THE MOST DIFFICULT DIAGNOSIS
Why Is Pain a Difficult Diagnosis for Dog Owners When Their Dog Has a Behavioral Issue?
Pain is one of the most overlooked causes of behavioural issues in dogs, yet it's also one of the most common. Many factors make it difficult for dog owners to recognise pain as a root cause and to accept the idea of a pain trial as a diagnostic tool.
1. Dogs Don’t Show Pain in Obvious Ways
Unlike humans, dogs rarely vocalise or limp unless pain is extreme. Instead, they:
Adapt their movements to avoid discomfort.
Compensate by shifting weight subtly.
Express pain through behaviour, such as reactivity, avoidance, or sudden aggression.
Because these signs are subtle or mistaken for training/behavioural issues, owners often don’t associate the behaviour with physical pain.
🔹 Example: A dog growls when being petted—not because they’re aggressive, but because they have arthritis. The owner may assume the dog is just "grumpy" or "dominant."
2. People Expect "Lameness" as the Primary Sign of Pain
Many owners believe that if their dog were in pain, they would limp or stop running/jumping. But dogs:
Mask pain instinctively (a survival trait from their ancestors).
Often continue to be active, even with significant discomfort.
May still enjoy walks/play but struggle later at rest—something owners don’t always notice.
🔹 Example: A dog that excitedly runs off-leash at the park but becomes irritable at home may be sore after activity, not during. Owners might blame this behavior on training issues, not discomfort.
3. The “He’s Always Been Like This” Mindset
Owners often assume that if a behaviour has been present for a long time, it must be personality-driven, not pain-driven. They may believe their dog is:
"Naturally grumpy"
"Overly dramatic"
"Reactive for no reason"
🔹 Example: A dog who has always hated being lifted might actually have chronic spinal discomfort. Since the behaviour has been present for years, the owner assumes it’s just "how the dog is."
4. People Struggle to See the Link Between Pain and Behaviour
Most owners view behaviour and medical issues as separate problems. They don’t intuitively connect pain with:
Reactivity toward dogs or people
Separation anxiety worsening
Refusal to get into the car or onto furniture
Barking at noises more than usual
🔹 Example: A dog that suddenly becomes reactive to other dogs may actually have hip pain—social interactions can feel more threatening when a dog can’t move comfortably. Owners may think it’s a "training issue" rather than a pain response.
5. People Resist Medications Without a Clear Diagnosis
Since pain trials involve giving medication without a confirmed diagnosis, owners may be reluctant, thinking:
"I don’t want to medicate my dog unnecessarily."
"What if it makes him worse?"
"He doesn’t seem in pain, so why would I give him painkillers?"
🔹 Reframing: A pain trial isn’t just giving medication blindly—it’s a diagnostic tool. If behaviour improves on pain relief, it strongly suggests pain was a factor.
6. Fear of the Implications (Denial and Guilt)
Owners may subconsciously resist the idea of pain because:
They feel guilty for not noticing it earlier.
They don’t want to accept that their dog may have a long-term medical condition.
They fear a pain diagnosis means expensive tests, surgeries, or lifestyle changes.
7. Chronic pain is difficult to spot in a veterinary clinic
Even in clinical settings, pain is often underdiagnosed in dogs presenting with behavioural issues.
The focus may be on obvious physical signs (limping, joint stiffness).
If the dog doesn’t react to a hands-on exam, pain may be ruled out too soon.
🔹 Reality: Many dogs won’t react at the vet’s office because adrenaline masks pain, or the pain is more apparent during movement rather than when being touched.
Always remember:
✔ A pain trial is diagnostic—it’s not about medicating permanently.
✔ If behaviour improves, it confirms pain as a factor.
✔ If there’s no change, then we’ve ruled it out and can focus fully on behavioural strategies.