Do the Pain Med Trial.
And then keep going until you have real answers.
I am going to say something that might ruffle some feathers, and I genuinely do not care.
Do the pain med trial.
I have a dog in my program right now. She came to me for biting people in the house when being touched. Which, yes, is a serious behavior. But before we do anything else, we do the right thing: we rule out pain first. So we sent her to the vet for a full workup. X-rays. The whole thing.
Hip dysplasia confirmed.
And the vet cleared her.
"She is not limping. The hip dysplasia does not seem to be bothering her."
She is biting when touched. She is crying out during normal activity. She cannot settle. She is escalating.
I am not a vet. I want to be really clear about that. But I have been doing this long enough to know that not limping does not mean not hurting. Stoicism is a survival mechanism. Dogs are wired to mask pain. That is not a green light. That is a dog doing exactly what dogs do when their body hurts and nobody is listening.
Not limping does not mean not hurting.
Here is the thing I keep coming back to. I wrote about this a few months ago when my own back was out, and I noticed how much shorter I was with my dogs. How sounds that never bothered me suddenly did. How Rumor's normal snuggling felt impossible. My behavior changed because my capacity changed. Pain does that. To all of us.
Research out of the Autonomous University of Barcelona found a direct link between pain and aggression in dogs. The most common cause? Hip dysplasia. Dogs with no previous history of aggression who developed pain became more impulsive, bit more frequently when handled, and were more likely to assume a defensive posture than dogs who had shown aggression before. Their owners were often completely blindsided because nothing in that dog's history prepared them for it.
Sound familiar?
When a dog is in pain, the brain shifts into survival mode. The pathways that normally handle sensory input, coordination, and emotional regulation get taken over by pain signals. You cannot train your way around that. Behavior modification does not fix a body that hurts. The downside of trying a pain med trial is minimal. The downside of not trying is a dog who keeps suffering while everyone looks for answers in the wrong place.
About 80% of my cases have a medical component. That was not something I set out to specialize in. It just kept showing up, case after case, until I could not ignore it anymore. And now I feel a responsibility to say something when I see it being missed.
So I am genuinely asking, not coming for anyone: what is the hesitation? What do you actually lose? A few weeks and the cost of the medication. What do you lose by not doing one? A dog who keeps getting labeled a behavior problem while her body is quietly screaming that something hurts.
She is telling us. In the clearest way she knows how.
And sometimes, even after you do the pain med trial, you keep going. Because the answer is not always straightforward. And the owners who refuse to stop asking questions are the ones who actually get there.
I want to tell you about a dog I have known for a few years now. He has been reactive since adolescence. When I first met him, something about the way he moved felt off. I could not name it exactly. But something was not right.
So we did what you do. Private sessions, group classes, protocol after protocol. Relaxation work, pattern games, management, modification. And nothing was sticking. Not in the way it should have. Not in the way it would for a dog whose body was working with him instead of against him.
At some point, when nothing makes sense, you have to be honest.
I sat down with his owners and said: I know I have mentioned this before, but I really think there is more happening here. We need to get him to a vet. X-rays at minimum. Possibly a referral.
They listened. They always listened. That matters more than I can say.
The vet referred them to a veterinary behaviorist. They did a pain med trial. They adjusted his anxiety medications. They got X-rays. They sent him to a rehab vet. And then that rehab vet, and the vet before them, essentially said: there is nothing wrong. This is just who he is.
His owners knew that was not true. They live with him. They know him. And they did not stop pushing.
They found a new rehab vet who took the case seriously and confirmed that he should be making more physical progress than he was. Around the same time, I came across an article written by my friend Anthony De Marinis about Tethered Cord Syndrome in dogs. I had been hearing about this condition in the industry and wanted to understand it better. As I read, I kept thinking about this dog. The tendencies described looked a lot like what I had been watching for years.
Again: I am not a vet. But I had a feeling this was the direction we needed to go.
His owner scheduled a neurology consult with a specialist here in Illinois. They did a dynamic MRI.
He was diagnosed with Tethered Cord Syndrome.
And when that diagnosis was sent back to the primary vet, the response was: not possible. Too rare. Doesn't make sense for him.
Except it does make sense for him. Because they did the actual testing. And the testing confirmed it.
He is now on medications to help manage the syndrome and has been making real strides. We have paused formal training, likely permanently, and that is okay. His owners do a beautiful job managing his world and giving him a genuinely full life. They have gone above and beyond for this dog in ways that most people never will.
But it did not come without tears. It did not come without years of frustration. It did not come without being told, repeatedly, by multiple professionals, that their concerns were not valid. That it was not a thing. That this was just their dog. And that is the part I cannot let go of.
This is not just a vet problem. I have watched other trainers dismiss these concerns too. People in this industry who should have known better, who heard a worried owner and decided they were overreacting.
Our clients live with their dogs twenty-four hours a day. When they tell you something is wrong, something is wrong.
Tethered Cord Syndrome is rare. But it is real. And it can cause significant reactivity that is not resolvable through training, no matter how skilled the trainer or how dedicated the owner.
If training is not working the way it should, that is information. If a dog has been struggling since adolescence with no clear explanation, that is information. If an owner keeps telling you something feels wrong, that is information.
Do the pain med trial. And then keep going until you have real answers.
You don't lose anything by trying. You have everything to lose if you don't.
Further reading: Tethered Cord Syndrome in Dogs by Anthony De Marinis. Anthony's article follows his own dog Journey through a years-long diagnostic process and is one of the most thorough accounts of this condition in the dog training world. Worth reading in full.