Becoming "AWARE": Recognizing Pain in Pets

Once I had a house call to a family whose dog could no longer get up, and hadn't been up for several days.  The family told me that they didn't think he was in pain because he still wagged his tail and wasn't yelping or whining in pain.  When I went over there, I found a sweet old labrador retriever, who wagged, but was in terribly rough shape  With towels around him, the strong smell of urine made it difficult to breathe, and it was clear he had not been moved from this spot for several days.  When I lifted his skinny rear legs (skinny because he had bad arthritis for a long time and the muscles had atrophied from not using them much) that was moist from urine, he winced, and he had such bad sores on his leg that there was bone exposure over his hip.  This immediately brought tears to my eyes.  This dog was definitely in pain- and had been for a long time.  

Unfortunately this experience is not unique, but thankfully most cases are not this severe.  It is nearly on a daily basis, however, that I find great pets owners missing obvious signs of pain.  Furthermore, our pets often HIDE signs of pain, and often that tail continues to wag because they love us so incredibly much.  The question remains: Why is it so difficult to recognize in our beloved pets?  

I believe the answer to this question is multifactorial-- Although most of us spend more time with our pets than our bestest of friends, the truth is that it can be difficult to recognize pain, after all they don't speak English, and come to terms with the fact that our pets may be in pain.  

It is so important to become pain AWARE.  This is an acronym that I came up with to help decode signs that may indicate pain:

• A: Any behavior change or daily pattern.  Changes in appetite, anxiety, aggression, sleeping patterns, responses to other pets/ people, are all things to take notice of and not ignore.  
• W: Weight shifting, Signs of limping or lameness. These are all signs of pain, even though you may not hear wincing or yelping- if your pet were not in pain, they would not be limping.  
• A: Activity level changes, including reluctance to move, or sleeping more (especially seen in cats).
• R: Restlessness.  Difficulty sleeping, difficulty getting in a comfortable position, etc. 
• E: Expression & Appearance.  Watch for signs like panting, trembling, shaking, facial expressions (dilated or constricted pupils), excessive licking, or vocalization.