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Featuring Demian Dressler, DVM and Susan Ettinger, DVM, Dip. ACVIM (Oncology), authors of The Dog Cancer Survival Guide

How Do We Tell If A Loved Dog Is In Pain?

Updated: November 22nd, 2018

Pain.  The very word makes us wince.

Same with the word cancer.  A friend recently brought up the fact that some of us  refer to cancer as “The C-word.”

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So when we put these together and talk about cancer pain, we have quite a loaded topic on our hands.

Before I get into how to tell if a dog is hurting, let me give a quick word of caution.  Since cancer pain is so important, we can get a little tunnel vision.  The first question we want to ask is, “Is my dog in pain?”

Pain is a massive life quality destroyer.  No question about it.  The mistake is when we interpret no obvious pain as good life quality.

Absence of pain does not a good life make.

Other  life quality negatives include nausea, loss of appetite, fatigue, disorientation, loss of social pleasures, loss of normal body functions, boredom, chronic stress, low self esteem, and more.  Not just pain.

All must be factored in during life quality analysis.  This topic is covered in some depth in The Dog Cancer Survival Guide.

In medicine, when we are talking about something we see in an animal we call it a “sign”.  When we are referring to something we experience, we use the word “symptom”.  In veterinary medicine, we talk about signs and in human medicine we talk about symptoms.

Some more common tumors that may cause pain, or at least discomfort, are:


ready-to-rupture hemangiosarcomas

very inflamed mast cell tumors

solid tissue sarcomas that are about to split

larger bladder tumors, usually transitional cell carcinomas

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I would like to share with you some of the ways a clinician evaluates pain, based on a hand’s on approach.  We go about it in kind of a technical way.  Pain assessment can be accompanied by biting, so the safest option is have your veterinarian do it.

Pain assessment is very tricky.

One of the most consistent signs of painful stimulus is called the withdrawal reflex.  This happens  when a painful area is touched, squeezed, or similarly stimulated, and the dog pulls it away.  Oddly, this reflex is not connected to the brain but happens in circuit in the spinal cord.

Another useful sign is when pressure is applied to the painful area, the dog will turn and look at you.  Sometimes they do a little more than that!

Sometimes pain can be detected when there is a body position shift to alleviate the discomfort.  For example, if we exert gentle back pressure on a standing dog and this is a sore area, sitting quickly may be due to pain.

A painful abdomen can be detected by palpating, with flat fingertips, towards the middle of the dog’s belly.  Veterinarians have to be cautious,  as some tumors, like blood-filled hemangiosarcomas, may be on the verge of a rupture.  We will look for what we call “splinting”, which is when there is a tensing of the muscles of the abdomen.

Almost 100% of the time, limping is due to pain.  There are very few mechanical problems of a limb causing limping that are not causing pain.

Many sore dogs will pant when they are not comfortable.

Occasionally a dog will simply seem down, or just kind of off or lackluster.  This can be a vague sign of pain too.

Often dog lovers in my examination room will point out that their dog is not vocal, and suppose that there is no pain.  This is an error.

Recall times have we walked around with a sprain, a sore back, or some other injury that hurts? For what portion of this time were we exclaiming, “Ouch! Ow! Ow!?”

No vocalization means there may be pain, or there may be no pain.

We have to be careful when we use these physical signs.  There can be what we call “false positives,” which means we have a sign which can mean there is pain, but not this time.  If we take the sign to mean there is pain, this is a false positive…an error.

So when a dog yips every time we touch an area, probably it hurts.  Some dogs will be vocal for other reasons though, such as fear.  So it’s tricky.

Panting dogs can be hot.  A positive leg withdrawal can mean the dog remembers having her nails cut.  Splinting in the abdomen may mean the person doing the test is poking the dog with his fingertips.  A standing dog who sits with back pressure my be just trying to please.

One way to increase the accuracy is by seeing if the response is reproducible.  Do you get the same response every time?

Another way of increasing accuracy is by looking at multiple signs to get the big picture.

A rather technical way of doing it is by taking a heart rate (how many beats in a minute), then stimulating the area in question.  Next,  take another heart rate.  The second heart rate should be higher if there is pain.


A lot of information can be gained by the use of pain medication.  Sometimes after pain medicine is started, when we look for the same pain sign, it is gone.  Usually the dog will be happier along with this.  I have used this approach when the signs are very vague.

As you can see, the way a veterinarian assesses pain may be a little different from what one would imagine.  Since your four legged family member cannot speak, we use other ways to try to make sure our patients are not experiencing any pain.

All my best,

Dr D


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Leave a Comment

  1. […] Animals are specialists at hiding their ache, however typically it’s obvious that they are hurting. […]

  2. Kay Holmes on November 26, 2018 at 6:29 pm

    My 11 1/2 year old English cocker has advanced melanoma of the mouth. I have twice had a thumbnail sized tumor removed from his lip, in oct, 2917 and in aug, 2018. His lymph node under his chin has gotten huge and the mouth melanoma is now the size of a small apple. Hanging out of his mouth.It bleeds some and smells horrible. He has been on pain medication and antibiotics for over two months. We opted against cancer treatments because his mother had lymphoma and the treatments were so horrible.He still runs in yard, wags his tail and eats like normal.
    We have an appointment to debulk the mass..this week.my husband said that we had to do that or put him down.
    It’s so sad….I can’t put him down when he still seems happy. Do you think the surgery will kill him.? Do you think We should put him down?
    I’m so torn..is he ready????.

    • Dog Cancer Vet Team on November 27, 2018 at 7:43 am

      Hello Kay,

      Thanks for writing. We’re not veterinarians here in customer support so we can’t offer you medical advice. However, we can provide you with information based off Dr. Dressler’s writing 🙂

      As Dr. Sue writes in the article below, if a lump is 1cm or larger, or has been there for over a month, get it checked by a vet ASAP. This might mean getting a fine needle aspirate (or a biopsy in some cases) to determine what the lump is– it’s better to know sooner rather than later. Here’s the link to the article where Dr. Sue goes into more detail on this: https://www.dogcancerblog.com/articles/bump-lump/lumps-on-dogs-when-to-get-them-checked-by-a-veterinarian/

      You know yourself, and your boy the best, and there are a number of factors that you have to take into consideration (finances, your dog’s personality, your personality, treatment options, age, etc) before making a decision as each dog and their health situation is different– there is no one right fit. This is where Treatment Plan Analysis can be really beneficial. Here’s an article on how to end treatment plan analysis paralysis https://www.dogcancerblog.com/blog/make-decisions-dog-cancer-treatments/

      You also have to factor in your guardian type– do you want your dog to be as comfortable as possible? Are you okay with handling the side effects of particular treatments? How important is quality of life? Do you think he would be the same after surgery? It’s a lot of questions, but you have to ask yourself these and many more when making a decision. Here’s a link to an article on guardian types that you may find helpful: https://www.dogcancerblog.com/blog/why-your-personality-is-so-important-to-your-dog-with-cancer/

      You should also ask yourself, how is your boy’s quality of life? Is he still happy? As Dr. D says in the article below, Life quality is a critical part of your dog’s care. Nobody wants to have a longer life if the life gained is a bad one. So, when a dog’s Joy in Life is taken, life quality goes down. Here’s the link: https://www.dogcancerblog.com/articles/life-quality/time-and-the-joys-of-life-in-dog-cancer/

      In the Dog Cancer Survival Guide, Dr. D writes that there are a number of treatment options (besides surgery, chemo and radiation) in the Full Spectrum Cancer Care that you could consider, under your vet’s supervision– Nutraceuticals, Diet, Brain Chemistry Modification, and Immune System Boosters and Anti-Metastics Here’s an overview article on Full Spectrum Cancer Care that may be useful: https://www.dogcancerblog.com/blog/what-is-full-spectrum-cancer-care/

      We can’t tell you what the right choice is because we’re not vets, each dog and their situation is different, and we don’t know your boy. But you do, and once you figure out what is most important to you both, you can then make a more informed decision 🙂

      We hope this helps!

  3. Brenda on January 22, 2018 at 1:02 pm

    Yesterday we said good bye to Rex, our beautiful 7 year old German Shepherd. He was diagnosed with lung cancer one month ago and although he had responded well to meds, (was eating well and was happy and mobile) we knew that his time with us was limited. Yesterday morning he declined steadily and we rang the vet to let him know we would be bringing Rex in for the last time. Shortly after Rex passed away in his own time on his favourite doggy bed in our arms. We are devastated but feel privileged to have had him as part of our family since his puppy-hood. I am writing this because I have been comforted by the information I have read which others have posted, and, to people whose pets are unwell, my advice is to treasure your final times with them. Brenda

  4. Kim Farley on November 9, 2017 at 11:35 am

    I have a little dog mixed breed we have been told she has lung cancer …She also having tummy trouble swelling up and getting small back and fore …drinking alot of water had a x-ray done showed noting…wrong with tummy…But lung cancer.. She still eating popping ,peeing, but when her tummy get bloated… she is miserable…should we stop her from drinking so much water or what…

  5. Susan Kazara Harper on June 16, 2015 at 7:58 pm

    Dear dear Sarah, I know how your heart aches, truly. Don’t you dare regret the decisions you made for Lily. Your love for her, and hers for you is a bond that no one else can touch. I know without a doubt that Lily loved you as unconditionally as only our wonderful animals can, and all your decisions were right for both of you. You chose based on your love, and that is never wrong. Lily will be with you always, and believe me, the time will turn the ache into sad smiles, and then into happy ones. The final days were but a small drop in the bucket of abundance you had together, so please don’t focus on those final times. Remember her with the joy she brought to your heart. It’s a rare gift. One day there will be another set of eyes looking to you, and your heart will fill when you know Lily has sent that being to share the home she had. Take care my dear.

