissue has healed. Arthritis is a common cause. Cornell says that chronic pain that is not managed can make the body more sensitive, so pain spreads beyond the first place.

Chronic pain often grows slowly, so it looks like “just getting old”. It is not. If your dog is older, read when is a dog a senior for the changes to report at each visit.

Do not give your dog human pain medicine

When a dog limps, many owners look in their own medicine cabinet. The US Food and Drug Administration (FDA) says: stop and call your vet before you reach for any bottle. The FDA says that a human pain reliever may last longer in a dog, be absorbed faster, and reach higher levels in the blood. Possible results include stomach ulcers, kidney failure, liver failure and death.

The FDA also says:

• No over-the-counter anti-inflammatory pain medicine is FDA-approved for dogs. The approved ones need a vet’s prescription.
• A medicine left over from another dog may not be right for this dog.
• Two anti-inflammatory medicines at the same time increase the risk of side effects.

Give only what your vet prescribes, for this dog, exactly as the label says. The FDA says to ask for the Client Information Sheet with each prescription. If your dog takes a pain medicine every day, the free vet visit summary helps you list it for the next visit.

What to write down before the vet visit

Cornell asks owners to record what they see with photos, videos or written notes, because the vet may not see the signs in the clinic. Keep it short and factual. For each day, write:

1. the date and time;
2. what you saw, in plain words: “slow to get up from the bed”, “would not jump into the car”;
3. how long it lasted;
4. what happened just before: a walk, a play session, a long rest;
5. appetite and sleep, compared with normal;
6. any medicine from your vet, and the time you gave it.

Film your dog as it gets up, walks on a flat floor and goes up a step. Thirty seconds of video often tells the vet more than a long description.

The Medical and Dosing Tracker has a one-month daily check page, a symptom and trigger log and a weight tracker, so the changes are in one place. Its one-page vet visit summary lists what changed since the last visit.

What the vet does

Cornell says the vet starts with a full physical exam to find the cause of the pain. Tests can include X-rays and blood work. Then the vet makes a plan for your dog.

Ask these questions at the visit:

• What is the most likely cause of the pain?
• What signs tell me that the treatment works?
• Which signs mean I must call you before the next visit?
• When do you want to see my dog again?

Once treatment starts, Cornell says to watch your dog’s progress and stay in contact with your vet. Keep the same notes as before. Then you can show the vet a clear before and after. The daily dose grid in the Medical and Dosing Tracker shows who gave each dose and when, so nobody gives a dose twice.

When pain is part of a serious illness

Some pain comes with a long illness, such as cancer. If your dog has cancer, the daily symptom diary in the Dog Cancer Care Journal scores each sign against your dog’s normal. Our guide to dog chemo side effects lists the signs to report during treatment.

If pain cannot be controlled, quality of life becomes the main question. Our guide on how to know when to put your dog down has the questions vets suggest. Talk with your vet early. You do not have to make that decision alone.

For two common pain signs, read dog limping but not crying and dog panting at night when it is not hot.

This guide is one step in our complete guide on how to care for a senior dog: vet visits, weight, joints, mind and nights, in order.

For cats, read signs of pain in cats.