Young Dogs Can Hurt Too
Debunking the Age Myth
This post is the first in a series covering common myths surrounding pain in dogs and cats.
Myth: My dog can’t be in pain because they are too young
This is the myth we encounter most frequently in our practice and it is also one of the most concerning and problematic. You can probably guess why. If we assume pain only affects older dogs, we may dismiss behavioral changes as just being in the dog’s head merely because they are young.
The reality
Osteoarthritis (OA), a big contributor to behavioral issues in dogs, is a young dog disease.1 That means that chronic pain secondary to osteoarthritis is also a young dog disease and all dogs of all ages could be affected by chronic pain. Unfortunately, OA usually isn’t diagnosed until its later stages when it’s advanced and the signs of pain are quite obvious. An unfortunate reality, because early intervention has the best chance of reducing the progression of this painful disease.
What osteoarthritis is and what it does
Osteoarthritis (OA) is a term to describe chronic, low-grade inflammation and degeneration (wear-and-tear) of the joints that isn’t caused by an infection or immune-mediated disease. In dogs, OA is usually caused by developmental orthopedic disease—a condition that affects growth and development. These diseases include hip dysplasia, elbow dysplasia, osteochondrosis/osteochondritis dissecans (OCD), angular limb deformities, and patellar luxation, among others. When joints aren’t formed properly, as in these diseases, they experience an abnormal amount of strain. This abnormal strain wears down the joint tissues which causes chronic inflammation and pain. And that doesn’t take long in many cases.
My dog, Ian, is a prime example of how quickly OA can develop. Ian was a German Shepherd that my parents got for me when I was 16 as a consolation prize for moving in the middle of high school. And Ian was an awesome dog. He was sweet, smart but not too smart2, and he offered me friendship while I was in the midst of some serious teenage angst. But Ian had a major problem—he had hip dysplasia. While X-rays of normal dog’s hips look like this, by the time Ian was 11 months old his looked something like this:
Pretty terrible. Ian’s local vet referred us to an orthopedic specialist to see what could be done. As far as I can recall, the specialist told my mom that Ian’s hip joints had degenerated so much that they couldn’t do a total hip replacement. Essentially there was no hip socket for the ball joint of the femur (thigh bone) to sit in. Since his activity level was normal, we were told there was nothing else to be done but that we should expect his condition would worsen over time. I don’t think any pain management was prescribed and physical therapy certainly wasn’t. This was the mid-90s afterall—addressing these issues has come a long way since.
We brought Ian home and went about life as normal, watching out for signs that he was having difficulty moving around, and knowing he might eventually need a femoral head ostectomy (FHO) surgery.
Many young dogs living with chronic pain appear normal
Ian is also a good example of how dogs are so remarkably stoic and can live with chronic pain without showing obvious outward signs. He was active, went on walks, ran after squirrels, and, on one particularly memorable winter’s day, knocked me tail over teakettle off my sled. We thought he was living his best life despite his hip dysplasia and, on the surface, he was.
Eventually he started having issues moving around, so when Ian was 6 years old and right before I started vet school, we had a surgeon perform an FHO on his worst hip. I know this surgery did wonders to relieve his pain because after he recovered, for the first time we could remember, Ian started wagging his tail. We had assumed Ian’s prior lack of tail wagging was just him—that he was a stoic dog that didn’t express doggy joy in that way. We may have even assumed that it was a breed thing: “maybe German Shepherds just aren’t naturally effusive dogs?” Turns out, we were wrong. Ian was naturally effusive and wagged his tail all the time, at least he was once his pain was under control.
That fact that we didn’t notice Ian’s pain for years sits heavy in my heart, even now, decades after his death. I see clients go through similar experiences, both when I point out signs of their dog’s pain in the exam room and when we see how much their dog’s behavior changes once they’re on a good pain management plan. It’s hard not to beat yourself up for missing signs of pain in a beloved friend, or, especially if they’re irritable and aggressive because of their pain, mistaking these signs for some sort of personality flaw or anxiety disorder. If you, like me, have made these mistakes, please give yourself the grace to acknowledge you were doing the best you could with the tools you had available at the time. Sometimes we just don’t have the right tools, but we can do better once we get them.
How to catch pain as early as possible
Armed with the information that all dogs of all ages can be affected by chronic pain, keep an eye out for potential subtle signs. They include:
sloppy sits
dragging feet
wear on the tops of the nails
stopping frequently on walks
reluctance to get up from rest
shifting limb to limb while moving into a down or sit position
shifting weight off of a particular limb or side of the body
asymmetry in the muscles of the limbs
waking in the middle of the night
You can find more signs to look out for in this quiz from Canine Arthritis Resources and Education.
There are many behavior changes associated with pain as well, including increased irritability and aggression when approached and during petting, which you can read about here.
Next steps
If you identify any of these changes in your own dog or one you know, get a veterinarian involved. Gather the information I mentioned at the end of the last issue, and bring it with you to your dog’s vet appointment.
Bear in mind, however, that identifying chronic pain in dogs from a physical exam alone is tricky, and some veterinarians may dismiss pain if your dog is young too (one reason why OA usually isn’t diagnosed until its later stages). If you feel like your concerns are being dismissed, get a second opinion. We frequently collaborate with veterinarians with additional training in rehabilitation and find they are excellent at identifying subtle signs of pain that others (me included) often miss.
Next week I’ll cover another myth we encounter about pain in animals, which I alluded to briefly above. Stay tuned!
All my best, Kelly
If have any questions or comments about this issue, upgrade your subscription to post them in the comments. You also have the opportunity to participate in our weekly Q & A—I’ll start the thread today and will answer those questions in a video post next week.
Insightful Animals is operated by me, Kelly C. Ballantyne, DVM, DACVB. I’m a vet behaviorist, nature fanatic, bird artist, wife, and mom to two hilarious Ragdoll cats, Pipit and Towhee. In my day-to-day, I consult directly with pet parents and veterinarians on a range of behavior problems in dogs and cats.
The story is a bit different in cats, which I’ll cover soon.
If you’ve ever had a dog that was too smart, you know what I mean.