    • disqus_KKB0snvAU9 on February 8, 2016 at 10:16 pm

      Beautiful words Susan Kazara Harper and much deserved sarah wilson dont you ever doubt it

  6. Susan Kazara Harper on June 1, 2015 at 4:13 pm

    Dear Rose, Panting usually relates to discomfort at some level. I hope you’ve been able to consult with your vet as every dog truly is an individual and there may be other factors at play. Have you discussed an action plan for her? You may be able to make subtle adjustments related to her eating or timing of any meds which may have a positive effect on the night-time panting. Work with your vet and really connect with your Yogi. Your instincts are very important here. Good luck to you both.

  7. sarah wilson on May 27, 2015 at 11:47 am

    hi there.
    sitting at home and
    very much alone after having to have my best friend put down yesterday! have spent all day today just driving anywhere to avoid coming home and not being greeted by her.
    Racked by a miated on her quality of life.xture of anger and guilt so thought I’d tell my story.
    Lily was a rescue dog and had a character of her own which included doing dressage when she wanted something and was loved very much. so,,,,,,,,,did I do right by her?
    I took her to the vet a few months ago when she developed small lump on her teet. the vet was very abrupt and said she had cancer and would need an operation, chest xrays etc etc. At forteen I was very concerned about the outcome of an operation but obviously did not want her to suffer either. she was behaving normally, still going for and enjoying going for walks, eating and drinking well and seemed her normal self so I made the decision to leave things alone for now, not wanting to risk spreading te cancer by invasive surgery.
    Three months later the tumour had trebled in size and I knew I was going to loose her but concentrated on keeping her pain free. she was, until two days ago, very active and showing no signs of distress. However yesterday she had a bout of diarrohea and was not her normal self so I took her to the vet who advised that I should have her put down. Neither of us were prepared and the whole experience has been awful with the vet almost accusing me of being selfish for not having the operation done. Yes I was selfish at wanting as much time with her as possible but responded the minute I knew she was not feeling well. had she been younger I would not have hesitated to have the operation and equally had she shown signs of pain I would have ended it sooner but when is the right time? Can’t stop crying now as I feel I let her down even though I know in my heart I did my best for her.

  8. Rose on May 10, 2015 at 4:24 pm

    My yogi is 8 us old. She has cancer and at night in bed she also is starting to pant really fast? Don’t know what us happening? Need help?

    • Mary on March 12, 2017 at 2:47 pm

      I was told by the ER Doctor that panting is a sign that they are in pain and also can be anxiety

  9. Susan Kazara Harper on October 23, 2014 at 7:46 pm

    Laura, I hope you’ve taken your girl to the vet to have her checked. This could be a variety of things, but your vet will be the one to diagnose. Good luck.

    • laura on October 23, 2014 at 11:39 pm

      Thank you susan for getting back to me..we had to say goodnight to my belle on monday she had a mass under her belly i felt it but didnt wont to hurt her so i wasnt sure ? The vet was very good and got straight to the point and said shes not well he didnt need to say anything really i new in my heart that she was ill. She was my beautiful,bouncy, wet nose,sparkly eyes,energetic, slightly clumsy, strong, brave, resilient girl…

      I will never forget you and i will alway miss and love you my daring you was my brightest star in my life..

      Thank you for this article my advice to everyone who has an inkling to your dog being in pain go to the vets because i knew that she was in pain and if you know your dog as well as i did then you know…. but they are so resilient and try to hide it

      • Susan Kazara Harper on October 25, 2014 at 8:14 pm

        I’m so sorry Laura. Belle will always be with you my Dear.

      • Mary lister on November 16, 2014 at 2:30 am

        I’m so so sorry Laura, I am going through the same thing my boxer is 12, and has histeocytic sarcoma, she has huge tumors and can barely walk, but loves to be with me, and follows me wherever I go, and she still eats also and wags her tail, we have an appt tomorrow for the vet to say goodnight and I am having such a hard time with this and want to wait, I don’t want her to hurt, but I just can’t imagine life without her…

  10. Laura Crosland on October 18, 2014 at 8:18 am

    Hello we have a golden retriever she 11 years old and for the past few weeks started to drooling and seemed out of sorts today has had alot of trouble getting up her legs have been giving way a few time and she just looks so depressed its not like her. she has been eating and drinking fine i hope im wrong but she seem in pain and is very quiet any i thought

  11. Susan Kazara Harper on July 30, 2014 at 1:29 pm

    Hi Deano, Well it could be many things. Your pom may have gotten a scratch or a bite and the lump is a local response or even an infection. Equally yes, it might be something more serious. Let me ask you this. If you woke up one morning and had a golf ball sized lump suddenly appear on your body, would you go to the doctor? The best thing to do when your dog gets a lump is make an appointment with the vet. There is no reason to believe that if you wait, the lump will go away. It may be nothing, but if it’s “something” you will feel happier getting it checked out as soon as possible. Good luck!

  12. deano on July 29, 2014 at 11:57 pm

    My 10 year old pomeranian has just developed an almost golf size fatty lump/not quite hardened nodule overnight is it something to worry about as it was completely smooth on Monday

  13. lynsey on July 25, 2014 at 1:26 am

    Would really appreciate some help with my boxer. He is 9 years old and for the last 3 weeks has been completely lame in his left front leg. Won’t put any weight on it , just drags it along the floor and crys horrendously when he tries to get out of bed. At first the vet thought it was arthritis and started treatment for that with no success. He was then put on 40mg of metacam and 200 mg of tramadol 3 times a day with no change. They then added 800mg of gabapentin to the mix which still didn’t help. They have now done 6 x rays and blood tests that have all come back completely clear. He is now on 800mg of gabapentin 3 times a day and 50 mg of predisilone which still isn’t doing anything. They have said the only other option now is sending him for a scan which is going to cost £3000 and that still might not show what the problem is. I don’t know what to do next. He can’t carry on in this much pain I hate to see him like this. Would it be kinder to put him to sleep or would a scan find something that’s fixable? I know there is no definite answer but any feedback would be greatly appreciated x

    • Susan Kazara Harper on July 25, 2014 at 4:35 am

      Goodness Lynsey, this is distressing. Can you or your vet tell where the source of the pain is? Is your dog’s paw tender? The leg? The shoulder? Did the xrays go from foot to shoulder? There must be a way to isolate the source of the problem … it could be anything from a problem in the paw to something higher up. It could be an impingement in the spine that feeds the leg. This probably all sounds like old ground to you, but I suspect you need to be referred to a specialist. Ask your vet if there is an orthopedic specialist you can go to. It’s no reflection on your vet, and you have every right to ask for every way to determine what is causing this. I’m sure your vet wants to know as well, and should have no problem helping you find a specialist. Something major has happened to cause this. I suspect that if you let your boy go without knowing what it is, you will always be plagued by that decision. But I don’t know you, and you now your dog the best. There has to be a way to discover what is wrong. Once you know that, it may be serious, or it may be something that can be fixed. But at least you will know. Good luck from all of us on the Team. Let us know what you find out. Give your boy a gentle cuddle from us.

  14. Susan Kazara Harper on July 8, 2014 at 5:50 am

    You pose very valid questions, and they’re ones that we as dog guardians often face. So here are some thoughts. You and your vet know your dog best. If there is any evidence of heart or lung problems, or other symptoms that may make sedation a problem, it’s a matter of weighing those factors against the benefits of surgery. If sedation is not a problem, you may want to ask about the possibility of using cryosurgery to freeze the epulis. Even a de-bulking surgery, where the vet reduces but doesn’t completely remove the epulis may be worth considering if it’s a toss up between surgery and not being able to eat. If the epulis continues to grow there could be real issues of discomfort as well as inability to eat. Again, these are information points for you and your vet to work out together. To address fear of the vets, which won’t help any procedure, are you able to occasionally drive your boy to the vets, get out in the parking lot, walk around, and go home? Try it a couple times, then do the same, walking into reception, say hi to everyone, and go home. Use soothing words and treats and ‘good boy’s all along the way. This can all help desensitize him to the visit. I’m sure the vet staff will be happy to say hello and pet him, give him a treat etc. so it will become a good experience. It takes time, but all things that are worth it, do. Good luck!

