Dogs were the first animals to benefit from behavior-based pain scales. The pioneering instrument was the University of Melbourne Scale (UMPS) that assesses pain through physiological and behavioral variables. The University of Glasgow Composite Scale (CMPS) and its short version (CMPS-SF) assesses pain in dogs only through behaviors and there is a specific scale to assess pain after orthopedic surgery (4A-Vet).
Access the topics below to learn about and use the scales.
Short Form of the Glasgow Composite Measure Pain Scale (CMPS-SF) (Reid et al 2007)
University of Glasgow 2008. Licensed to NewMetrica Ltd. Permission granted to reproduce for personal and educational use only. To request any other permissions please contact jacky.reid@newmetrica.com
The Glasgow CMPS-SF presents four assessments:
1) Look at dog in Kennel
2) Put lead on dog and lead out of the kennel
3) Palpation of the painful area
4) Overall
Items correspond to scores ranging from 0 (normality or no change) to 5 (highest possible change).
A. Look at dog in Kennel.
Is the dog?
Score
Videos
(i)
Quiet
0
Crying or whimpering
1
Groaning
2
Screaming
3
(ii)
Ignoring any wound or painful area
0
Looking at wound or painful area
1
Licking wound or painful area
2
Rubbing wound or painful area
3
Chewing wound or painful area
4
In the case of spinal, pelvic or multiple limb fractures, or where assistance is required to aid locomotion do not carry out section B and proceed to C. Please tick if this is the case then proceed to C.
B. Put lead on dog and lead out of the kennel.
Is the dog?
Score
Videos
(iii)
Normal
0
Lame
1
Slow or reluctant
2
Stiff
3
It refuses to move
4
C. If it has a wound or painful area including abdomen, apply gentle pressure 2 inches round the site.
Does it?
Score
Videos
(iv)
Do nothing
0
Look round
1
Flinch
2
Growl or guard area
3
Snap
4
Cry
5
D. Overall.
Is the dog?
Score
Videos
(v)
Happy and content or happy and bouncy
0
Quiet
1
Indifferent or non-responsive to surroundings
2
Nervous or anxious or fearful
3
Depressed or non-responsive to stimulation
4
(vi)
Comfortable
0
Unsettled
1
Restless
2
Hunched or tense
3
Rigid
4
After watching the videos corresponding to all sub-items of each item on the scale, watch the test videos, and analyze and score the behaviors. Then check the responses for each video. You are able to use the scale when your scores are up to 20% higher or lower than the template scores in at least three tests.
The total score ranges from 0 (no pain) to 20 (when locomotion is not accessible) or 24 points (maximum pain). Rescue analgesia is indicated when total scores are ≥ 5 out of 20 or ≥ 6 out of 24.
After reading and training the previous items, click below to assess pain in your animal.
The 4A-VET Pain Scale (Rialland et al 2012)
The 4A-Vet presents six characteristics:
1) Global subjective appreciation
2) General attitude
3) Interactive behavior
4) Gait evaluation
5) Reaction to the surgical wound palpation
6) Intensity of the reaction
Items correspond to scores ranging from 0 (normality or no change) to 3 (highest possible change).
1. Global subjective appreciation
Score
No pain
0
Light to moderate pain
1
Moderate to severe pain
2
Intolerable pain
3
2. General attitude
Among the following clinical signs, how many are present?
Respiratory modification
Moaning
Hunched back
Stays immobile in antalgic posture
Animal agitated or depressed
Appetite decreased
Looks at, gnaws or licks wound
Score
No sign present
0
1 sign only
1
2 to 4 signs present
2
5 and more are present
3
3. Interactive behavior
Score
Animal is alert and responds to voice and touch
0
Responds timidly
1
Does not respond immediately
2
Does not respond or responds with aggressiveness
3
4. Gait evaluation
Score
Normal use of limb
0
Limping but affected limb is used when walking
1
Limb used only at rest
2
No use of limb
3
5. Reaction to the surgical wound palpation
Score
No visible or audible reaction after 4 palpations
0
Visible or audible reaction at the 4th palpation
1
Visible or audible reaction at the 2nd and 3rd palpation
2
Visible or audible reaction at the 1st palpation
3
6. Intensity of the reaction
Score
No response
0
Answers slightly, tries to withdraw itself
1
Turns the head or vocalizes
2
Animal tries to flee or attack or is not assessable
3
TOTAL
18
The total score value ranges from 0 (no pain) to 18 points (maximum pain). There is no defined rescue analgesic point.
