Assessing Pain in Dogs

As a veterinarian, it’s your job to give voice to the voiceless and remove any suffering your patients may be experiencing.

When it comes to assessing pain, a number of factors should be considered, including psychological and behavioral signs, response to palpation, and body tension.

You can assess the pain level in your patients more accurately by remembering the sometimes subtle signs of pain.

The following pain scoring system is provided by the International Veterinary Academy of Pain Management.

[Looking for how to assess pain in cats? Click here.]

Pain Score: 0

• Psychological and Behavioral Signs: The dog is comfortable when resting, happy or content, not bothering the wound or surgery site, and seems interested in or curious about its surroundings.
• Response to Palpation: Nontender to palpation of the wound, surgery site, or anywhere else.
• Body Tension: Minimal

Pain Score: 1

• Psychological and Behavioral Signs: The dog is content to slightly unsettled or restless and seems distracted easily by its surroundings.
• Response to Palpation: The dog reacts to palpation of the wound, surgery site, or other body part by looking around, flinching, or whimpering.
• Body Tension: Mild

Pain Score: 2

• Psychological and Behavioral Signs: The dog looks uncomfortable when resting, may whimper or cry, and may lick or rub the wound or surgery site when unattended. The dog’s ears are droopy, and the dog’s face displays a worried expression (eg, arched eyebrows, darting eyes). The dog is also reluctant to respond when beckoned and is not eager to interact with people or its surroundings but will look around to see what is going on.
• Response to Palpation: The dog flinches, whimpers, cries, or pulls away when touched.
• Body Tension: Mild to moderate
• Next Steps: Reassess analgesic plan

Pain Score: 3

• Psychological and Behavioral Signs: The dog is unsettled and cries, groans, bites, or chews the wound or surgery site when unattended. The dog guards or protects the wound or surgery site by altering its weight distribution, such as limping or shifting body position. The dog may be unwilling to move all or part of its body.
• Response to Palpation: The dog may show subtle responses to palpation, such as shifting eyes or increased respiratory rate, if it is too painful to move or is stoic, or the dog may have a more dramatic response, such as a sharp cry, growl, bite, or pulling away.
• Body Tension: Moderate
• Next steps: Reassess analgesic plan

Pain Score: 4

• Psychological and Behavioral Signs: The dog groans or screams continuously when unattended, may bite or chew at the wound, and is potentially unresponsive to its surroundings. It may be difficult to distract the dog from its pain.
• Response to Palpation: The dog cries at nonpainful palpation, which may mean it is experiencing allodynia or wind-up pain or may fear worsening pain. The dog may react aggressively to palpation.
• Body Tension: Moderate to severe; may remain rigid to avoid painful movement.
• Next Steps: Reassess analgesic plan