    • PH on July 8, 2014 at 8:14 am

      Thanks for the reply. Our Vet is going to take him in for the surgery and see what can be done. Hoping de-bulking can help. As for conditioning Caleb, the funny thing is that he is never stressed in the waiting room. It’s that table and anyone other than me putting their hands on him. Oh well, at 15, we just have to manage through it. It has become worse with age.

      • Susan Kazara Harper on July 9, 2014 at 3:07 am

        Well, at 15 he certainly deserves to have his wishes fulfilled! Perhaps you can ask the vet to either treat him on the floor rather than on that table, or to come out of the practice room to look him over where he is more comfortable. Good luck!

  15. PH on July 6, 2014 at 4:54 pm

    We have a Corgi a week shy of 15. Relatively fit, rather deaf, and deathly afraid of the Vet (no trauma, just his quirk). He has a rather large Epulis on his lower gum, doesn’t seem to pain him, eats like a horse. I fear surgery of some sort is the next step before it gets much bigger, but I have to wonder if it will do much good. At what age do you say, no, I am not putting my dog under anesthesia? His Aunt was ill at 12, and went under anesthesia and crashed, we almost lost her. Several month later she was gone anyway. What to do? Is it the right thing to put him through the surgery? Am I doing it for him or for me?

  16. Susan Kazara Harper on June 1, 2014 at 1:46 pm

    Hi Nikki, We’ve had no evidence that Apocaps cause any growth to increase; they are designed to help do just the opposite. You’ve mentioned that this is a rapidly growing mass, and the vet hasn’t been able to get it out entirely. I’m a little confused why a fine needle aspirate was done. If 80% of the mass was taken there should have been plenty of tissue to do a proper biopsy. Have you been able to ask about being referred to a vet oncologist? With so much unknown, you may feel better having an expert, and that’s no reflection on your vet. No one can know everything. But you want to take the best care of your dog, and you have a lot of gray areas. Equally, there may be another specialist surgeon who could review the notes and determine whether closer work could be done. Please hang in there. Find out about specialists you can get to and put your team together. All vets want the best for your dog, and should have no problem with your requests. Give Bennie a big hug please.

  17. Nikki Landry on June 1, 2014 at 9:53 am

    Dr. D, I just started my dog on Apocaps for the first time. Is it possible, apocaps could enlarge his tumor? I’m not sure if his tumor is growing rapidly because of the apocaps or if it is because of the type of tumor it is. I have his test results, but the results of his tumor came our undefined. The vet did a fine needle biopsy and the results came back undefined. Basically, the vet knows it’s cancerous, but he’s not sure what kind of cancer it is. He did a chest xray of my dog and his lungs were clear. Here is what the results say based on the Fine Needle Biopsy. These results are from before he had the tumor removed. RE:2000 MICROSCOPIC INTERPRETATION MICROSCOPIC INTERPRETATION – malignant neoplasia, undifferentiated, type uncertain. Large 6x6cm rapidly growing firm mass caudal to the scapular spine. Excisional biospy some cystic necrotic tissue in center of mass. Relatively avascular. Two pieces.

    Ever hear of anything like this? The vet was able to remove 80% of the tumor because the other 20% is attached to muscle or nerves.

    Anything you can suggest to help my dog? He’s on pain meds, and apocaps, healthy diet, and he’s eating really well.

  18. Don Dressel on February 26, 2014 at 8:47 pm

    Just to let everyone know what my wife and I went through with our 10 year old collie a few years ago. He was diagnosed with lymphoma and we put him on chemo. He was dead within 3 months as the vets office overdid him on chemo. If we were to go through that again we would have put him on prednisone and let it go at that. A co-worker who’s golden lab came down with the same disease put her dog on prednisone and the dog lived 3 more years.

  19. Kellie Esarey Lucas on January 20, 2014 at 4:34 pm

    I have a 3 year old female rat terrier , 4 days ago she started acting as if she scared, shivering, panting, clinging for dear life. She is well taken care of and loved very much. Heres the strange thing she seems to only do this at home. Anywhere else she is fine. Nothing has changed at home she still eats and is going to the bath room. Dont know what to do can anyone give me some answers please i desparate

    • Susan Kazara Harper on January 21, 2014 at 4:38 am

      Hi Kellie, This is unusual. A couple things could be going on. She could be ‘masking’ when she goes out… our dogs instinctively do not show weakness outside their home environment. Such an extreme reaction at home must indicate though that something has changed. Really go over every possible situation…. has there been a new visitor, is anyone in the home stressed, was there a storm or anything else that could have made a scary noise, any new cleaning products (including laundry detergent) ??? Is it even POSSIBLE that something happened in the home, maybe when you weren’t there, that could have set her off? Is she more scared in certain areas of the home? Was a package delivered? Please also give her a really good check. Does she have any areas that are sensitive when you touch them? Is her tummy tender? If you absolutely certain that the answer to it all is no, I recommend you get a vet check done to rule out any physical problems. How is her poo? In the home, take the focus off “what’s wrong with her” (what’s her name by the way)? Walk with her or carry her through each room and in and out of the doors, being very calm and happy the entire way. Let her know that you know everything is OK. Something has spooked her, and you’re lucky that she loves you enough to show you. I hope this helps. Good luck.

  20. christine handy on May 30, 2013 at 5:17 am

    Dear Dr. Dressler, I have a 9 year old, male, mixed breed neutered dog. He was diagnosed in April of this year with amelanotic melanoma. The tumor in his mouth was removed. I do not plan to have radiation or chemo. I am trying a few holistic herbs and veggies. Sometimes he will vomit all of his meal. He is spending more time under the sofa. He eats, plays and goes for walks. Do you know how much the vaccine costs? Do you think my dog is in any pain? I have read that this cancer is very aggressive. Do you have any idea how much time I have left with him? What symptoms should I look for when the cancer gets worse? Or will it be obvious? I feel so impotent. Is there anything I can do for him? Should I continue to give him his monthly Trifexis? I would appreciate any info/guidance/advice you can give me. Is it my fault that he has cancer? I did have his teeth cleaned when needed but maybe not enough. Thank you. Christine.

  21. Sanser Meitou on May 27, 2013 at 11:06 pm

    My dog Cosmo, an American Staffordshire bull Terrier mixed, diagnosed with cancer three years ago. He is now fourteenth and half. I have the priveleged to own this loving creature since he was four months old. I know he is in pain, his vet said there is nothin more he can do. Cosmo has his better days and a bad days. He is taking short walk, sometimes he will just laydown for at least 25 to 30 minutes then try to get back up to walk home. Inside me is dying and numb. Tears pouring down my cheeks and trying to control myself around him. He does manage to stop and look straight up at me. I will try to pretend everything its ok. What next. The question is am I gonna be able to handle when it’s time for him to go. My mom just passed away 7 months ago, but never like this how I feel about my mom like how feel about my Cosmo. He does climb into bed with me, so I have to make a bed on the floor so both of us can share. He is used to sleep right by my side and so do I. Any suggestions please it will be very much appreciated. Thank you for the love of Cosmo.

    • Dr. Demian Dressler on May 28, 2013 at 11:18 am

      Dear Sanser,
      I would like to help but am having a little trouble figuring out what information you need….are you asking about ways to cope with pet loss? Can you please clarify the question, thank you very much!
      Dr D

  22. Noud Durnez on February 6, 2013 at 10:05 pm

    Hi Dr,

    I have a 7 year old Female chow, who has always been very relaxed and loving (Similar to your profile picture i noted). Last week we noticed she had broken teeth and we got those extracted. When investigating the chipped canine tooth, the doctor noted that she had what seemed Melanoma in her mouth. This was the reason for her teeth needing to be extracted. He took an X Ray of her chest and noted some lumps in her lungs too.
    From what he told us, and from reading up on this, I assume this is stage 3 Melanoma as it has spread already. (Samples have been sent to the lab to be tested to confirm this).

    The vet informed us that we should look out for bleeding, and that that would be our que to say goodbye.

    The thing I am trying to find out is, “is having the cancer in her mouth and lungs painful to her?”

    She has always been relaxed, so playfulness is difficult to use as a gauge. She’s still eating enough, plays with her brother a little bit, so things don’t seem so bad. But her mouth is swollen (because of the cancer) and she is continuously licking her mouth / rubbing her tongue against the area where the teeth were removed.

    Would you say that the cancer is causing her pain?
    Is there anything else we can do to ascertain when its time to say goodbye?
    We are having difficulty waging up her level of discomfort to the joy she has of being with us for these final days.

    I would appreciate some assistance with this difficult situation..

    (Cape Town SA)

  23. Maria on December 7, 2012 at 4:24 am

    I’m so sad. my dog started having diarrhea a few weeks ago. the first days we thought it was somithing she ate got her discontrolled. After a few days we took her to the vet, after a full examination he gave her subcutaneous fluidsand send me home with antibiotics and to cook rice and chicken for her.we also did blood work they said everything looked normal but the protein and calcium were low. I went back with her they put her special diet and prostora max. within this process we start noticing that her stomach was swelling up, she never stopped doing diarrhea, drinks water and pees a lot, lot i mean. i’m so scared she might be very sick, it’s hard to know it she is pain she doesn’t complain she seems happy most of the time can someone give me a word of advise? tanks to all of you animals lovers out there.

