Dog hidden chronic pain: the signs owners read as ageing

Quick answer

Dogs in long-term pain rarely cry. What they do instead is change: they take the stairs more slowly, sit down oddly, stop greeting you at the door, sleep in a different place, get grumpy about being touched in one spot, and pant at night for no obvious reason. Almost every one of those gets filed under "getting older".

Chronic pain is also not confined to old dogs. Hip and elbow dysplasia produce joint damage in the first year of life, disc disease shows up in middle age, and dental pain affects dogs of every age. The phrase that costs dogs the most comfort is "he's just slowing down", because it converts a treatable problem into an accepted one.

Most of the useful information comes from watching, not handling. Look before you touch.

• Behaviour change is the main language of chronic pain in dogs. Limping is the exception, not the rule.
• Stiffness that is worst after rest and eases with movement is the classic osteoarthritis pattern.
• Young dogs get arthritis. A puppy that seems lazy or reluctant on stairs needs examining, not excusing.
• Never give human painkillers. Ibuprofen and paracetamol cause ulceration, kidney failure and liver damage in dogs.
• Film your dog walking, rising and doing stairs before the appointment. Video changes what a vet can see.

Decide in 60 seconds

Why chronic pain looks like personality

Acute pain produces an obvious reaction: a yelp, a limp, a lifted foot. Chronic pain does not, because the body adapts. Nerves change their sensitivity, muscles compensate, gait reorganises, and the dog builds a new normal around the discomfort. That new normal is what you see, and it develops slowly enough that nobody notices the transition.

There is also a behavioural reason. Dogs are social animals that maintain their place in a group, and reduced expression of pain is a common pattern across species that live in groups. The consequence is that a dog will often keep doing something it enjoys, such as chasing a ball, while quietly avoiding things it does not have to do, such as climbing onto the bed.

That asymmetry is diagnostically useful. Ask what your dog has stopped doing rather than what it still does. Dogs give up the optional activities first.

The signs, grouped by where they show

Movement.

Hesitating at the bottom of stairs or taking them one at a time. Taking the sofa in two stages instead of one jump. Refusing the car when it used to leap in. A shortened stride, or a hind end that swings both legs together at a canter. Sitting with one leg out to the side rather than tucked. Lying down in stages, or dropping the last part of the way. Struggling on laminate and tile while moving normally on carpet. Lagging on the second half of walks. Turning in a wide arc rather than pivoting.

Posture and shape.

An arched or roached back. A head carried lower than it used to be. Front legs planted wider. Muscle wasting over the hind quarters or over one shoulder, which is easiest to feel by running both hands down the dog symmetrically with your eyes shut.

Sleep and rest.

Changing bed, abandoning a favourite raised spot, repositioning repeatedly through the night, getting up and lying down again, panting at rest in a cool room, or seeking cold hard floors.

Interaction.

No longer coming to greet you. Moving away when approached. Flinching or turning the head when touched in a particular area. New irritability with other dogs or with children. Reduced play, or play that stops sooner than it used to.

Grooming and coat.

Persistent licking over a joint, saliva staining on the front of a wrist or hock, or a change in coat direction and texture over one area.

Eating.

Chewing on one side, dropping food, taking longer over meals, approaching the bowl and walking away, or preferring soft food. Dental pain is common, painful, and easy to miss because dogs keep eating through it.

Weight is the cheapest pain treatment there is. Record it monthly and keep the trend visible.

What differs by life stage

Puppies and juveniles, up to about a year.

Hip and elbow dysplasia begin here, and juvenile dogs with dysplasia are often described as calm, lazy or well-behaved rather than as painful. Other causes at this age include osteochondritis dissecans in the shoulder, elbow or hock, panosteitis in fast-growing large breeds, growth plate injuries after a fall, and congenital patellar luxation in small breeds. A young dog that tires quickly, sits down on walks, or bunny hops at speed needs orthopaedic assessment, not more exercise.

Adults, roughly one to seven.

Cranial cruciate ligament disease is the commonest cause of hind limb lameness in this group, and it frequently starts as intermittent stiffness rather than a sudden non-weight-bearing lameness. Disc disease appears in chondrodystrophic breeds such as dachshunds, French bulldogs and beagles, and back pain in these dogs often shows as reluctance to jump and a tense abdomen rather than as an obvious neurological sign. Dental disease is well established by this age in many dogs. Immune-mediated joint disease produces shifting stiffness with fever and general malaise. Undiagnosed injuries from a fall or a game months earlier become chronic.

Seniors, from around seven, earlier in giant breeds.