After reading and training the previous items, click below to assess pain in your animal.
University of Melbourne Pain Scale (UMPS) – Firth & Haldane (1999)
The UMPS presents six main characteristics, some subdivided into sub-characteristics:
1) Physiological measures (dilation of the pupil, heart and respiratory rate, body temperature, salivation)
2) Reaction to palpation
3) Activity
4) Mental state
5) Posture
6) Vocalization
Items correspond to scores ranging from 0 (normality or no change) to 3 (highest possible change).
The pain scale includes six categories. Each category contains descriptors of various behaviors that are assigned numeric values. The assessor examines the descriptors in each category and decides whether a descriptor approximates the dog´s behavior. If so, the value for that descriptor is added to the patient´s pain score. Certain descriptors are mutually exclusive (eg. a dog cannot be in sternal recumbency and standing up at the same time). These mutually exclusive descriptors are grouped together with the notation “chose only one”. For category 4, mental status, the assessor must have completed a preprocedural assessment of the dog´s dominant/aggressive behavior to establish a baseline score. The mental status score is the absolute difference between preprocedural and postprocedural scores. The minimum possible total pain score is 0 points, the maximum possible total pain score is 27 points.
The examples of behavior referring to each item on the scale do not necessarily correspond to those considered by the authors of the article that developed the scale.
1. Activity (choose one)
Score
Videos
At rest; sleeping
0
Semiconscious
0
Eating
0
Awake
1
Restless (pacing continuously, getting up/down)
2
Rolling, thrashing
3
2. Mental status (choose one)
Score
Videos
Submissive
0
Overly friendly
1
Wary
2
Agressive
3
3. Posture
Score
Videos
a) Guarding or protecting affected area (includes fetal position)
2
b) Choose one
Lateral recumbency
0
Sternal recumbency
1
Sitting or standing, head up
1
Moving
1
Standing, head hanging down
2
Abnormal posture (eg. prayer position, hunched back)
2
4. Vocalization (choose one)
Score
Videos
Not vocalizing
0
Vocalizing when touched
2
Intermittent vocalization
2
Continuous vocalization
3
5. Physiologic data
Score
Videos
a) Physiologic data within reference range
0
b) Dilated pupils
2
c) Percentage increase in heart rate relative to basal (choose one)
> 20%
> 50%
> 100%
1
2
3
d) Percentage increase in respiratory rate to basal (choose one)
> 20%
> 50%
> 100%
1
2
3
e) Rectal temperature exceeds reference range
1
f) Salivation
2
6. Response to palpation (choose one)
Score
Videos
No change from preprocedural behavior
0
Guards/reacts* when touched
2
Guards/reacts* before touched
3
* Includes turning head toward affected area; biting, licking, or scratching the affected area; snapping at the handler; or tense muscles and a protective (guarding) posture. Does not include alert barking.
Firth AM & Haldane SL (1999). Development of a scale to evaluate postoperative pain in dogs. Journal of the American Veterinary Medical Association, 214(5): 651–9.
After watching the videos corresponding to all sub-items of each item on the scale, watch the test videos, and analyze and score the behaviors. Then check the responses for each video. You are able to use the scale when your scores are up to 20% higher or lower than the template scores in at least three tests.
The total score value ranges from 0 (no pain) to 27 points (maximum pain). There is no defined rescue analgesic point. Arbitrarily, analgesia can be performed when the score is > 8.
After reading and training the previous items, click below to assess pain in your animal.