  24. Amanda on November 30, 2012 at 4:59 am

    I have 110 pound pit bull named Gorgeous. She weighed more then that when we got her 2 yrs ago. She is approx 7 years old. She was a rescue dog. She recently has been jerking away when we pet her right shoulder and upper back area. After further inspection she seems to be rather sensitive in her leg also. She is so fat I know that has to play a part in her pain. She struggles to walk and run. The day we got her we went right to petsmart to buy her collar and basic nessecities and if we stood still in an isle for more than 30 seconds she would plop down and lay down on the floor panting. We thought it was funny then. Now I am truly concerned for her health. I don’t know if her new pain is weight related or if there is something more serious going on with her. She is such a good girl. She has lost about 5 pounds since we got her but does anyone know anything else that can be wrong? Do these symptoms fit any specific illness? I plan to take her to the vet next week but I can’t afford hundreds and hundreds of dollars in tests.

  25. Adam on November 26, 2012 at 6:12 pm

    this person has clearly put a lot of effort into their dog. they can’t help where they are financially. please think before you put someone down like that. it’s wrong.

  26. paige on November 9, 2012 at 6:10 pm

    my dog is limping sevrely and have big lumps the size of pennies to quarter size could yousay whats wrong? if you can thx cuz shes a friend i had sceince i was 5 and she is about…9 or 10 plssss help

  27. justine on August 13, 2012 at 11:28 am

    Today my 9 year old chocolate lab has been acting odd. She has not eaten her food and will not get up or even move. I tried giving her some water and she only had a little. She doesn’t have diarrhea, but has thrown up a little bit. Can you help me and tell me what’s wrong with her and how can I help her? does she have cancer?

  28. hiral on July 13, 2012 at 8:26 am

    Hi, I have read the entire book, and its truly helped me but however having 3 different vets and my dogs health going down is put me into this worry. Sox nearly 7 year old female GSD, not neutred was limping and later diagnoised with Osteosarcoma and her Tail is the pain point, she cannot lift her tail up during urinating or passing stools… she is on 1ml tramadol daily since july1st, last 10 days she has to be carried for her walk and she soils her tail with her stools and legs, her stools are blood red in color and very very lose.. we had done an xray to check how badly cancer s spread, my vet gave her 3 months.. its barely 15 days and its beggning to worry me… i cant even think of putting her down, but she doesnt even allow me to sponge her tail n legs… what options do i have.

  29. Avery on July 10, 2012 at 1:02 pm

    Well we have our answer, the vet said it is cancer, but it is inoperable due to the location… Rex would have to have his entire upper pallate and jaw removed and then there would be no quality of life. We are using prednisone to try and shrink it some, stave off the bleeding. We also are going to use some pain management to keep him comfy until he either seems unhappy, or stops eating. Right now his is extremely obese (107 lbs up from 56lbs from just 3 years ago) and doesn’t miss a meal! He is still spunky and willing to play and still does his shivers and dancing when he sees me, so I am not ready to let him go, and he is not ready to go!

  30. Avery on July 8, 2012 at 6:03 pm

    Is it possible for a mouth injury to turn into cancer? Like Mast cell cancer? My dog is a mixed breed, mostly australian shepherd, he is 9 – 11 years old (we adopted him from a shelter, we are his third home they said he was 2-4 years old judging by his teeth) we have had him for 7 years. Last year he bit a cactus and got cactus needles in his mouth, we held him down and removed all the large ones, but there were a few left on his upper pallate. They were tiny and hair-like, so we figured that they would work their way out. Now a year later, his mouth looks terrible, his teeth are displaced and he has an open sore on the roof of his mouth that has started bleeding. He has been on several rounds of antibiotics, all getting progressively stronger/larger doses but nothing seems to heal it. Now it looks worse than ever, and is bleeding all the time. He is overweight and hasn’t lost a pound, hasn’t lost his appetite or spunk, but I am sure it is painful. He is going to the vet this week, but he is very uncooperative for an exam in his mouth. Last vet said he would have to put him to sleep to have a good look and excise it, it was going to cost over 2,000 so we went the antibiotic route first, second, third and now on the fouth. We are trying to evaluate whether or not we should euthanize him, it just seems that he isn’t in any pain… but he really must be. I cannot imagine his mouth not causing him pain. Okay, anyway I just wanted to ask if a mouth injury can turn into a cancer tumor. All else will be evaluated by a vet.


    • Dr. Demian Dressler on July 10, 2012 at 9:37 pm

      Dear Avery,
      mast cell tumors can have connections to prolonged inflammatory reactions, and this may be one case of that.
      You should have a biopsy done so you can determine if cancer and what kind so that the best treatment (above and beyond surgery) can be considered.
      As to life quality and decisions based on pain versus no pain (and pain control in this case would be pretty important), here is a post I think you will find useful:
      Dr D

  31. jeri thompson on July 3, 2012 at 5:44 pm

    this question is not about cancer but i really hope you can help. our family pet, a 10 year old black lab has bruscillosis as of June 2011. He has been on aggressive therapy twice to no avail. He has a wonderful appetite, drinks his water, greets us at the door and seems to have his pain controlled with medication. We have had to increase his pain medication over the last months to continue to “keep him comfortable”. We judge this by his inability to get comfortable when resting, or not being able to settle down and rest at all. We have struggled with whether or not it is time to put him down which is almost unbearable for us to even consider. Our most recent concern is he has begun to tear up stuff. He has chewed an 8 foot bush completely down while staying outside during the day. He has chewed up things in the house at night like hard plastic items. Our biggest concern is are we letting him suffer for selfish reasons. He lives in the house and is only outside during the day while we are at work. He has a large fan on him, and a big tub of water to get in. Just looking for advice. Thanks for any help you can give me.

  32. Bonnie on May 4, 2012 at 7:26 pm

    I need help with my 2 year old handsome american bulldog, i went to the vets with him beacuse i was concerned about his tence muscle (spasims) attacts he has when asleep the vet said it was’nt anything to be concerned about and that they sounded like twiching when your sleeping,
    duration – is a bout 3 seconds hard tence muscle movement, then he will shake for 2 seconds , and then back to sleeping? of late he has been quite lathargic, and he looks unwel,
    medical check confirmed – weight 46klgs was good – tempreture was good – and he is in good shape as he is walked/run evey day/2nd day, eating fine atm and went of liquids(water) for about 10 hours before he had water! please help me regarding info on TENSE MUSCLES when sleeping?

  33. Bonnie on May 4, 2012 at 7:12 pm

    Hi, I have a 2 year old american bulldog, his weight is 46klgs and he has a very healthy appearence. I wanted to know what muscle spasims are? what could be the cause?
    when my american bulldog sleeps i can see his back legs, stomach/back area become very tence for a period of 3 seconds, and then shakes i never noticed it before appart from the occasional twitch when he was dreaming! is there any immediate danger! my vet said it was him dreaming, but she was hopeless when visited on other occasions, (will be going to another vet) but just wanted views on what it could be?

  34. nicole on April 23, 2012 at 5:43 pm


    Are you F’Ing serious?????? Someone should put you to sleep! Why do you even own dogs? People like you make me sick!!!!!! if you really can’t afford a vet and you keep your dog outside and don’t know if its paralyzed you are an idiot! I hoe you get the same treatment your dog has gotten when you get sick!!!

  35. nicole on April 23, 2012 at 5:38 pm


    Are you F’Ing serious?????? Someone should put you to sleep! Why do you even own dogs? People like you make me sick!!!!!!

  36. nicole on April 23, 2012 at 3:17 pm

    My dog was diagnosed with spindle cell sarcoma! He is 11 and it is in his upper right shoulder. We assumed it was another lymphoma. It was diagnosed through only a needle aspiration and when we went to a surgeon he didn’t feel the need for us to do $500 biopsy! It has tripled in size and is massive ( he looks like a hump back) He has been ok and is on tramadol in case of pain but is starting to show signs of lameness on that leg:-( I Bernie loves the vet and always happy to go there so hard to take him in wagging his tail and seeming energetic! He does sleep all day and we are giving him walks steak whatever he wants! He is starting to get restless and moaning a little when laying down which is always ! He is a good big old lab who has never complained about anything and so it is really hard to judge if he is in pain or just irritated he gets upset can’t scratch his ears ! everything is happening so fast and I love this dog with all my heart but how do I bring a happy dog in to put him down? I know he is ok right now and he wants walks and food but he is uncomftorable the rest of the time and I don’t want to wait until he is too the point he can’t walk and is miserable:-( The location and size of tumor made it almost impossible to remove and he is a huge old lab and we were not going to amputate and do chemo! The tumor has tripled and spread all over his body! I went to put him in truck yesterday and he would not jump up, I lifted his front end and the his bottom determined to get him to his favorite water spot! I could not get him in the truck and needed help to lift him after ( we have a ramp he has never used scared of it) I guess I am asking a dog with such a great personality and he loves to please how will I really know when it is pain ? And is spindle cell sarcoma painful? can’t find any info really about this specific type as far as pain! We just had to get rid of our cats (husband found out severely allergic) and my son is devasted now his buddy Bernie! We are going to get a puppy end of May ( not sure I am ready ) more for my son! It is so hard to know if we should take him in now when he isn;t too uncomftorable or if we can trust his tramadol every 8 hours for now is enough to keep him happy! Bernie is 11 and my son s 5 we have had bernie since 6 weeks and he has been an incredible dog! I have guilt that as we have a special needs child we hadn’t given him all the attention he deserved he last few years and desperately trying to make up for it! I mean he has always been loved and slept on our bed act… but we got so busy we didn’t give him all the attention he needed when he was up for it! I feel incredibly guilty but I will not let my dog suffer I just don’t know if he is?

