Is my pet or animal in pain?
Each animal experiences and demonstrates pain, discomfort and suffering in a unique way. Pain is a complex and multidimensional experience with sensory, motor, emotional, and physiologic characteristics. All animals possess the neuroanatomic components necessary for transmission and perception of pain; thus, it must be assumed that animals do experience pain even if they cannot communicate it in the same way that humans do.
The behavior displayed by an animal depends on many factors, particularly its species, breed, age, sex, personality, environment, and most importantly, the severity and duration of its problem causing the pain. Evolution has made it difficult for many animals to outwardly display pain in the presence of humans and other animals. As such, it is often difficult to quantify pain in our patients. While no one or two behaviors in and of themselves are diagnostic for pain, interactive and noninteractive (unprovoked) behavior assessment may be useful for "scoring" pain in veterinary patients.
Most identifiable forms of pain in animals focus on studying acute or sudden, severe pain in our pets. The signs of acute pain in animals can be very different from signs of chronic (long term, long standing) pain but both types of pain encompass various behavioral and physiologic (heart rate, respiratory rate, blood pressure) characteristics. Most acute pain in animals is characterized by obvious anxiety or agitation, and increases in heart rate, respiratory rate (panting) and blood pressure, with often very different respiratory characteristics (rapid, shallow breathing) exhibited between species. However, these physiologic changes rarely accompany chronic pain, which owners, handlers and caretakers are more likely to question in their pets. As such, the focus of most chronic pain diagnosis in animals becomes behavioral responses and life style changes, which may be subtle to detect and to comprehend at times. Behavioral responses to pain vary greatly between species and these differences may be linked to an animal's innate survival mechanisms.
NOTE: Many of the signs or symptoms given below may be seen in normal animals. Just as pain may cause any of these signs, many of these symptoms are likewise exhibited by animals which are happy, healthy and NOT in pain. Thus, all or any of the following possible indications of pain must be taken in context of what is normal for the individual, the herd, its environment and its routine lifestyle.
Dogs and Cats
Possible behavioral signs of pain in dogs and cats include but are not limited to the following:
- Abnormal postures:
- Tenseness
- hunched up
- praying mantis position
- sitting or lying abnormally
- stiffened gait or posture
- head hanging down
- lying quietly for long periods of time
- low or weak tail carriage or wagging
- altered facial expressions such as grimacing
- Abnormal gait or movements:
- stiff gait,difficulty in moving, rising, sitting
- partial or no weight bearing on one limb (obvious lameness)
- thrashing
- restlessness
- circling
- trembling
- shaking
- slow rising
- ear position different than usual
- changing positions frequently
- remaining still or in one position constantly
- teeth chattering or grinding
- flinching
- guarding of body parts
- Vocalizations:
- unable to vocalize as usual
- screaming
- whining
- whimpering
- moaning
- crying
- growling
- hissing,
- barking (intermittent, constant, or when touched)
- Miscellaneous:
- ears held close to head
- ears not moved regularly
- constant attention, licking, rubbing, or focusing on an area
- panting
- agitation
- depressed or poor response to caregivers
- apathy
- changed sleep cycles or unable to sleep or dream naturally
- lack of grooming
- dull
- submissiveness
- stuporousness
- urinates or defecates without attempt to move
- other changes in housebreaking
- aggression
- timidness
- fearfulness
- attempts to hide, retreat, or escape frequently
- non interactive
- conversely remaining very attached or close to caregivers
- defensive attitude
- widened pupils
- squinting or constant tearing of eyes
- Appetite:
- decreased, picky or absent
- off scheduled meal
- fumbling with food or water
- exaggerated head movements during eating or chewing
Horses
Possible behavioral signs of pain in horses may include but are not limited to the following
- Abnormal postures:
- Restlessness
- Agitation
- rigid stance
- head pressing
- feet held abnormally under the abdomen
- limbs held forward one another or in abnormal positions (weight rocked back on heel or forward on toe)
- fixed board like stance with immobility,
- splinting;
- lowered head or neck
- inability to move head and neck
- fixed position of head, neck and limbs
- inability or unwillingness to move tail
- tail clamped to body
- ears held in abnormal positions
- weight shifting from one limb to another
- getting up and down frequently
- frequent changes in recumbency when recumbent
- ear position immobile, back or flattened
- dorsal recumbency (foals)
- Abnormal gaits or movements:
- Restlessness
- reluctance to be handled
- flared nostrils
- muscle tremors
- head bobs on movement during trot
- walking in circles
- sweating at rest or sweating excessively during exercise
- rolling, thrashing, kicking or biting at body
- constant head, lip, eyelid, tongue or swallowing movements
- frequent excitement or aggression
- head shaking
- stomping
- tail swishing
- playing in the water vs. drinking
- lip curling
- head tilting
- attempts to urinate without production
- uncontrolled anxiety
- restlessness
- escape attempts
- straining to urinate or defecate
- Vocalizations:
- whinnying frequently
- "calling" to other horses
- Snorting
- Forced expiratory noises
- Miscellaneous:
- profuse sweating (often foamy) in all or one area of body
- dilated pupils
- glassy eyes
- wide eyed look
- anxious appearance
- groaning or moaning
- forced expirations
- increased sleeping time
- non response to caretakers or normal stimuli
- eyes appear dull, listless, and distant
- Appetite:
- feeding with unexplained interruption
- playing in food
- bruxism
- food held in mouth uneaten
- decreased eating or drinking
- off schedule eating or drinking
- non finished meals
Swine, Ruminants, Camelids, food animals
