Advances in veterinary medicine, nutrition and overall awareness of all aspects of pet care mean dogs are now living longer. As a result, the ageing dog population continues to increase, with between 30 and 40 percent of pet dogs reaching seven years or older (AVMA, 2017; AniCura, 2024). While this is a positive development in many ways, longevity brings the challenge of managing age-related musculoskeletal deterioration and the chronic pain this can cause. With dogs now spending a significantly longer portion of their lives as seniors, ensuring quality of life during this phase is an important area of focus. This article explores the gap in early pain recognition for senior dogs, in particular the behavioural manifestations of untreated musculoskeletal pain, and how veterinary and behaviour professionals can collaborate for better welfare outcomes.
How vets can uncover the early clues of musculoskeletal pain
Vets can gently prompt owners to reflect on their dog’s daily life and bring to light behaviours that may otherwise go unreported
Industry guidelines suggest senior dogs should be seen every six months for a health evaluation, but nearly half of dog owners believe an annual check-up is sufficient for a healthy senior dog (Wallis et al., 2024). This gap reduces the opportunity for early diagnosis and intervention and places more importance on information gathered during vaccination visits, which 80 percent of dog owners attend (PDSA, 2024). Utilising resources such as the BSAVA Ageing Canine Toolkit alongside asking specific questions can start to uncover early signs of pain-related behaviour change that owners may not have thought of as clinically relevant. Examples of such questions are:
- “Has your dog started to slow down on walks?”
- “Has your dog become more noise sensitive?”
- “Does your dog tend to groan or sigh when they lie down in the evening?”
By framing questions in this way, vets can gently prompt owners to reflect on their dog’s daily life and bring to light behaviours that may otherwise go unreported.
When quiet struggles turn into loud problems
If subtle signs are missed or dismissed, pain can progress unchecked. Over time, this begins to interfere more noticeably with daily life, and behaviour changes become harder for owners to ignore. At this point, veterinary help is often sought not because of suspected pain, but because the dog’s behaviour has changed in ways that directly impact the owner’s life, such as:
- Refusal to go for walks
- Restlessness or destructiveness at night
- Withdrawal from social interactions
A significant portion of pain-related behaviour change manifests as fear and anxiety
A significant portion of pain-related behaviour change manifests as fear and anxiety (Mathews, 2000). The bidirectional relationship between pain and anxiety is well documented: pain can trigger anxiety, while anxiety amplifies the perception of pain. In such cases, pain is the primary issue, while anxiety and fear emerge as secondary behavioural issues. The presenting complaint from the owner to the vet, however, is not “I think my dog is in pain” but “my dog keeps clawing at the carpet at night” or “my dog gets really anxious in the car”, with little observation of the wider context of behavioural changes (Belshaw, 2020a, 2020b). The owner’s priority to address the issue of anxiety and the need to conduct a health check, alongside the time constraints of a standard veterinary consultation, mean it’s not always possible to assess in sufficient detail other changes in the dog’s behaviour. In such situations, referral to a clinical animal behaviourist can complement the veterinary assessment by providing additional insight into the dog’s behaviour.
Case studies
The following case studies illustrate how pain can masquerade as behavioural change, and how collaborative care can bring a positive resolution.
1. An eight-year-old Labrador showing destructive behaviour overnight
Tilly’s owners sought veterinary advice when she began showing destructive behaviour overnight by digging and pulling up the carpet, following a bout of colitis. Trazodone was prescribed by her vet, which showed some benefit but did not fully resolve the issue. Tilly was referred to a clinical animal behaviourist, and during the consultation several behavioural indicators of discomfort were identified. For example, Tilly’s social interaction with dogs had changed, and she was now avoidant of a boisterous Dalmatian she used to walk and play with. In the evenings, she couldn’t settle for long – getting up and changing position or location frequently – and was hesitant to get on her favourite chair, walking around it several times before jumping up. This information was shared with the referring vet, and although finances prevented diagnostic imaging, a more thorough veterinary examination identified suspected arthritis in her right elbow and sacroiliac joint. The referring vet prescribed grapiprant (Galliprant) and reduced the trazodone, and a tailored behaviour modification plan was implemented. With this combined approach, the destructive behaviour stopped entirely, and Tilly’s quality of life markedly improved.
2. A 10-year-old American Bulldog mix showing anxiety in the car
Bramble started to show escalating anxiety in several different contexts: she would become distressed in the car and pant heavily even on very short journeys, and was avoidant of going down steps and across door thresholds; consequently, she had to be taken outside on a lead so she could toilet. A behaviour consultation identified that over the past two years, she had stopped jumping up on the sofa, preferring to stay in her own bed on the floor. She had started to frantically claw at the bottom of her bed when settling and would groan when she lay down. She had slowed down on walks, and once home, would diligently lick down both front limbs and around the carpal joints. Upon feeding this information back to the vet, X-rays and ultrasound were arranged, which revealed spondylosis, lumbosacral disease, iliopsoas tendinopathy and multiple areas of arthritis. Bramble was referred for regenerative medicine alongside implementing a behaviour modification plan. The anxious behaviour fully resolved along with the other issues once her overall comfort and mobility improved.
These cases give examples of owners initially seeking help for behaviour problems, yet with the root cause being undiagnosed pain. Through behavioural assessment and veterinary collaboration, both Tilly and Bramble received targeted treatment, leading not only to the resolution of their behavioural concerns but also to a marked improvement in quality of life.
A collaborative path to better welfare
This collaborative approach reduces the risk of pain-related changes being misinterpreted as inevitable signs of ageing or purely behavioural issues and provides veterinarians with a richer context for diagnosis
Clinical animal behaviourists can complement veterinary care by identifying subtle behavioural indicators of potential pain and discomfort. Unlike shorter veterinary consultations, behavioural assessments last a couple of hours in the home environment where the dog is most relaxed, allowing detailed history taking and observation. These insights can then be shared with the referring veterinarian, who can determine whether further investigation or treatment is warranted. This collaborative approach reduces the risk of pain-related changes being misinterpreted as inevitable signs of ageing or purely behavioural issues and provides veterinarians with a richer context for diagnosis. By combining medical and behavioural expertise, both professionals can deliver more accurate interventions and safeguard the welfare and quality of life of senior dogs.