Pain Description
No Pain
Extreme Pain
Rate your dog’s pain:
1. Fill in the oval next to the one number that best describes the pain at its worst in the last 7 days (0 = no pain, 10 = extreme pain)
0 1 2 3 4 5 6 7 8 9 10
2. Fill in the oval next to the one number that best describes the pain at its least in the last 7 days (0 = no pain, 10 = extreme pain)
0 1 2 3 4 5 6 7 8 9 10
3. Fill in the oval next to the one number that best describes the pain at its average in the last 7 days (0 = no pain, 10 = extreme pain)
0 1 2 3 4 5 6 7 8 9 10
4. Fill in the oval next to the one number that best describes the pain as it is right now (0 = no pain, 10 = extreme pain)
0 1 2 3 4 5 6 7 8 9 10
5. Fill in the oval next to the one number that best describes how during the last 7 days pain has interfered with your dog’s GENERAL ACTIVITY (0 = does not interfere, 10 = completely interferes)
0 1 2 3 4 5 6 7 8 9 10
6. Fill in the oval next to the one number that best describes how during the last 7 days pain has interfered with your dog’s ENJOYMENT OF LIFE (0 = does not interfere, 10 = completely interferes)
0 1 2 3 4 5 6 7 8 9 10
7. Fill in the oval next to the one number that best describes how during the last 7 days pain has interfered with your dog’s ABILITY TO RISE TO STANDING FROM LYING DOWN (0 = does not interfere, 10 = completely interferes)
0 1 2 3 4 5 6 7 8 9 10
8. Fill in the oval next to the one number that best describes how during the last 7 days pain has interfered with your dog’s ABILITY TO WALK (0 = does not interfere, 10 = completely interferes)
0 1 2 3 4 5 6 7 8 9 10
9. Fill in the oval next to the one number that best describes how during the last 7 days pain has interfered with your dog’s ABILITY TO RUN (0 = does not interfere, 10 = completely interferes)
0 1 2 3 4 5 6 7 8 9 10
10. Fill in the oval next to the one number that best describes how during the last 7 days pain has interfered with your dog’s ABILITY TO CLIMB STAIRS, CURBS, DOORSTEPS, ETC (0 = does not interfere, 10 = completely interferes)
0 1 2 3 4 5 6 7 8 9 10
11. Fill in the oval next to the one number that best describes your dog’s overall quality of life over the last 7 days
Poor
Fair
Good
Very Good
Excellent
Consider treating pain when total score is ≥30.
Consider treating pain when total score is ≥30.
Click below to assess pain in your animal.
Quality of life in dogs with pain secondary to cancer – Yazbek & Fantoni (2005)
1. How much do you think that the disease is disturbing your dog’s quality of life?
0. ( ) very much
1. ( ) much
2. ( ) a little
3. ( ) not at all
2. Does your dog still do what it likes (eg, play or go for a walk)?
0. ( ) no
1. ( ) rarely
2. ( ) frequently
3. ( ) in a normal way
3. How is your dog’s mood?
0. ( ) totally altered
1. ( ) some episodes of alteration
2. ( ) changed a little bit
3. ( ) normal
4. Does your dog keep its hygienic habits (ie, does your dog clean itself)?
0. ( ) no
1. ( ) rarely
2. ( ) less than before
3. ( ) yes
5. How often do you think that your dog feels pain?
0. ( ) all the time
1. ( ) frequently
2. ( ) rarely
3. ( ) never
6. Does your dog have an appetite?
0. ( ) no
1. ( ) only eats when forced; will eat more of what it likes
2. ( ) little
3. ( ) normal
7. Does your dog get tired easily?
0. ( ) yes, always
1. ( ) frequently
2. ( ) rarely
3. ( ) no
8. How is your dog sleeping?
0. ( ) very badly; not sleeping at all
1. ( ) badly
2. ( ) almost normally
3. ( ) normally
9. How often does your dog vomit?
0. ( ) always
1. ( ) frequently
2. ( ) rarely
3. ( ) never
10. How are the intestines of your dog functioning?
0. ( ) very badly
1. ( ) badly
2. ( ) almost normally
3. ( ) normally
11. Is your dog able to position itself to defecate and urinate?
0. ( ) never positions itself to urinate or defecate
1. ( ) rarely positions itself to urinate or defecate
2. ( ) sometimes positions itself to urinate or defecate
3. ( ) urinates and defecates normally
12. How much attention is your dog giving to the family?
0. ( ) indifferent
1. ( ) little attention
2. ( ) increased attention; the dog is needy
3. ( ) has not changed
Scores are summed to define the quality-of-life score. Total scores may range from 0 to 36.
The mean score for healthy dogs is 34 ± 3 (minimum 27 and maximum 36). The mean score for dogs with cancer is 21 ± 5 (minimum 12 and maximum 29).
Click below to assess pain in your animal.