Possible behavioral signs of pain in horses may include but are not limited to the following
- Abnormal postures or movements:
- sitting positions
- rising from a sitting position
- abdominal splinting
- reluctance to move
- flank watching or kicking
- stomping
- repetitive lying down and standing
- constant recumbency
- separation from rest of herd
- stilted gait
- arching of the back
- tucked up position
- reduced grooming efforts
- constant tail switching/wagging
- no tail switching (clamping of tail)
- agitation
- unreasonable calmness and tolerance to touch
- dog sitting
- repetitive rolling
- assuming lateral recumbency for prolonged periods of time
- Vocalizations:
- Grunting
- forced expiratory effort
- bellowing
- bleating
- crying
- high pitched noises
- squealing
- any vocalizations elicited by pressure in one or more areas
- Miscellaneous:
- Aggression in normally passive species
- head pressing
- teeth grinding
- ear droop
- eyes dull listless and distant
- reduced grooming efforts
- lacrimation
- blepharospasm
- straining to urinate or defecate
- grazing on knees
- poor body condition
- weight loss
- lip curling
- reduced rumination/cudding
- resentment of handling
- flank watching
- shivering
- piloerection
- increased periocular tension
- jaw clenching
- apathy
- Appetite:
- decreased in almost all ruminants and swine
- abnormal grazing
- lip smacking and curling
- rumination and chewing decreases
- playing with food, water bowls, or drinker spouts without actual eating or swallowing
Small rodents, Lab animals, Ferrets and Rabbits
Possible behavioral signs of pain in small rodents, lab animals, ferrets and rabbits may include but are not limited to the following. (Note: Bear in mind that pain is much more difficult to detect in these animals than in cats and dogs. This is due to multiple reasons. Foremost, the behaviors which are associated with pain in these species are very subtle. Additionally, we are less familiar with normal behaviors in these species. Many of these species are nocturnal and will be relatively inactive during the day. In addition, they will often change their behavior in the presence of an observer).
- Abnormal postures or movements:
- attempts to escape or hide
- aggressive behavior if handled
- reduced spontaneous (eating, moving, grooming, rearing) activity
- complete immobility
- altered gait
- stretching
- back arching
- abdominal pushing or touching
- sudden short movements during sleep
- hunched up posture
- piloerection
- attempting to push abdomen or lower it to floor
- immobility
- stinting
- reluctance to curl when sleeping
- lameness
- ataxia
- head extension and elevation
- absences of normal behaviors
- Vocalizations:
- Squealing
- high pitched noises
- teeth grinding
- grunting
- Miscellaneous:
- excessive grooming or biting
- lack of normal grooming
- self mutilation
- soiling of the coat
- accumulation of secretions around the eyes or nose
- reduced body weight
- reduced production of urine and feces
- half closed, dull or unfocused vision
- strained facial expression, bulging eyes
- excessive respiratory rate or effort
- lethargy
- isolation
- Appetite:
- reduced appetite and water intake
- excessive water consumption
- excessive urination
Birds
Possible behavioral signs of pain in birds may include but are not limited to the following: (Note: Although some painful type behaviors may be common to all birds, in reality the pain behavior of a golden eagle is not the same as that of a parrot. To assess pain in birds accurately requires that the observer be familiar with the normal behavior and pain associated behavior of the given species of bird as well as that of the individual bird.)
- Reluctance to perch
- Aggression in a normally passive pet
- Mouth breathing
- attempts to escape
- anxiety
- restlessness
- struggling or aggression with handling
- inappetance
- crouchlike stance, head pulled into body
- isolation
- foot lifting
- jumping
- decreased head movements
- increased prehension or swallowing type behavior
- vocalization
- wing flapping
- wing droop
- "mouth breathing"
- ruffled feathers
- lack of preening or excessive preening
- localized or generalized feather loss
- catatonia (immobility and non responsiveness)
- weight loss
- decreased activity
- decreased social interaction
- decreased appetite or water intake
- decreased feces or urine production
- limping
- immobility
- reduced egg production
- decreased dust bathing
- changes in preening
Reptiles and Amphibians
Possible behavioral signs of pain in reptiles and amphibian may include but are not limited to the following:
- anorexia
- hunched posture
- stillness or immobility
- aggression in normally passive animals
- stinting on palpation or touch
- blepharospasm
- flight responses or startling easily
- aeorphagia
- dysphagia
- elevated head and/or extended neck position
- color changes
- constant dull color
- avoidance and withdrawal reactions
- biting at affected areas
- lethargy
- isolation
- lameness
- ataxia
- absence of normal behaviors
- body less coiled at site of pain
- foot or digit flicking
- rapid respirations
- repetitive pulling head into shell and then extending the neck out and up
Fish
Possible behavioral signs of pain in fish may include but are not limited to the following:
Note: There is currently an active debate in the scientific community as to whether fish can perceive pain in the same context as "higher" animals. We are happy to refer you to several articles so you may be aware of the current information on both sides of the question. Whether you agree or disagree that fish can perceive pain, we feel that fish should be treated in a humane manner just as any other animal. Please email us at animalpainhelpdesk@cornell.edu to be of more assistance with this important question.
- Reflexive responses such as muscular and behavioral avoidance
- rapid or labored respirations (gill or mouth movements)
- color changes
- posture and orientation changes
- water column utilization
- decreased activity, lessened swimming
- agitated swimming
- activity at bottom of tank consistently
- secretion accumulation around eyes, mouth, gills
- skin changes and growths
- strong muscular and behavioral avoidance
- strong reflexive responses