Table 2.

Identifying the subtle signs of pain at home and in the practice

At home	Patterns of behavior	• Changes in interactions with family, visitors, other family pets • Decreased appetite and food intake • Diminished play • Overgrowth of nails signaling decreased scratching behaviors • Changes in normal routines
	Mobility	• Change in normal resting spaces • Increased sleeping • Decreased jumping • Difficultly climbing stairs, utilizing intermediate surfaces to get to higher surfaces or not going to higher surfaces at all • Sliding down the edge of surfaces to decrease jumping-down height • House-soiling • Lameness (rare)
	Response to touch	• Changes in petting preferences • Sudden dislike of grooming care, perhaps only over one specific physical location • Sudden dislike of being picked up
In the practice	Personality	• Change in demeanor: less or more approachable • Hiding in carrier when previously came out willingly
	Mobility	• Altered gait • Changes in jumping (no longer jumping onto examination table, difficulty getting onto examination room chair, etc) • Changes in exploratory behaviors
	Appearance	• Evidence of muscle wasting • Evidence of increased or decreased grooming (alopecia, mats, dull coat) • Nail overgrowth
	Response to touch	• Objects to petting or examination touches
	Ability to obtain biologic samples	• Resistant to handling for blood or urine sampling • Changes in behavior compared with previously (eg, no longer comfortable for hindlimb blood draw)