Osteoarthritis affects many joints at once, so the picture is generalised stiffness rather than one bad leg. Spinal changes narrow the space around nerve roots and produce a dog that struggles to rise and drags a hind foot. Dental disease is nearly universal without care. Cancer becomes a real consideration, and bone pain from a tumour in a large breed can present as a limp that seems out of proportion to any trauma.

The important non-painful mimic.

Degenerative myelopathy produces progressive hind limb weakness, scuffed nails and knuckling in older dogs, and it is not painful. Distinguishing it from painful spinal disease changes the plan entirely, and it is one of the reasons a proper neurological examination matters.

Breed patterns worth knowing

Chondrodystrophic breeds with long backs and short legs are prone to disc extrusion, which can be a sudden emergency but often begins with weeks of subtle reluctance to jump.

Giant and large breeds carry more elbow disease, more cruciate disease, and a higher risk of bone tumours. Their osteoarthritis also appears earlier in life.

Toy breeds have patellar luxation and severe dental disease, and their small mouths crowd teeth in a way that accelerates periodontal problems.

Flat-faced breeds may have spinal malformations, and their limited exercise tolerance from breathing makes it hard to tell airway limitation from orthopaedic limitation. Both can be present.

Working line dogs of any breed often continue working through pain, so absence of complaint means very little.

Ruling out what is not pain

Several conditions produce reduced activity without pain, and they need different treatment.

Hypothyroidism causes lethargy, weight gain and coat change. Heart disease causes exercise intolerance, coughing and sometimes fainting. Anaemia causes weakness and pale gums. Respiratory disease limits exercise before it limits movement. Canine cognitive dysfunction produces night-time restlessness, disorientation, altered interaction and changed sleep patterns that overlap heavily with pain. Vestibular disease causes a head tilt and unsteadiness that owners often read as weakness.

This is why a full physical examination and, in most cases, blood tests come before a diagnosis of arthritis. Two things can also be true at once, and older dogs frequently have both pain and something else.

Coat direction and texture change over a spot a dog licks. Look for asymmetry as much as for obvious damage.

The home routine that catches it early

Film the same four things every few months and keep the clips: walking away from and towards the camera on a non-slip surface, rising from lying down, going up and down a few stairs, and getting into the car. Comparison across months shows changes that day-to-day observation cannot.

Weigh monthly and record it. Excess weight increases the load on every joint and worsens every orthopaedic condition, and weight control produces measurable improvement in comfort on its own.

Feel the dog symmetrically once a month with your eyes closed, running both hands down the neck, back and limbs together. Asymmetry in muscle bulk is far easier to feel than to see.

Keep the nails short. Nails that touch the ground when the dog stands change the angle of the toes and the loading of the whole limb.

Put down rugs or runners on slippery floors along the routes the dog uses. Slipping is both painful and frightening, and dogs avoid rooms where they slip.

Look in the mouth once a month. Bad breath, red gum margins, tartar and a dog that turns its head away are all reasons for a dental assessment.

What never to do

Do not give paracetamol, ibuprofen, aspirin or any human anti-inflammatory. They cause gastrointestinal ulceration, kidney injury and liver damage in dogs, and they complicate the treatment your vet can then give.

Do not use medication prescribed for another dog or left over from a previous course. Dose, drug choice and monitoring depend on the individual, and combining two anti-inflammatories is dangerous.

Do not push, press or manipulate a painful area to demonstrate it to someone. You will get bitten and you will make the dog defensive about examination.

Do not stop all exercise. Controlled, regular, low-impact movement maintains muscle and joint health; it is the long unpredictable weekend walk after five sedentary days that causes problems.

Do not rely on supplements alone. Joint supplements may have a place alongside treatment, but they do not replace analgesia in a dog that is in pain now.

Do not accept "he's old" as the endpoint of a conversation. Ask what specifically was examined and what the plan is.

When to get help

Go immediately for a dog that cannot stand, that cries out when its neck or back is moved, that has suddenly lost use of the hind legs, or that is panting hard at rest with a tense abdomen.

Book promptly for hind limb scuffing or knuckling, for a limp that has lasted more than a few days, for a dog that has stopped using stairs or furniture, for new irritability about being touched, and for anything that has changed noticeably in the last few weeks.

Book a routine appointment for stiffness after rest, for reduced greeting or play, for changed sleeping habits, for reluctance to jump, and for any dog over about seven that has not had a full examination in the last year. Giant breeds should be assessed earlier.

Bring the videos, the five-item score, the monthly weights, the dog's full diet including treats and supplements, all current medication, a history of any previous injuries or surgery, and a clear description of when the signs are worst: after rest, after exercise, in the cold, or at night. That timing is one of the most informative things you can supply.

A well-managed dog with arthritis is not a dog that has stopped moving. It is one that moves comfortably every day.