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We Can't Train Past Pain | Kate Knows Dogs

Oct 9 / Kate Woods, IAABC-ADT, FFCP
Pain in dogs is not limited to acute injuries. What do you think of when you hear (or read) the word?

How do you think pain looks in a dog? Could you recognize it? It's simple enough to think of a limp. If your dog's not bearing weight on one leg, their movement looks different. They'll stand off-balance. They might avoid certain activities. What about pins and needles from a pinched nerve? An ear infection? Nausea? Could you recognize those?

Before I say much more, I should make it clear that I am not a veterinary professional and if you have specific questions about your dog, you should talk to your trusted veterinary team as soon as possible. This article contains general information only, and may not be applicable to all dogs or situations.
With the obligatory disclaimer out of the way, let’s talk pain. In this article, I’m mainly talking about chronic or subclinical pain. This kind of pain can be hard to pinpoint, partly because it can be inconsistent. It’s also difficult or impossible to reproduce in a clinic environment. Even without a diagnosis, a “wait and see” approach might be a waste of time, money, and welfare.

Revised October 9, 2024: This blog contains links to some primary sources (scientific articles published in peer-reviewed journals) and some secondary or tertiary sources (textbooks; websites from veterinary sources). I have revised the citation style to be more consistent with academic styles. A legend is included in the list at the foot of the article. 

“But my dog is healthy!”

I believe you. You should know, though, that healthy doesn’t always mean pain-free. If you've had a dog for any length of time, then you've witnessed a dog in pain. Maybe your puppy came home at eight weeks, fit as a fiddle. You know, then, that he spent the next few months growing, losing, and replacing a full set of teeth. I'm sure that puppy was a bit of a shark throughout that time! We think of teething, rightly, as a normal developmental stage. What we often forget is that it's extremely painful! Puppies chew to relieve the pain in their mouths. It's easy to forget that when we're focused on the pain in our hands, our shoes, and our furniture!

Even your young, healthy adult dog has experienced pain before. She’s probably gotten into something that she shouldn't have at some point. She’s been a little off, or maybe vomited once in a while. Perhaps she’s had an injury. Maybe you've cut a nail too short. Any of these things can cause pain, even if it's temporary. Did you know that even young adult dogs can have arthritic changes in their joints, too (Arthritis AWARE)? Whether or not this changes her activity levels or behavioural diversity, it may cause her pain or discomfort. Dental disease, too, is a relatively common and often treatable cause of pain, even in our young dogs (Barnes, Hiscox, and Bellows n.d.).

Your senior dog could be developing aging-related changes in his organ function. Of course, we know that arthritis and cancer can be painful, but so can be more mundane conditions. Kidney disease, for example, is likely painful, and it may only be detected once it’s advanced (Llera, Weir, and Ward n.d.). Systemic disease like endocrine dysfunction can have knock-on effects in the muscles, organs, and skin, like itching. While itching is technically distinct from pain, it can be profound, and scratching or licking excessively in response to itching can certainly be associated with painful wounds (Moriello 2018; Llera, Hunter, and Ward n.d.).

“My vet can’t find anything wrong.”

Pain is often treatable, even without a clear diagnosis. Behaviour experts know that if pain is present, it should be treated before embarking on a training plan (Mills et al. 2020). Pain can cause stress, and we know that in humans, at least, pain may be exacerbated by stress (Wyns et al. 2023). It can also disrupt sleep, which can in turn disrupt healing and body repair processes. Pain increases irritability, which can impair social interactions. As highly social species, both dogs and humans suffer from more than just the pain itself.

Pain can influence learning (Mills et al. 2020). Of course, we know that unpleasant outcomes can have an inhibiting effect on behaviour, and escaping unpleasant circumstances can be highly motivating. Pain has been found to contribute to as many as 8 in 10 cases of problem behaviour in some veterinary behaviour practices (Mills et al. 2020). It's clear that pain can have a profound effect on quality of life for our dogs. What we often don't recognize is that our dogs' pain probably affects our quality of life, too. Surely, it’s worth trying.

