The potential role of pain in problem behavior is widely acknowledged, but there seems to be a lack of structure to recognizing the many ways which it can impact both normal acceptable activity but also problem behavior. From a scientific research perspective, it is often difficult to present definitive evidence concerning the breadth of the problem given the individuality of animal behavior and impact of specific context on exact behavior shown at any given time.
In this presentation, I will present evidence from my clinical experience and research to illustrate the scale and nature of the issue with a view to increasing awareness of the problem. Indeed, at our referral clinic in excess of 80% of problem behavior cases seen by us have some form of association with a medical and often painful condition. While only a veterinary may make a specific diagnosis, many of these conditions can be suspected from close observation of the patient, and so concerns can be raised by non-veterinarians working in the field. The more you look, the more you will see, and (in my experience) the more concerned you will become about this issue.
I have recently suggested that the relationship between a problem behavior and pain can be classified in one of four categories:
- the presenting complaint is a direct manifestation of pain;
- unidentified pain is underpinning secondary concerns within the initial behavior problem;
- there is an exacerbation of one or more signs of problem behavior as a result of pain;
- or they are adjunctive behavioral signs associated with pain.
I will argue that, in general, it is better to treat suspected pain first rather than consider its significance only when the animal does not respond to behavior therapy. The time taken for these measures to take effect can be spent usefully building the skillset of owners so they are better prepared and able to execute the problem behavior management protocols necessary to totally resolve the issue.