Study finds pet parents still miss subtle signs of canine pain: full analysis
A new study in PLOS ONE is putting numbers behind a problem many veterinarians already know well: subtle canine pain is easy for pet parents to miss. Researchers at Utrecht University found that dog owners were not meaningfully better than non-dog owners at identifying low-key behavioral signs of pain, even though obvious signs such as movement-related pain were more readily recognized. (research-portal.uu.nl)
The study, published April 1, 2026, assessed pain-sign recognition in 530 dog owners and 117 non-dog owners using an online questionnaire built around 17 behavioral signs and three written case descriptions. Participants gave higher pain-likeliness scores to signs such as change in personality, hesitant paw lifting, fluctuating mood, and reduced play than to air sniffing, nose licking, and yawning. In two of the three cases, the dogs were described as having painful conditions, one with overt movement-related signs and one with subtler changes. (research-portal.uu.nl)
The most notable finding was the gap between overt and subtle pain recognition. Dog owners scored the obvious movement-related pain case slightly higher than non-dog owners, but there was no meaningful advantage when the case involved subtler signs such as restlessness at night and increased attachment or “shadowing” of family members. In some individual behaviors, non-dog owners were actually more likely than dog owners to associate freezing or turning the head or body away with pain. A University-linked explainer on the paper suggested that familiarity may sometimes breed complacency, with owners normalizing behaviors they see every day. (research-portal.uu.nl)
That fits with earlier work on canine osteoarthritis and chronic pain recognition in general practice. A 2020 qualitative study found that pet parents often first notice slower walks, stiffness, panting, reluctance to jump into the car, reluctance to get out of bed, reduced play, or a more withdrawn demeanor, but may not initially interpret those changes as pain. Other veterinary references make the same point from the clinical side: behavioral indicators can be subtle, and dogs may still greet, wag, or continue normal-seeming activities despite discomfort. (pmc.ncbi.nlm.nih.gov)
Industry and clinical commentary around osteoarthritis pain points in the same direction. In a Clinician’s Brief forum, Dr. Zimmerman said that once a dog is already hesitating on stairs, reluctant to jump into the car, or showing gait changes, clinicians may already be behind on pain control, adding that younger dogs can adapt function and continue activities that reassure pet parents everything is fine. That perspective matters because it reframes “subtle” signs as early-stage opportunities rather than vague owner impressions. (cliniciansbrief.com)
Why it matters: For veterinary teams, this study supports a more deliberate approach to client education and history-taking. AAHA’s 2022 pain management guidelines emphasize that clients play an important role in assessment and reassessment, and they specifically call for education on recognizing signs of pain. In practice, that may mean asking about behavior change as carefully as gait, using validated owner-reported tools like the Canine Brief Pain Inventory or Helsinki Chronic Pain Index, and avoiding language that limits pain discussions to limping, crying, or obvious injury. If subtle signs are routinely normalized as aging, stress, or personality, diagnosis and intervention for osteoarthritis and other chronic pain conditions may come later than they should. (aaha.org)
The study also suggests that experience can help, but not automatically. Owners whose dogs had previously experienced a painful event were somewhat better at recognizing certain pain signs, which hints that education may be most effective when it is concrete, behavior-based, and repeated over time. For clinics, that could support using pre-visit questionnaires, exam-room handouts, follow-up messaging after orthopedic or senior visits, and side-by-side examples of stress behaviors versus possible pain behaviors. (research-portal.uu.nl)
What to watch: The next step is likely less about new diagnostics than better implementation, especially structured screening for early osteoarthritis and other chronic pain conditions during routine visits. Expect more emphasis on checklists, owner-reported outcome measures, and communication strategies that help pet parents connect small changes at home with clinically meaningful pain. (pmc.ncbi.nlm.nih.gov)