As a pet parent, if you're not a veterinarian or a canine wellness professional, it's not your job to figure out exactly what's causing the pain. As a behaviour professional, that's not my job, either. My job is to help you organize your observations, describe your dog's behaviour, and address it appropriately. If your dog's behaviour is suggestive of pain, the first thing we have to do is ensure that it's assessed and treated, if necessary. Even if we can change the problem behaviour, no training in the world can relieve pain in your dog.

“The problem is behavioural, not physical.”

Dog behaviour is dynamic. They respond to environmental changes that we don't even detect, and that’s an environment we share with them. Now imagine how much less insight we have into their bodies! By the time that we can see what looks like pain, if we even recognize it, it's likely the dog has been suffering for some time. It's important that we try to see it for what it is.

What we do often notice are behaviours that annoy or embarrass us. Even if we train as positively as possible, we have a tendency to interpret refusal or reluctance to perform certain behaviours, especially well-known ones, as a kind of insubordination. Whether it’s a recall in an uncontrolled environment, or a challenging technical exercise in a competitive obedience trial, high-stakes refusals can be particularly painful to us. Reduced performance may be the first or most obvious sign we notice (Mills et al. 2020)! Unfortunately, this can put a strain on our relationship by clouding our judgement and colouring our interpretation. It does not serve our dogs or us as their teammates to hold our dogs to account for their pain.

Even if it seems like your dog's medical history shouldn't be relevant to your trainer or behaviour consultant, if you're working with someone competent, they will be better equipped to do their job well if they understand the context for your dog’s behaviour. Part of that context is your dog’s medical history. A good trainer can even help you organize your observations so that you may communicate them effectively with your veterinary team. Tracking behaviour change can also help you measure your dog's response to a new treatment plan, which can help your vet do their job better, too.

"So, what does pain look like?"

It can be a lot of things. If you've taken a class with me or if you've been a client of mine before, then you've probably heard my spiel. My Take on Teeth mini-course has a lesson dedicated to recognizing behavioural signs of pain! If you haven't learned from me yet, here are a few behaviours that would prompt me to ask questions:

1. Rejecting food

Does your dog have a normal or lean body condition, but sometimes miss meals? Would you describe him as “not food motivated?” If your dog rejects food often, or even only in certain contexts, and it doesn't have a clear learning-related cause, then this would be a red flag for me. A learning-related cause could be something like tricks or bribes, where we offer the dog food and then do something they don't like. That could also contribute to food rejection behaviour.

2. Drooling, slurping, or lip-licking outside of an eating or social context.

If your dog seems to salivate excessively, that can suggest a possible medical condition. This one's tricky, since salivation can also be a sign of anticipation when your dog expects a yummy reward! Some dogs have looser flews or jowls that don't effectively hold saliva in their mouths, which can make them seem like they're drooling, but they're not really. If you dog seems to slurp, lick their lips, or even lick their front legs in a non-specific way, then they may be salivating excessively, and you should ask your vet about it.

3. “Obsequious” or excessively needy behaviour.

If your dog almost literally gets under your skin, you’re probably well-acquainted with the shock of a wet nose in your armpit. I find it beyond annoying! A relaxed, goofy dog may not trip any alarms, but a worried one does.

If you can regularly see the whites of your dog’s eyes, or she always seems to be smiling with the corners of her mouth upturned, she probably has a certain amount of facial tension. If he wears his ears on the back of his head like a ponytail, or his ears are often in airplane formation, or if he used to have floppy ears like a Labrador and now he has more rosy-shaped ears like a greyhound, then he has a lot of facial tension. You guessed it - this all adds up to a great big vet visit to discuss the possibility of pain (Wiseman-Orr et al. 2004; Mills et al. 2020).

4. Excessive humping. 

If your dog regularly does living room yoga - spending a lot of time in downward dog position - then you should suspect pain. Similarly, if they stand with their back feet well behind them instead of standing square when they're apparently relaxed, or arch their back, you have to wonder if they're relieving pressure somewhere (Southeast Veterinary Neurology). Believe it or not, excessive or new humping behaviour, too, may suggest pain or discomfort (ASPCA).

5. Avoiding gear, kennels, or the car.

Has your dog always avoided the car? Do they seem not to settle, or whine while they're in there? Are they newly or increasingly gear-shy? Do they avoid a snug kennel even though they used to seem to like it? Ding, ding, ding! Even if you haven't noticed any other signs, these are alarm bells (Barnes, Hunter, and Ward n.d.).

