Chronic pain is not old age: recognising it in dogs and cats

Normal ageing reduces stamina and slows recovery: an older animal tires earlier and takes longer to bounce back from effort. Chronic pain instead produces selective avoidance: specific actions disappear while others, apparently more demanding, remain. A dog with hip pain may still walk a long way on the flat and refuse three steps; an arthritic cat may sprint horizontally and never again climb onto the windowsill where it has slept for years.

The second distinguishing feature is timing. Musculoskeletal pain is typically worse after rest and improves with light movement over the first few minutes, then worsens again with prolonged effort. Anyone who watches only the walk, and not the two minutes after getting up from the bed, misses exactly the window in which the sign is most visible.

In dogs chronic pain shows first as a change of choices and only later as a change of movement. Frank lameness is a late sign and is often intermittent, which means it is frequently absent on the day of the consultation.

The confounders column is the useful part of the table. A sign counts as evidence only if the test conditions stay constant: same flight of stairs, same flooring, same time of day, same route. Changing one variable and concluding that the dog is worse is the most common error in home assessment.

A cat compensates for pain by reorganising the environment it lives in. It does not limp and does not complain: it takes alternative routes, lowers the height of its jumps, splits them into two stages and stops visiting high places. The most reliable sign is not how it moves but where it goes and where it no longer goes.

• Jumps split into stages: using the chair to reach the table it used to reach in one leap.
• Reduced maximum height: measure in centimetres the highest point reached spontaneously and repeat the measurement monthly.
• Eliminating outside the tray: high sides and hooded trays become an obstacle before they become a preference.
• Patchy grooming: dull or matted coat over the back and tail base, where flexion is needed, and overgrooming above painful joints.
• Longer, thicker claws: a cat that no longer climbs does not wear its claws down and starts snagging on fabric.
• Less interaction: it moves to ground level and stops sleeping near people if reaching them requires a jump.

Measuring maximum jump height is the single most useful home datum in a senior cat. Record the highest point reached without intermediate footing, note the date and repeat at regular intervals. A progressive reduction across three readings is concrete clinical information, far harder to dismiss as an impression.

Tools exist that were built and tested to be completed by the owner rather than the vet. They are short, repeatable questionnaires, and their advantage is producing a comparable score before and after a treatment change.

None of these instruments makes a diagnosis. They do two things: they make comparable over time a picture that otherwise stays narrative, and they measure the response to treatment. The baseline score must be collected before any therapy, because without a starting value the change cannot be calculated and treatment response becomes an impression again.

When the signs are compatible with pain but imaging is not conclusive, or not yet indicated, the vet may propose a treatment trial: a defined period of analgesic therapy with a check on the effect. It is a genuine diagnostic tool, but it works only if the protocol is set in advance and not altered along the way.

1. 1

   Fix the starting point

   Complete the questionnaire and record two or three objective measures before the first dose: time to stand, distance walked before asking to turn back, maximum jump height in the cat.

2. 2

   Agree the duration and the criteria

   Ask your vet how many days the trial should last and what change counts as a response. A trial with no declared duration always ends up stopped too early or continued too long.

3. 3

   Change nothing else meanwhile

   No new supplement, no diet change, no modification to the exercise programme during the trial. Every added variable makes the result impossible to attribute.

4. 4

   Record daily, not only at the end

   One line a day with the same three measures. A ten second video of getting up from the bed, always filmed from the same position, is worth more than any description.

5. 5

   Repeat the questionnaire at the end

   Complete the same instrument again and compare the two scores. Bring both to the consultation, along with the videos, and discuss whether the change justifies continuing.

A chronic pain consultation takes little time when the material arrives already organised. The vet's main difficulty is that in the consulting room the animal is in a state of arousal that masks the signs: many dogs do not limp on clinic flooring and almost no cat displays there what it avoids at home.

• Three short videos filmed at home: getting up after rest, going down a step or a flight, walking ten paces in a straight line.
• The objective measures you collected, with dates: time to stand, maximum jump height, walk distance.
• The completed questionnaire, with the date it was filled in.
• The full list of medications, supplements and diets in use, including doses that were missed.
• Current weight and the weight trend over the last six months: excess weight is the modifiable factor with the most direct effect on joint load.
• The questions you want answered in writing, for example which tests are needed now and which can wait.

Weight control deserves its own line because it is the only intervention that acts on pain without drugs and with effects measurable within weeks. Studies in dogs with osteoarthritis have shown improvement in lameness with body weight reductions of a few percentage points, achieved over a couple of months. It is the first subject to raise in the consultation, before any discussion of supplements.