    • Dr. Demian Dressler on April 25, 2012 at 6:46 pm

      Dear Nichole,
      the truth is that most cancers worsen life quality at some point and this may include pain. Life quality is the important question versus just pain:
      Usually dogs with painful areas move or act uncomfortable when the area is touched or pressed. If it is this big it sounds like there is indeed discomfort.
      So what can we do?
      You have to decide what your goal is:
      As to ways of controlling pain aside from treating the tumor (please read the Guide for more ways to treat tumors including diet, apocaps, neoplasene, low dose palladia, immune stimulants, and more) you should ask your vet about NSAIDS like metacam, increasing tramadol dose, gabapentin or amandtadine, possibly a fentanyl patch, and acupuncture. These are all good things to consider so touch base with your vet and do your reading…
      I hope this helps
      Dr D

  37. Bette Mitchell on March 23, 2012 at 2:33 pm

    My 9 year old American Bulldog just had a biopsy for a tumor on his prostate that is calcified and several tumors on his spleen. They said 2 days for results but it has now been 3 days and I’m so worried about him being in pain!
    He lost 6 pds in 2 weeks and will not eat even his favorite “people foods”.
    I wish I knew what to do! He is my baby and I can’t stand to think he’s in pain.

  38. Jessica on March 17, 2012 at 2:51 pm

    Ny dog has lympnode cancer I recently found out last week she has two large lumps on her neck and on the back of her legs are swollen she does not eat very much but does drink a lot which the vet said of that is normal for live lympnode cancer I don’t know what to do she is my baby and I had her for 11 years she just turned 11 on valentines day she doesn’t seem to be in pain but she’s always panting and can’t settle down she is constantly moving and can’t get comfortablethe vet gave me a steroid for her she said it would help her breathe betterand give us more time I dont wanna b selfish if she is in painbut I don’t know she also gave me antibiotic but I just don’t know if it’s timer nah I don’t want her to suffer I just want her to be happy

  39. Rachel on March 10, 2012 at 7:05 pm

    Oh, we also did a scan of her lungs in June to see if the cancer had spread and at that point it had not!


  40. Rachel on March 10, 2012 at 7:02 pm

    Dr. D,

    I have a golden retriever mix named Sandi and she is approximately 11-12. We have had her for 8 yrs. In Sept. of 2010 I noticed a lump on her left hip. She was due for her check-up in Jan 2011 so I waited until then to get it checked. The doctor thought it was a fatty tumor but did a needle aspiration to make sure. It came back as non cancerous. Well it continued to grow and in June of 2011 I took her to another vet (because we had moved to CO) and it was diagnosed as a soft tissue sarcoma. The vet referred us to a specialist and they were very business like and no compassion and basically said they could do it but could not guarantee anything. They also said they could amputate the leg. It was also going to be around $4,000 either way!! So I talked to my vet for advice and she said that since Sandi was already an older dog that recovery for either surgery would be hard on her, plus, removing the tumor would be hard because of placement and size (softball at this point) so her quality of life may not be so great afterwards. Well, I still wanted to get my baby the care she deserved but could not afford it so I called Golden Retriever Rescue of The Rockies and told them of the situation and wanted to know if I could surrender my dog because I could not pay for the surgery and they get her the surgery and readopt her. They told me that if their vet could do it that they would just pay for the surgery and I could keep her!!! I was ecstatic. So we payed a visit to their vet and he said that he did not recommend the surgery for the same reasons my vet gave. I felt so hopeless. So I just decided to let it go and use pain management until it was “time.” We have since moved again to SC (my husband is military and I moved to CO to live with my mom while we waited for our house to sell in NE) and before we left CO I saw our vet one last time and loaded up on the meds. She is currently on 100mg of Rimadyl (1/2 pill twice a day). Her tumor is now cantaloupe size. She seems to be doing great!! She runs with the other dogs in the backyard, she jumps on and off the bed multiple times a day, she chases her tail, she plays like a puppy with our lab, she humps our lab, she goes up and down the stairs, she still runs to the door when we get home. She pretty much does everything she did before.

    When I touch or mess with her tumor she does look at me (like you mentioned) but doesn’t snap. Although, she does the same thing if I touch her other hip the same way. She does sometimes just look at me and paint for a few minutes (but she looks as if she is just relaxed and happy). So my question to you is… do you think she is in pain? We only started her on pain meds in Dec. because of the size and I wanted to be safe. Should I take her to another vet soon for evaluation?

    I am so distraught over the whole situation. I wish I would have just put the $4,000 surgery on my credit card and now I would not have been going through this (even though 2 vets recommended against it). I just feel helpless.

    Are there any signs of change in the tumor I should look for beside growth?

    Thanks in advance and sorry my post was so lengthy.


    • Dr. Demian Dressler on March 16, 2012 at 12:28 pm

      Dear Rachel,
      this sounds difficult. As to pain, this is a question your vet should be answering as I cannot ascertain this over the internet. I am wondering however, about the fact that you have not mentioned any of the steps available for dogs other than surgery and Rimadyl. Have you read the Guide? Apocaps? Neoplasene? Diet? Immune support? Antimetastatics? Brain chemistry modification? Deliberate steps to increase life quality daily? Touch therapies? How about low dose Palladia? All of these are in the book, so its time for some self-education so you can be the most effective guardian for your dog.
      I hope this helps

  41. Ashley on February 23, 2012 at 4:20 pm

    My dog is 9.5 and she is a very energetic dog. She was diagnosed in December with lymphoma and has been on high doses of prednisone since then. She is still fairly active during the day, happy to see us, eating, running around in the backyard. However, when night time rolls around she is very restless, and is panting. She is also on tramadol at night to help if she is in pain. We are also trying melatonin. I hate to put her down when she stills seems happy to be with us but I hate to have her struggle at night.
    Thoughts, anyone have similar experiences and expert opinion.
    Ps. I just had to put my 13.5 year old love down because he was bleeding internally which was very sudden and shocking.

  42. Gina on February 12, 2012 at 4:11 pm

    My 9 yr old dog (Lab/Great Dane Mix) has Osteosarcoma and was diagnosed about 6 wks ago. The tumor has increased in size since he was diagnosed. He is favoring the front right leg which is where the tumor is but still is the happy, playful dog he has been. He is taking Tramodol and Rymadyl for pain which seem to help but I want to know what signs to look for pain wise and when will I know its time to put him down. He eats like crazy and is drinking water like normal. I dont want to put him down for selfish reasons but I dont want him to be in pain so I need some advice. What should I look for and will he let me know he is in pain and what will it look like? Any advice will be helpful.

    Thank you!!

  43. Lydia on December 12, 2011 at 2:38 pm

    Thank u for the infomation. I am comfused with my dog.. He seems to be lame.. He was doing fine, but stayed outside alot, he’s had some skin problems abt a year, ask a vet, she said probally allergies. but large patches of hair would just pull out. he was heavy set in the hip area, don’t know if he over ate, unless, he took the other dogs food, never saw this., but I only fed them 2 cups a day each. abt a month ago I noticed he was week in the front legs, than last week, he layed down and never got up. the second day, we held him with a blanket under his chest and walked him slowed, he hadn’t urinated in 2 days, but did after we walked him. that was his last walk, he refuses to stand for more than a couple of mins. Been using pee pads under him. noticed to day, that left foot he consitantly lays on is really swollen. can’t get him to shift to other one.. we now have to move him by a halter collar and than a soft rope under his back end. he never makes a sound like it hurst.. still growls at the other dogs if they come near, he eats good, but refuses to drink, so I put boost in his can food to get him some liquids. I give him antibiotics, and qluesomine, advil, even nexium every other day with advil. I aso add some whey protein. he never yelps, or anything. this is a vocal dog, and a biter if he’s hurt, but he doesn’t even attempt to bite us when we move him. very unusual for him. Thought of putting him to sleep, but it just breaks my heart. and I cannot afford a vet. any ideas. could he be paralysed and not feeling anything. His bowel movements are regular now that he’s eating soft foods, he urinates. he will yelp for us when we first come in, but other than that pretty quite and sleeps. I’ve left a camcorder on him for hours to make sure.. nothing, no movement, just sleeping like he always did. so puzzled.

