The link between pain and behaviour.
Did you know that up to 80% of behavioural cases may have an underlying health condition? A reality that highlights the importance of working with qualified behavioural professionals and your veterinary team. In this article, clinical animal behaviourist and registered veterinary nurse Becka delves into the link between pain and behaviour.
One of the main roles of a clinical animal behaviourist is to perform a detailed behavioural assessment, allowing them to identify potential predisposing, causal and/or maintaining factors that may be influencing an animal's behaviour. Occasionally, when no external factors can be identified, internal factors such as a physical health complaint or pain must be considered.
The International Association for the Study of Pain (IASP) defines pain as “an unpleasant or emotional experience associated with or resembling that with actual or potential tissue damage”. Moreover, American nursing professionals Bebe and McCaffery defined pain as “whatever the experiencing person says it is, existing whenever the experiencing person says it does”. Unfortunately, unlike humans, animals are unable to self-report their pain; for this reason, we must be skilled in identifying signs of pain such as behavioural change.
Most of us are familiar with acute pain, which is adaptive, beneficial for survival and usually lasts for a short period (from a few moments to a few weeks), typically resolving once the underlying cause heals. Acute pain is thought to feel like a sudden, sharp, and intense physical sensation which acts as a warning sign of injury, illness, or tissue damage. Common causes of acute pain may include surgical procedures, accidents, injuries, infection or inflammation. Behavioural signs of acute pain may be obvious, for example, lameness, vocalisation, interfering with a wound or sudden aggressive behaviour when approached or touched.
Chronic pain is often, however, harder to identify and is defined as “pain that persists or recurs for longer than 3 months” (IASP). Chronic pain is counterproductive, is often less obvious and is very frequently mistaken as a behavioural problem. Common conditions that can result in chronic pain include joint, muscle, dental disease, ear, skin or gastrointestinal conditions and the signs can vary significantly based on the individual and related condition.
Chronic pain is always a concern for behaviourists and must be ruled out as part of an assessment since pain is often a symptom of a physical health complaint. Clinical animal behaviourists are unable to diagnose; thus, they will always work on referral and liaise closely with your veterinarian.
Animals experiencing chronic pain can develop a negative cognitive bias or pessimistic outlook to life; they may become more cautious, fearful or depressed, which can significantly impact the welfare and quality of life of both the animal and their caregivers. Additionally, chronic pain can lead to sensitisation of the nervous system, making pain harder to manage; it can also alter the structure and connections in the brain, resulting in chemical imbalances and disruptions, which in turn may impact the physical, emotional and social health of the animal. Behavioural complaints associated with chronic pain can lead to a breakdown in the human-animal bond and subsequently relinquishment or euthanasia of animals.
Though no fault of owners or animal professionals, there are several reasons that chronic pain may be underdiagnosed. Animals instinctively mask their pain to appear less vulnerable and to increase their chances of survival, for this reason, animals will often hide their pain until they are no longer able to cope. Instead, animals are fantastic at adapting, shifting their weight, compensating, altering their conformation or developing new habits or behaviours to manage their discomfort. Animals will often continue to do the activities that they love; think of the old dog who continues to chase their ball on the beach despite their osteoarthritis diagnosis or the dog that continues to eat their favourite treats regardless of their severe dental disease. These behaviours are often driven by dopamine, a hormone associated with pleasure, motivation and reward and can become habitual.
Complications can arise when animals visit the veterinary clinic. Fear and stress can result in tension of the muscles and joints and animals experiencing pain can become protective or display aggressive behaviours during assessments, thus, making pain harder to identify or diagnose. Furthermore, chronic pain scoring systems, pain trials and imaging are not always reliable, depending on the individual, the timescale and the type of pain they may be experiencing.
It is important to note that ageing is not a disease; if you have noticed changes in your pet’s behaviour, conformation or movement, contact your veterinary team for advice. By identifying signs of discomfort early, we can help to diagnose conditions early, prevent the progression of disease, improve the health and welfare of animals and prevent the development of problematic behavioural complaints.
