How to know if your dog is in pain — a vet’s checklist

The short answer

Dogs in pain change their behaviour before they change their faces. Watch posture, sleep architecture, mobility, eating, and engagement. If two of the twelve below have changed for more than three days, your dog is probably in pain. The kindest test of the hypothesis is a trial of analgesia from your vet.

Twelve signs that matter

1. Restlessness. Lying down, getting up, lying down again. Cannot find a comfortable position.
2. Reluctance to move. Refuses stairs they used to manage. Hesitates at thresholds.
3. Stiffness on rising. Particularly after sleep. Improves with movement, then worsens later.
4. Changes in posture. Hunched back. Tucked abdomen. Head held lower than usual. Standing in a praying position.
5. Reduced appetite. Pain suppresses appetite. Especially relevant if the dog refuses favourites.
6. Disrupted sleep. Waking in the night. Repositioning frequently. Whining at rest.
7. Reduced grooming. Coat looks unkempt; matted in places. The dog who used to clean themselves is no longer doing it.
8. Hiding or seeking isolation. Particularly important in cats; relevant in dogs too.
9. Aggression where there was none. A dog who growls when picked up may be hurting where you are picking them up.
10. Excessive licking of one area. Repetitive focus on a paw, joint, or abdomen — often pointing at the source.
11. Panting at rest in a cool room. A pain marker more than a temperature one in dogs.
12. Vocalising at routine activities. A small yelp on jumping into the car. A grunt on lying down. Subtle, repeated.

Three signs that look meaningful but lie

• Tail wagging. Affection persists past most other functions. A dog wagging at the family is not necessarily a dog without pain.
• Eating a favourite treat. The motivational pull of high-value food often overrides moderate pain. Eating a treat does not rule out clinically significant pain elsewhere.
• Looking “okay on a good day.” Days vary. The pain assessment that matters is the modal day across a fortnight, not the strong Saturday.

The trial of analgesia — the most useful test

When the question is unclear, the cleanest answer is a trial of veterinary analgesia. Your vet prescribes a course (commonly an NSAID for 7-14 days, sometimes with gabapentin as an adjunct). You watch for change.

• If the dog visibly improves — moves more freely, sleeps better, eats more, engages more — pain was present and the analgesia is helping.
• If the dog does not improve — either the analgesia is inadequate (escalate or add adjuncts) or the working diagnosis is wrong.

This is not a guess; it is a structured clinical experiment. Many cases that present with vague behavioural change are resolved this way within a fortnight.

Pain-scoring scales owners can use

• Helsinki Chronic Pain Index (HCPI). 11-item owner questionnaire. Validated in dogs. Useful for tracking week-on-week change.
• Liverpool Osteoarthritis in Dogs (LOAD). 13-item. Specific to OA but transfers reasonably to other chronic pain.
• Canine Brief Pain Inventory (CBPI). Owner-reported. Brief; useful for clinic visits.

Your vet can supply printed versions or digital copies. Score weekly, same day, in pen. The trend matters.

What pain in a dog actually looks like, in a paragraph

A dog in chronic pain is, most often, a slightly less alive version of the dog you remember. Less greeting at the door. Less interest in the walk. Less play. More sleeping in unfamiliar spots. More minor irritability. Less of the dog who decided things; more of the dog who tolerates them.

That sentence — “a slightly less alive version” — is what owners describe most often when they describe their pre-diagnosis dog in retrospect. If you are reading this and recognising your own dog, the next step is the trial of analgesia. The question often resolves quickly.

Editorial reference, not veterinary advice. — Dr. NRS, last reviewed 27 April 2026.