  44. Muriwca on December 9, 2011 at 10:26 am

    We are so confused and torned apart. Our 13 year old yellow lab has lymphoma. We are giving him half a tablet of pridnosone everyday and 2 Lukeran (2mg) every second day. He still enjoys very slow walks in the woods, but mostly, he just lies there. He no longer can go up the stairs which means he spends a considerable amount of time alone. He has lost a lot of weight, has problems getting off the floor but maintains a reasonable appetite due to the pridnosone.
    We are assuming either he has degeneration of the spine or the cancer is in his bones We don’t want to submit him to more tests as this would be stressfull.
    How do we know if he is in pain? How do we know it’s time to let him go.
    We just don’t know what to do.


  45. Jennifer on December 8, 2011 at 10:06 am

    My Zoey is a Boxer and was just diagnosed with Lymphocarsonoma. Her lymphnodes by her neck were so swollen on both sides. I kind of figured that was what it was when I found the lumps. The specialist we took her to said it is in other parts of her body. According to what I have researched and read online I have decided it best not to proceed with the chemo. I have contacted the specialist to ask them a question and they just want me to come in for another appt. We are a one income family right now because I’m in school and they know this. We have spent alot of money lately on her and would gladly continue to do so if it meant we would have several years with her (she is only 5). He has not told me how long she may have, what to expect, etc. He did give her a shot for chemo and prednisone until we decided what we were going to do. I want to put her down before she starts to suffer but don’t want to do it to early. She is still eating and drinking but has lost weight. She still plays with our other boxer, Maggie, once in a while. She does shake like she is scared once in a while and last night she started panting and then stopped. She is still having bowl movements and has frequent urination. She has stopped vomiting since being put on the on the prednisone. She was laing on the floor and urination without even realizing it yet again. I thought it had stopped. Does this mean she is near the end? SHe was just diagnosed last week.
    Thank you

    • Dr. Demian Dressler on December 10, 2011 at 5:42 pm

      Dear Jennifer,
      just to reiterate the facts, this cancer is one of the best responders to chemotherapy, with about 80-85% of dogs getting better and living for a median survival of 12-14 months. I hope you have gathered this information and that you are clear on this data since online information is not always reliable (sort of funny I am writing this here online..)
      I do not believe that urination on the floor nor the signs you mentioned means she is near the end right now. It is probably caused by the prednisolone. Please discuss this with your vet and have the urine checked at the minimum.
      Also don’t forget about diet, apoptogens, immune support, and the other steps you should be taking with your dog’s cancer in the Guide. Don’t give Apocaps on same day as high dose prednisolone (again, have veterinary supervision).
      A post that may help: https://www.dogcancerblog.com/blog/life-quality-in-dog-cancer-dr-dresslers-joys-of-life-scale/
      All my best
      Dr D

  46. lyndsy on November 29, 2011 at 11:35 pm

    hi there, my dog Cassie had a op in March this year to remove a Cancer lump whiles she was under they did an xray of her lung which showed a small dark shadow. yap lung cancer, over last 7 weeks she has been couging alot, so 3 weeks ago i took her to my vet, they said its the cancer getting worse, she looked so sad, i was in tears, i just cant see her looking sad, so vet gave me antibiotics, said there might be an infection, and the antibiotics would act as a pick me up, they work for the first 2 weeks, now im back to where we where 3 weeks ago, Cassie over the last week, as been having mishaps in the house, and we take her out alot, her eyes have alot off sleep in them, and are very weepy, and i have noticed in this last week her back legs are not as steady, can i ask, im i thinking right, is it time that i made the hardest choice im ever gonna made, or am i jumping the gun, i just cant see her suffer plz i need some advice 🙁

  47. Therese on November 6, 2011 at 2:35 pm

    Dear Dr Dressler,
    Our precious Maja, a labx and foxy x was diagnosed with Lymphoma on Friday…I was sort of prepared for the bad news, but putting her down is not happening right now as she is still walking, eating, wagging her tail, cuddeling with me etc etc, so I think for the time being she needs to spend her last few months with us being spoilt rotten! I am concerned though as she doesnt show pain….she did show pain when her lump on her neck was large, but after putting her on chlorella her lump on her neck reduced in size….anways i am trying to make her feel as comfy as possible….hard to do when she doesnt tell me if anything hurts! She lies down alot, she doesnt have lots of energy…but can manage a short walk. I looked at those Acocaps, but they are not available in NZ I dont think. Which sux as that may have increased her chances slightly, although she does have the worst type of Lymphoma so i guess nothing can cure that.

  48. Shashanca on October 26, 2011 at 10:34 pm

    Hello I have a Pug,she is my world! Her name is Pixi she is about 15years of age she is a very liveley dog but at the moment I have some concerns.Last year I took her to the vet because their was a huge ball like thing growing on her stomach.The vet had told me it is a tumor but for me to remove it she may not survive the surgery due to her old age cause of anethstetic. So I left it but now a year later she has these tumors grown all over her body now,on her tail,big one on her foot,and three small ones on her sides.Now the thing is that she seems so fine.She is still the same pugy but a few things have changed the past few months. She has a cough the whole time as if she has a fur ball stuck in her throat,her eyes have become red and looks so different,she has lost some weight,she sometimes goes into a deep sleep that she looks dead I have to now and again shake her to wake her.This week in the mornings she vomits a little but it looks like white foamish sort and she seems to be weak.
    During the day she looks ok but in the mornings not so good.She drinks a lot of water lately too.Another thing she shouts for my attention like shouts,it’s actually so funny because she is still her silly self.I notice as well that when she sleeps,she breaths heavily and moans slightly. She doesn’t cry of pain. Am I in complete denial because I love her so and don’t want to face the truth,is my babe at her last days,how do I know if she is suffering,Please help,what should I do?

  49. Kim on October 14, 2011 at 7:29 am

    Dear Dr. Dressler, My 6 yr old Sheltie was diagnosed with Lymphoma on 9/6/11 with lumps on her belly and a small one on her hind leg. She started Prednisone that day. It is now 10/14/11 At first she was just panting from the medication and now her breathing sounds are very loud. Sometimes she has a hacking cough but it goes away. The vet had to add Pepcid AC because she stopped eating. She is eating and drinking good but seems to have trouble swallowing. She now follows me everywhere and is very clingy. She can not seem to get comfortable to sleep and no longer sleeps in her bed. She seems depressed. The lymph nodes did shrink for awhile but now are back big like the day she was diagnosed. I don’t know when it is time to put her to sleep. I don’t want her to suffer and to me it seems like her quality of life is poor. Even though she still is active and wants to go for walks it is hard because the collar presses on the lymph nodes. This is very hard on me because I love her and it will be hard to say good bye. The vet gave her 60 days to live without chemo. Any advice would be appreciated as it is breaking our hearts. Thank You.

  50. Kim Shimmin on September 7, 2011 at 4:55 pm

    Our Doberman of 13 yrs has been diagnosed with osteosarcoma this week, usual symotoms of limp thought arthritis but not to be. WE have not gone down the amputation track as she is old and would have recovery issues. Question is at dau 3 she seems OK on the tramadol meds, but we gather this will be a day to day evaluation whilst we don’t what her to suffer any pain I am selfish enough to want to have her as long as possable, were do I draw the line. Hard to thing how it will be without her by my side.

  51. susie drake on September 7, 2011 at 12:33 pm

    I am thinking about putting my basset hound Rosco down. He is 10 years old. He has had valley fever for 6 years on and off medication. Now he has cancer. It is very hard to look at him and not cry. He stopped barking the other day. His neck is swollen. It is very hard for me and my 2 children. I just don’t want him to be in pain.

    • DemianDressler on September 13, 2011 at 8:47 pm

      Dear Susie,
      I am very sorry to hear this news. You may want to check out this blog post (click here). The Guide also has a very useful section on end of life decisions if you would like more information that can help you, as well as some steps that you can take that may be manageable for you to help Rosco’s life quality.
      I hope this helps

  52. jenniferkayy on August 20, 2011 at 8:05 pm

    My dog is a 11 year old border collie with what we think are hip dysplasia and fat tumors. There are only three visible tumors currently. We are wondering if he if sick cause he seems to he huffing? Or sobbing, some sort of exasperated sounding noise and we are wondering if something is wrong. Help?

    • DemianDressler on August 24, 2011 at 6:24 pm

      Dear Jennifer,
      I am sorry I cannot diagnose this problem online. Please bring your dog to the veterinarian as soon as possible.
      Dr D

  53. sreedharan on August 11, 2011 at 12:05 am

    This is a very informative article by you on diagnosing pain. My 5 year old male black labrador has been going out for walks- 5 times a day,with the early morning and late evening walks of the longest duration- and distance- 35 mins average- 2 tio 2 1/2 kilometres. Whenever he gets back he starts panting heavily. This has been happening for the last one year. Got all his blood tests done- including thyroid hormones etc and the c-rp tests for infalamation. All are normal. After 20-30 minutes of panting he stops and becomes normal. Since w elive in India- a rather warm climate in Delhi in summers- the vet says he will pant-and since he is black he will absorb more heat and will have to release it. However I feel he may be developing some strain and may be in pain. Is there a preventive supplement for this? What about the famous- DOG GONE PAIN- supplement from AUSTRALIA- IS THAT GOOD. cAN RELEIVING HIM OF HIS PAIN HELP IN REDUCING THE PANTING?

