Topic 3.5 Behavioural Indicators of Pain, Disease and Distress

Behaviour is often the earliest and most sensitive indicator of changes in an animal’s health and welfare. Animals experiencing pain, illness, injury or emotional distress frequently communicate these experiences through alterations in behaviour long before obvious physical signs become apparent. Changes in activity levels, social interactions, appetite, task performance, body posture or emotional responses may all provide important clues that an animal’s wellbeing has been compromised. For assistance animals, recognising these subtle behavioural changes is particularly important, as they may continue attempting to work despite experiencing discomfort or illness.

Historically, behavioural concerns have sometimes been attributed to poor training, disobedience or reduced motivation without adequate consideration of underlying medical conditions. Contemporary veterinary behavioural medicine recognises that many behavioural changes have a physiological basis. Pain, disease, neurological disorders, endocrine conditions, sensory impairment and age-related changes may all alter behaviour. Consequently, behavioural assessment should never occur independently of physical health assessment, and medical causes should be considered before behavioural interventions are implemented.

Behavioural indicators of compromised welfare are not always specific to a single condition. The same behaviour may result from pain, fear, anxiety, frustration, fatigue or environmental stress. Effective assessment therefore requires practitioners to consider behavioural observations alongside the animal’s medical history, occupational demands, environment and previous behaviour patterns. Occupational Therapists are not responsible for diagnosing medical conditions; however, they play an important role in recognising behavioural changes that warrant further investigation and timely referral to a veterinarian.

This chapter explores common behavioural indicators of pain, disease and distress, examines factors influencing behavioural presentation and discusses the Occupational Therapist’s role in recognising compromised welfare within assistance animal partnerships.

Behaviour as an Early Indicator of Health

Animals often compensate for illness or discomfort, particularly working animals that have been selectively bred and trained to remain engaged with their handlers.

Behavioural changes frequently precede obvious clinical signs such as lameness, weight loss or physical abnormalities.

Early behavioural indicators may include:

• reduced enthusiasm for work
• reluctance to perform familiar tasks
• altered movement patterns
• decreased playfulness
• reduced social interaction
• increased rest
• changes in appetite
• altered sleep patterns
• decreased concentration
• reduced responsiveness.

Recognising these subtle changes allows earlier veterinary assessment and intervention, potentially preventing progression of disease and protecting long-term welfare.

Recognising Pain-Related Behaviour

Pain does not always present as overt vocalisation or obvious lameness. Many animals display subtle behavioural changes that may easily be overlooked or misinterpreted.

Possible indicators of pain include:

• reluctance to jump, climb or change position
• hesitation when performing previously routine tasks
• stiffness after rest
• altered gait or posture
• guarding a body region
• reduced activity
• increased sleeping
• changes in grooming behaviour
• irritability during handling
• reduced tolerance of equipment such as harnesses or vests
• changes in facial expression
• altered tail carriage
• reduced willingness to engage in training.

Pain may also reduce an assistance animal’s ability to perform occupational tasks safely and consistently.

Behavioural Indicators of Illness

Systemic illness often produces behavioural changes before physical abnormalities become obvious.

Examples include:

• reduced appetite or thirst
• decreased interaction with handlers
• increased hiding or withdrawal
• unusual vocalisation
• lethargy
• reduced exploration
• changes in toileting behaviour
• altered sleeping patterns
• reduced attention during work
• decreased motivation.

Behavioural changes should always be interpreted within the context of the animal’s normal routine and personality.

Recognising Emotional Distress

Behavioural indicators of emotional distress may reflect fear, anxiety, frustration or chronic stress.

Common signs include:

• avoidance behaviours
• increased vigilance
• startle responses
• repetitive behaviours
• excessive panting unrelated to temperature or exercise
• lip licking
• yawning outside normal fatigue
• pacing
• trembling
• displacement behaviours
• excessive vocalisation
• withdrawal from interaction.

Not all stress is harmful. Acute stress can be an adaptive response to novel situations, whereas chronic or poorly managed stress may compromise learning, welfare and long-term health.

Age-Related Behavioural Changes

As assistance animals age, behavioural changes may reflect normal ageing, chronic disease or cognitive decline.

Possible indicators include:

• slower task performance
• increased rest periods
• altered sleep-wake cycles
• reduced stamina
• changes in social interactions
• decreased sensory responsiveness
• confusion in familiar environments
• altered learning ability.

Recognising these changes enables appropriate adjustments to workload, occupational demands and retirement planning while maintaining quality of life.

Behavioural Red Flags Requiring Veterinary Referral

Some behavioural changes warrant prompt veterinary assessment.

Examples include:

• sudden aggression in an animal with no previous history
• acute reluctance to work
• collapse or weakness
• persistent lameness
• rapid behavioural deterioration
• seizures or neurological signs
• marked changes in appetite or drinking
• repeated vomiting or diarrhoea accompanied by behavioural change
• significant weight loss
• persistent pain-related behaviours
• sudden changes in temperament.

Occupational Therapists should never attempt to manage suspected medical conditions independently through behavioural strategies alone.

Supporting Welfare Through Early Recognition

Early recognition of behavioural change allows intervention before welfare is significantly compromised.

Occupational Therapists can support welfare by:

• routinely monitoring behaviour during intervention
• encouraging handlers to recognise behavioural change
• documenting observations systematically
• reducing occupational demands when appropriate
• modifying environments to minimise stress
• facilitating timely referral to veterinary professionals.

Early intervention benefits both the assistance animal and the handler by maintaining safe, effective partnerships.

The Occupational Therapist’s Role

Occupational Therapists should be able to:

• recognise behavioural indicators of compromised health and welfare
• distinguish normal variation from concerning behavioural change
• appreciate that behavioural concerns may have medical causes
• document behavioural observations objectively
• educate handlers regarding early warning signs
• collaborate with veterinarians and other professionals
• refer promptly when behavioural changes suggest illness, pain or injury.

Occupational Therapists should avoid assuming behavioural changes are training problems until underlying health and welfare concerns have been appropriately considered.

Key Practice Principle

Behavioural change is often the earliest indicator of compromised health or welfare. Occupational Therapists should routinely monitor assistance animals for changes in behaviour, recognise signs that may indicate pain, illness or distress, and facilitate timely veterinary referral rather than assuming behavioural changes are the result of training or motivation alone.