Do you ever wish that it wasn’t so hard to figure out if your dog is in pain? It’s a human response. We can still help our dogs.
A frame from Lewis’ spinal CT scan. (This frame does not show the problem area.)
If you spent a week with me, you would not see signs of most of the physical pain I have.
For instance, I have an upper GI problem that causes pain after I eat many meals. It can be very uncomfortable. But you would never know through observation, because there is no position I can take, no behavior I can perform to alleviate the pain.
I’ve had kidney stones. You would not have known about them, even if you observed me at the time. Perhaps if they had been worse, I might have doubled over, thrown up, or fainted. But, while very painful, they weren’t up to that intensity. Again, there was no position I could take to get more comfortable, no overt behavior for you to perceive. You might have noticed a decrease in my energy, but that can be from so many things, right?
There are more. And in contrast, there are also some conditions for which you could get a pretty good idea of what hurts.
But this post is not about my senior health problems. It’s about the assumption, one I long held without even knowing it, that if a dog has any kind of pain, it will somehow show. Not only show, but show in a way that indicates exactly what’s wrong.
Many ailments cause behavior changes we can perceive. Toe, feet and leg problems can cause a dog to limp. They may paw at their ear or shake their head if they have an ear problem. But countless other conditions can produce symptoms we interpret as something else or symptoms that go completely under our radar—just as some of mine would if I didn’t tell you about them.
Why are we aware that we can’t always see signs of pain in humans but easily forget that when it comes to dogs?
Sound Phobia and Its Fallout
Lewis underwent sudden onset sound phobia on January 1, 2025. I knew at the time that there is often a component of pain. (I didn’t know how often.) I had my vet at the time check him out. She palpated him and had another vet, an equine specialist, look him over as well and look at some videos I provided. They didn’t find anything. I didn’t know at the time that this was not sufficient to identify pain. Palpation, contrary to common practice and our intuition, is not an evidence-based practice for detecting many types of pain in animals. My vet recommended against X-rays because she felt they wouldn’t show anything.
I dropped the idea for a while. Because of some research I read, I concluded that Lewis’ sound phobia was probably genetic and not pain related. This was a pile of wrong assumptions, including that those two things are not mutually exclusive. But my assumptions weren’t based on cognitive dissonance—not yet. I simply couldn’t see any signs of pain, and I was trying to come up with a reasonable explanation for why he might be an exception.
A dog behavior consultant was the first to urge me to ask for a pain meds trial for Lewis. I pushed back with my theory that since he was young at onset, he probably had no pain. And the vet didn’t find anything. My friend, politely not buying it, asked if the vet had done a meds trial. Um, no. So I asked for one. I saw no improvement over six weeks and gave up again. (Future Eileen points out I had no idea how to look for improvement, since I hadn’t seen any problems in the first place.)
Fast forward to taking Train + Simple’s scent work class. The class teaches scent work with an emphasis on body language and behavior. Naturally, several people in the class asked permission to share observations on Lewis’s posture and movement with me. They pointed out concerning details, and recommended I return to the vet with that information in hand. I was reluctant. I felt we had put this to bed already. But I did so. This time I had some more compelling videos to share.
Diagnosis
I am not going to cover Lewis’ diagnosis in more detail, since it’s not the focus of this post. But a CT scan 18 months after his sound phobia diagnosis revealed lumbosacral problems. He is currently on medications that show measurable evidence of helping (hey, we finally found a metric!). But we are not through yet with med trials, or even complete diagnosis.
Cognitive Dissonance
My goal in this post is to explore the idea that our dogs can have pain we can’t see and to share my original strong resistance to that idea. Only once in my life have I experienced worse cognitive dissonance, but at least that time it didn’t involve an animal in my care.
It was a leap of trust in expertise and science to listen to my colleagues who said, “Get thee to a vet,” when I really wanted to believe Lewis was fine.
I pursued a diagnosis, much of the time uncomfortable with it.