  54. Swisher on July 25, 2011 at 7:47 am

    My pitbull 9 mo old puppy was a very rambunctious, energetic and playful dog. He loved to play aggressively. We went on a week vacation so had a friend take care of him. My friend has several other dogs but kept him in the kennel most of the time. I know my friend and highly doubt any physical issue took place. When we came back, he will cry like hes in severe pain just by LIGHTLY touching him. Sometimes he just cries out of the blue when nobody is touching him. He acts downtrodden and sad. This is SOOO different than how he was just a week ago? What is wrong with him? Please help!

  55. connie barrett on April 8, 2011 at 6:08 am

    oops–the medicine she was taking for 10 months is acetazolamide

  56. connie barrett on April 8, 2011 at 6:07 am

    Hello, I have an unusual problem with my dog. She is a mix of many breeds and weighs 15 pounds. Last June, she collapsed and was diagnosed with encephalitis. She had a tomography and I saw the water in the middle of her brain. She was put on amozolide and mostly recovered from the disease although she has no sense of direction and doesn’t always walk in a straight line. She had a second tomography 3 months later and the brain looked the same. I still don’t understand that since she is mostly fine and was unable to do anything. 4 months ago a new vet said she had kidney disease and that a human with equivalent readings would be put on dialysis immediately. Now it gets worse. I looked up the medication and it turns out that it should not be given to dogs with kidney problems so I have been making it worse. I stopped the medicine but don’t know what to do now. We are living in Ecuador and I don’t have access to the same quality of veterinary care–3 vets saw her medication including 2 after the kidney diagnosis and none told me to stop the medicine. Incredibly–3 months shy of her 17th birthday–she eats, drinks and eliminates from both ends every day. What should I do? Thanks for any help you can offer.

  57. Keith Rowley on February 1, 2011 at 9:50 pm

    Thanks for this Dr. We lost one of our dear Rotties a year ago to unspecified microbial disease and now the other has osteosarcoma. He is nine years old and has been our daily companion and friend for the whole of that time, I’m afraid I’m getting rather tearful at my desk as I write this, and i’ve cried a good deal less of over the death of human family members. A friend of mine once said ‘dogs love you unconditionally,’ and never was a truer word spoken. Our Mephisto is on pain medication now. We decided against chemo-therapy and amputation as we know he would hate every minute and we would probably extendthe duration of his life but damage the quality. The pain guide you provide here is a useful guide.
    Aren’t dogs amazing? They teach us so much about love and loyalty and give so much in exchange for so little. And he enjoyed his walk in the park today – so just a little longer…

    • DemianDressler on March 8, 2011 at 9:43 pm

      Dear Keith
      sending you my best during this challenging time. Thinking of you,
      Dr D

  58. carson mccabe on September 27, 2010 at 9:43 am

    i forgot, charlie follows me EVERYWHERE and this was never the case before.

  59. carson mccabe on September 27, 2010 at 9:41 am

    I have a mixed breed that has bone, and now lung cancer. she walks around with her tail between her legs, she licks her bum and shakes when hasn’t been given meds on time and also pants. she’s on tramadol and gabepentin (sp). the bone cancer has caused her gate to become quite slow and laborious. at this point she can still go up/down stairs but obviously would prefer not too. i just hate to put her down if there is any hope at all. my vet says there isn’t but i was also told in dec. of ’09 that she wouldn’t live more that 3-6 mos and it’s been 9 months. please help!

    • DemianDressler on September 29, 2010 at 8:10 pm

      Dear Carson,
      What steps are being taken aside from the pain meds? Apocaps? Other supplements? Diet? Have you had a chance to read the Guide? Cancer medicine has many different tools that I hope you are able to use for your dog to increase life expectancy and life quality. It was for this exact reason that the Guide was written. The answer to your question literally filled a book. Although it takes a few days of reading, it will be well worth your while to arm yourself with this information to help your dog. By the way, I think this post will also help you with life quality analysis.

  60. Kevin on June 22, 2010 at 12:16 pm

    I purchased Dodger for my family on June 7, 2000. Dodger was a beautiful Welsh Pembroke Corgi who was the most caring dog I was ever around. Dodger ran around our back yard and often followed the neighbor’s horses even though he couldn’t navigate the fence. Dodger was social and loved to greet anyone who rang the door bell. Three weeks ago I took Dodger for his evening walk and noticed that he bumped into the car when we exited garage. The next day I took him to the vet and learned my Dodgi was completely blind. X-rays also showed two growths on his bladder and the Vet also told me that there was blood in his urine sample. The Vet told me to prepare for the worst and said Dodger could survive one day or one month. He prescribed pain medication and I took Dodger home. Dodger appeared fine for the first week. Although blind he ate well but couldn’t climb the deck stairs any longer. I couldn’t sleep for days and realized the puppy who sat on my lap when I brought him home from the pet store 10 years earlier was saying good by in his own way. Dodger would cuddle near my desk or attempt to follow me throughout the house but on Sunday, June 13, he was in so much pain. My son gave Dodger his medication and a few hours later he needed more just to move inches. That evening my kids who are home from college and my wife said good by to our beloved Dodgi and at 9:20 A.M. on June 14, my Dodgi rested on my lap as the Vet administered a shot. My youngest daughter who is entering her second year of college came with me but my wife and two other children could not. I knew this would be hard but never envisioned not hearing Dodgi bark when I left for my office or turn circles when I came home would leave me with a void that is difficult to explain. Thank you for allowing me to tell you about a my beautiful Corgi who we lovingly called Dodgi.

  61. Anne on February 24, 2010 at 8:02 am

    I am a young woman who has had both parents leave and the one thing i could not let go were my two dogs. one of them (lucky) has had a tumor that has grown so large we made a brace for it. i am concerned because i just took her to the vet for the first time in a while and they said she can get surgery but will eed xrays first to see if it is even worth it. unfortuantely the surgery is something i am unable to afford so my options are to let her live out a natural death and hope for the best or put her down. I cant imagine doing it and it brings tears to my eyes even thinking about it. I have been trying to look for signs of pain but she eats alot and drinks alot and with her brace on she is able to run a few feet. when the brace is off she licks the tumor alot, she pants quite a bit and is always rubbing herself accross the ground.
    im basically curious what the best advice would be. i have grown up with her and cant imagine putting her down but i dont know if im being selfish. everyday i would ask myself if i did the right thing and i just dont know when the times is really right. if anyone can help it would be amazing.

    thanks, anne

  62. Jeanine on February 10, 2010 at 7:14 pm

    Dear Dr Dressler,

    Thank you for answering my post and pointing me in the right direction.

    After reading the “joys of life scale” and some of the blogs related to it, I was able to think more clearly. I called the vet early Monday afternoon and had them come to our home late in the day. Tara was euthanized in our living room, on her own bed, with her family gathered round, at 5:00 pm on Feb 8, 2010. She looked so beautiful and so peaceful, for the first time in weeks and weeks.

    We were probably a week too late in doing this but at least we didn’t take any longer, thanks to you and the people who post on here. My thanks to all of you.

    She is missed terribly, our house feels empty and very quiet now without her, but I know it was the right thing to do.

    I have one more question for you; How long will Ace (Tara’s son) grieve for her? He is laying curled up right now, on the very spot she was laying in until our vets came to the door on Monday. My heart aches even more when I see him laying there and when he looks back for her every time I send him out to go potty. Seven years old and he never spent a day in his life without her.


    • Dr. Dressler on February 15, 2010 at 8:34 pm

      Dear Jeanine,
      It sounds like you made a very good, kind and compassionate choice. As hard as it was, you must feel this!
      Ace’s mourning is difficult to predict. These beings are all different, as are we.
      If it continues for a long time, a new canine family member might help, with your permission, of course, at some point in the future.
      Dr D

  63. Jeanine on February 6, 2010 at 8:44 pm

    Hello, I just found this site a few minutes ago. I was looking up how to tell if a dog is in pain because my 9 year old border collie has (probably) lung cancer. She got pneumonia last June 0f 2009 and was on antibiotics and lasix (sp)for about 2 weeks. Unfortunately, we didn’t have a follow-up x-ray done afterwards because we were tight on money.

    Throughout the rest of the summer and into fall, I kept feeling that she wasn’t fully recovered. She kept her tail tucked a good deal of time, but no other signs. Then in October our other border collie broke his elbow; a compound fracture that required 2 surgeries. That made things more than just “tight” for us.