6. Resource guarding, including caching behaviour.

While some amount of resource guarding in dogs is normal behaviour, pain is a risk factor for the development of possessive aggression or food-related aggression (check out this free webinar with Dr. Kenneth Martin, DVM, DACVB, by Fear Free). This type of aggression is when a dog protects their possessions, including food, with behaviour that is disproportionate to the actual threat (Landsberg 2018). Caching is not something we would consider to be an aggressive behaviour, but it can be a sign that chewing or consuming food items causes some kind of discomfort or pain.

7. Eating non-food items. 

Also called pica, eating non-food items is usually not a normal behaviour for dogs, although it may occasionally result from normal exploration and scavenging behaviours (Landsberg 2018). There are many possible causes and this is definitely something you should discuss with your vet. You should also reach out to an experienced behaviour consultant. Foreign body surgery can cost upwards of $10,000, so spending a little bit up front on the right professionals — and maybe the right insurance — may confer significant cost savings, not to mention great benefit to your dog (Trupanion; Well U)!

8. House soiling. 

Potty training should be one of the simplest tasks for your dog to learn, if you have the tools to do it. That's not to say it's easy - but it is simple. Dogs quickly develop substrate preference, which means that repeated pottying on the same type of surface will encourage them to potty on that surface in the future. If your puppy gets most of his practice in the living room, then your rug is going to see a lot of action. If you adequately supervise your puppy and get him outside when he needs to go, or if you can offer him access to an appropriate alternative, then house soiling should not be an ongoing issue once he has matured. New house soiling in an adult dog is always suspicious for a medical issue (Landsberg 2018).

9. Unpredictable or increased reactivity or aggression, including noise sensitivity.

It's common for a pet parent to make their first call to a trainer because their dog did something scary or upsetting. Sometimes the issue has been going on for a long time, and it's just now that it's reaching an intolerable point. Maybe it’s just now that the pet parent has the means to involve a professional. Whether it's new behaviour or old habits, reactivity, aggression, and noise sensitivity should always be assessed as veterinary problems first. Pain is a well-known risk factor for the development of reactivity, aggression, and noise sensitivity (Wiseman-Orr et al. 2004; Mills et al. 2020).

10. Blowing off recall. 

The first tip you'll get about teaching recall that you should always reward it generously. I agree! But what happens if your dog won't take her reward? Or maybe she will the first time, but she seems to get bored of them really quickly, and you keep having to find novel rewards to keep her interested. Stinky, sticky, meaty — it doesn't seem to matter what it is. Every time you take her out for a long line walk or an off-leash hike in nature, you have to bring something new, and you know that it probably won't be good enough next time. I'm not saying this has happened to anybody I know, or that their dog's name is Greta, but it could.

I hate to break it to you, but your dog probably feels sick or painful for some reason, and they’re associating that feeling with the food. If you've been driving places, you might want to consider the possibility of nausea or carsickness, even if this is the only sign you see. This is especially true for dogs who have had other health changes recently, like a new medication or an illness.

“Okay, I’m convinced, but I don’t know whom to call first.”

In general, it’s okay to reach out to the trainer if you recognize behaviour that is not compatible with your goals or that you need help to manage more effectively. If you suspect pain, you will need to arrange a consultation with your veterinarian, ideally before beginning any behaviour modification plan. Ideally, I would suggest you work with both a behaviour professional and a veterinarian to address your dog’s wellness as a whole. Any good trainer or behaviour consultant will refer you to your veterinary team or an appropriate specialist if they think your dog is showing signs of pain or illness.

When you do choose to include multiple professionals on your dog’s care team, it helps for them to be acquainted with one another and for each to have access to the other’s records. The last thing we would want is for members of your dog’s care team to give conflicting advice because each is not aware of what the other has said!

Remember, some pain can be temporary, and may be easily explained. Even still, it is usually treatable. If your dog shows frequent, new, or unusual patterns of behaviour that could indicate they are experiencing pain, reach out to your trusted veterinarian for advice.

Sources

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  • Non-academic website or blog post

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