Lewis’ frequent behavior after Clara died. Grief? Depression? Pain?
Learning about pain in dogs can involve an epiphany, but It’s not like the joyous one that I experienced about humane training. Of course, even that one stung at first. “I’ve hurt my dog in the name of training and I didn’t have to.” That’s an awful feeling, potentially generating guilt and shame—or cognitive dissonance. But there were things I could do! I learned good practices. I changed my behavior and my dog was visibly happier, right away! A lot of it is in our hands, usually with the help of a good trainer. And the dissonance can fade.
But the pain issue. I did not want to believe in it. Lewis acted fine. He still mostly does, to my eyes. When I got the results of Lewis’ CT scan, they included recommendations for when Lewis had “flare-ups.” I didn’t know how to see those.
There’s another human cognition issue here. While it’s true that Lewis does not limp, yelp, or do other abrupt behaviors that could signal pain, his behavior has changed, ever so slowly, over the past couple of years. He has lower energy. He runs less, plays less. I noticed, but attributed these things to other causes, e.g. “maturing” or his depressed response to Clara’s death (which was three months before the onset of his sound phobia). He did odd physical things that I had never known could be attributed to pain.
I habituated to his new normal. With my interest in cognitive biases, I’ll mention that psychologists refer to this lack of noticing slow change as creeping normality or, at the group, sociological level, the shifting baseline syndrome. But that’s just the “not noticing” part, not the “resisting” part.
Part of me still wishes I could go back to the days when I could say, and believe, “The vet checked him all over and he was cleared for pain. Whew!” I have stated such things in previous posts; I need to go add some “I was wrong” tags. Wanting not to see is an escape contingency, by the way. “Knowing this is aversive. I’d like to un-know it, please.”
And that can trigger another round of guilt. This is my dear dog we’re talking about. And I’d rather not know if he is in pain? That’s awful!
But that’s not right—I’m not wishing my dog to be in pain. I’m wishing for release from confusion. And I’m taking steps to get there.
Posture vs. Body Language
Remember when you first started to learn about dog body language? Some of that learning was painful. “OMG, when my dog flips on her back or does ‘kickstand leg,’ she’s not asking for a belly rub! It’s more like, ‘Don’t hurt me.’”
A lip lick from Zani; did it indicate stress or anticipation of something yummy?
But lots of it was fun, like learning to notice that your dog’s lower jaw drops when you invite her to play and learning about the wonderful variety we can see in tail wags.
As nuanced as dog body language is, and even knowing I’ll never perceive but a portion of it, it’s so much easier for me than learning about posture, stance, and movement in a dog. I am not strong in visual spatial skills. Engineering school was really fun, y’all! I did gain some rudimentary abilities to visualize. Which is good because now I am trying to learn to see things when my dog is in motion and compare them to a mental model.
After an embarrassing amount of practice, I am now able to tell if Lewis is doing a contralateral trot, which is something he avoided before being on medications.
Being Guided by Evidence
I first intended to list in this post the kinds of information that can help our vets assess the possibility of pain in our dogs and talk about what can constitute evidence for that. I realized I’m not qualified to do that, though. Instead, my message is about my resistance to believing Lewis was in pain or discomfort because I didn’t see what I would have considered to be obvious signs.
This may sound odd, but hear me out. How I “feel” about this situation doesn’t matter. What I want to believe doesn’t matter. What matters is helping Lewis feel as comfortable as he can, and that means following evidence-based practices. Not my gut, not my “druthers.” They can be wrong.
I don’t have to “believe.” I have to seek out and listen to experts and act on the evidence vets can verify for me. My behavior is what is important. And hopefully, usually, my feelings will catch up.
So here’s a shoutout to others who are in this uncomfortable mental state. It does feel better to know my dog feels better, even if I can’t see it consistently. And, through my vet, I hope to help him even more.
Copyright 2026 Eileen Anderson
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