    It took until Christmas for things to get back to normal. That’s when I noticed Tara (the female 9 y/o bc) was getting very picky with her food. Then came the dry cough again and her tucking her tail more and more. We finally took her to the vet on January 11th and had a chest x-ray done and blood work. Very high white blood cell count and numerous fibrous looking things in her lungs. She was also lame on her left hind foot and had a fever.
    The vet said it was either primary lung cancer, or possibly Blastomycosis. We had a urine test done for the blasto and it came back negative. She was put on Baytril and lasix, with a re-visit 2 weeks later.

    He took another x-ray on January 25th and her lungs were 3-4 times worse! We were told that unless we did a lung biopsy or that bronco-lavage wash to confirm what type of cancer it is, there would be nothing they could do other than continue lasix and keep her comfortable.

    We didn’t do either of those things because just with the few things I stated above, our vet bill is 627.00. The surgeries for Ace’s elbow cost us 6700.00!! We’ll be paying that one for the next 5 years! But what else could we do? How could we put a 6 year old dog down because of a broken elbow?!

    Anyway, sorry I got off the subject there. My main concern is that Tara does not suffer. Monday will be another 2 weeks since the 2nd x-ray. Sometimes she seems worse and sometimes she gives us glimmers of hope. Mostly, she is only eating enough to not starve to death. Maybe 3 tablespoons of rice and 4 bites of chicken for breakfast and dinner. She refuses any and all kinds of dog food now. She lays on her side alot, is very quiet, stares at me alot, wants to be petted alot. Her respirations are about 45 per minute, she sounds congested when she breathes sometimes, yet she is not coughing as much anymore. She changes positions several times if she’s not laying on her side, and is kind of just laying on her haunches with her head slightly off the floor over her front paws. She’s probably lost close to 10 pounds by now. Her collar looks like it was borrowed from a Mastiff!

    I need some help with deciphering these signs and knowing when enough is enough. I could send you the 2 x-rays if you would like. I just don’t want to put her down if it’s a fungus and there’s still time to save her! Not knowing for certain that it’s cancer, is really making this whole thing much more heart breaking.

    Please help! (Sorry for this being such a long post!)

    Thank you in advance,

    Jeanine Collins

  64. lovewrinkles on January 27, 2010 at 1:51 pm

    My dog had cancer(mct), yes. We went twice a week to the vet. Was treated with Masivet (kinavet), lomustine and vinblastine.

    Even on pain mediation (tramadol) he remained restless and most of the time his eyes open…….
    There were no signs of pain, but these worried open eyes made us suspect that he maybe was in pain????

    • Dr. Dressler on January 31, 2010 at 3:27 pm

      Dear Reader,
      I am not sure. Perhaps not pain, but I wonder whether there was some discomfort of some kind going on? Perhaps acid stomach, or excess histamine from the mast cells? Both of these could explain a vague discomfort, or perhaps it was due to something else entirely. Certainly famotidine (antacid), misoprostel (helps with the intestine), and benadryl (antihistamine) would be easy enough to try out if they were not part of the protocol.
      Hope that helps,
      Dr D

  65. lovewrinkles on January 19, 2010 at 1:46 pm

    My dog wasn’t sleeping anymore, most of the time. Laying with his eyes open! However he was still eating, walking outside, making his welkom dance when I came home. But even when he was sleeping (and snoring) mostly his eyes were open.
    He was also a bit restless, looked worried…..
    Are these also signs of pain?

    • Dr. Dressler on January 22, 2010 at 10:14 pm

      Dear Reader,
      we need more info here. Does your dog have cancer?
      Is there swelling of the eyeballs (glaucoma or some other problem causing protrusion)? Have you taken your dog to the vet?
      If not, get a vet’s input as there may be things going on that you are not yet aware of..we need more information for your dog.
      Dr D

  66. deborah jackson on September 1, 2009 at 6:09 pm

    i am sorry for my wrong spelling of words

  67. deborah jackson on September 1, 2009 at 6:07 pm

    O lsot my dog blue 8 years old to cancer august 279th. She had a tumor removed last november, she was okay until this month when her leg swollen. and she was always in the closet and would not greet me anymore, or just sit in the same spot and would sit sit and look I think she was letting me know its time. I took her to the vet and he said it might have spreaded and may need to be put to sleep. It turned out it was spreaded but my vet who had known my dog cremated her for free that I thak him so much for his support for me and my husband. i will miss him derly, it seems like I just cant get over this. time will heal

  68. diana on August 20, 2009 at 2:47 am

    i lost my dog tazz to cancer above the eye and then a short time he was blind then we had to put him down

  69. james carrell on August 14, 2009 at 5:29 am

    I feel for all of you, it is so hard to lose a baby,,,especially from something like “cancer”

    i am writing this in hopes of broadening everyone’s horizons.
    I can not promote this way of medicine enough,,,
    HOMEOPATHIC MEDICINE,,,,,this stuff is amazing!!!!!!!!!!!!!!!
    We lost our baby back in april,,,not from the “cancer”
    but rather, her stomach [IBD] another AUTO-IMMUNE disease, caused her too many issues.
    There are NO side-effects of HOMEOPATHY,,,,only HEALING-EPISODES.
    So if a CONVENTIONAL VET says chemo/radiation,,,,or even there’s nothing they can do,,,,,,,PLEASE,,,,look at HOMEOPATHY!!!!!!!!!

    we lost our baby, but she was NOT in pain!!!!!!!!!

  70. Jo Anne on August 6, 2009 at 6:28 am

    We just lost our wonderful Jazzie on July 22 due to hemangiosarcoma diagnosed in May. I purchased the book Dr dressler wrote and it was so helpful getting through this difficult time. I did all the things in his book BeyondSugery, Radiation and Chemo and so Jazzie had a great last couple of months. I considered chemo but after reading about hemangiosarcome, I believed it was best for him that he had a good quality of life. We all miss Jazzie. I am using some of the things i learned in the book to work with dogs who have been given to a sanctuary who had once been used in research. The dogs love the massages!

  71. Dr. Dressler on August 5, 2009 at 2:20 pm

    I am sorry to hear this sad news. I am thinking of you during your sad days. May you always be comforted by memories of your time together with your Corgi.
    Dr D

  72. Dr. Dressler on August 5, 2009 at 2:17 pm


    take comfort knowing you did all you could, and that your Pheobe shared a great life with you during her journey here.

    May your sadness during this time of departure be replaced by memories of the love you shared,

    With sympathy,
    Dr D

  73. Dr. Dressler on August 5, 2009 at 2:15 pm

    Apocaps may be a revolutionary step in helping dogs. These capsules are a novel way of helping the body turn on genes that allow deranged cells to be recycled into healthy, normal, young cells.

    If you would like more information, go to http://www.apocaps.com, and fill out the information request sheet.

    Dr D

  74. PATTY on August 5, 2009 at 7:57 am

    What is Apocap? I had two dogs die from cancer and we used the K9 but I have never heard of Apocap. Could you please let me kno what it is. Thanks.

  75. Aubrey on August 4, 2009 at 4:59 pm

    Thanks for the reassurance, I lost my Pheobe (a Rat terrier mix) on 8-1-09. She had been diagnosed with a hemangiosarcoma on her Spleen on Christmas Eve 2008, and had it removed New Years Eve the following week. During the operation the Veterinarian had found the Cancer had spread to all of the adjacent organs except the G.I. Tract. She was given a week to a month to live. She was quite a fighter and with the help of K9 Immunity (Feb-June) and Apocaps The last three weeks of July she survived 7 months after the operation. Perhaps if the Apocaps had come out sooner mabey she could have survived longer or been cured. Her Tumor had begun a rapid growth right before she started taking the Apocaps (July 12 2009). (It was about 10 pounds half her weight). She stopped regular eating about 3 days before the Apocaps arrived. July 29 2009 she started eating normal again, but the tumor had grown so much that she was having trouble breathing. I believe the tumor ruptured somtime during the night of July 31 2009. She would not lay down or sleep (Pheobe slept in our bed with us since birth), in the moring her tongue was pale, and she was hesitant to walk. She took her Apocap that morning but we brought her to her Vet for an evaluation to confirm her condition. It was the so hard to let her go after trying for so long to help her get better. Thankfully I have no regrets, because she’s been spoiled rotten. I will never get over her, but knowing she is no longer suffering must become my consolence. I am now the one in pain for her loss, but with time hopfully only the happy times will haunt my memories.

  76. margaret on August 4, 2009 at 3:52 pm

    Dear Sue, I’m so sorry for your loss. I know how hard it is having been in your position. I’ll keep you in my thoughts. margaret and the shih tzu boys.

  77. Sue Johnson on August 4, 2009 at 9:07 am

    Thank you so much for your comments regarding how to detect pain in dogs. I had to put my 11 year old Welsh Corgi down last night due to all that you have described. It was probably the hardest thing I ever had to do and I have lost many loved people that I knew, including my husband, to hardship and death but none who loved or was more loyal to me or I loved more. I appreciate all of your help and comments thoughout his illness. You are truly a caring Dr. and person. Please keep up the good work for others who need you. Sue

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