I recently got startled while I was already in pain, and—OUCH! It was shocking. Since Lewis startles a lot from noises and shows signs of being in pain or discomfort, I wondered if that also happens to him.
Here are the two incidents that keep running through my mind.
When Lewis Got Startled
Journal Entry
January 28, 2025, four weeks after Lewis’ onset of clinical noise phobia
In the afternoon, there were roofers working down the street at Daisy’s house, so I skipped Lewis’ walk and played with him in the yard instead. He had a pretty good time.
Tonight while Lewis was sitting on the couch, I went and looked at the sealed box of garden spikes that I had put on the coffee table. It’s practically a cube, and I wasn’t sure which was the top. I decided not to open it, but I switched its orientation. Presumably the spikes made some noise when I did that, but I didn’t notice a response from Lewis.
I walked away and left the box there, and a few seconds later, the spikes settled and made a soft “clink” sound and the box also made a small thump. It startled and scared Lewis horribly. It happened again a few seconds later.
He was trembling and slinking around. He wouldn’t eat kibble. I got out the roast pork, and he was able to eat. I invited him to sit on the couch with me, but he couldn’t/wouldn’t/didn’t wanta. After a while he went to lie down in the big crate. It took an hour before he appeared mostly OK again.
Commentary
Lewis likely experienced the acoustic startle response, when an audible stimulus causes muscles to tighten reflexively and prepare the body for fight or flight. It is known that it can cause fear conditioning of the stimulus. But also, the response itself could have hurt. We don’t know for sure. But if he was already in pain, it probably exacerbated it.
As a result of this event, he acquired a fear of clinking noises that generalized to the sight of cardboard boxes (Götz, T., & Janik, 2011).
I got the noisy stakes out of the house. But for months, Lewis stayed wary of boxes of any size, especially if they were on the coffee table or even just in that room. He kept an eye on me if I carried one through the house. I didn’t try to counter condition it other than tossing treats when I unavoidably had a box; we had more important things to work on. The box fear reduced over about six months as some daily meds started to help.
At the time of writing this, about 18 months later, Lewis is no longer leery of boxes. And when I clink a garden spike outdoors, he may look over, but doesn’t show concern beyond that.
When Eileen Got Startled
Last week, I tore a muscle in my back badly enough that I couldn’t stand up straight. It was one of the more painful injuries of my life. I couldn’t walk normally at all for several days, and in the mornings, I was so humped over that I had to cruise along hanging onto furniture like a toddler. The abnormality of my gait then caused bursitis to flare up in my hip. Good times! I took medications that enabled me to function somewhat until I could see my doctor, then got steroids. (Which is why I’m up very late at night writing this!)
About two days into this episode, I walked by the coffee table in the den. Yes, the same coffee table that had supported the evil box. I bumped my calf into the table, so lightly that it didn’t even hurt. But the bump was an unexpected stimulus. My threshold for startle was abnormally low, my balance was poor, and I instantly tensed up all over. YIKES! A shock went through the already-sore muscles in my back and I yelped.
My human cognition allowed me to know that the coffee table was not out to get me, so I didn’t develop a fear of it. But I did experience fear in the moment, both from the pain and because my body knew that falling in my current state would be Really Bad. I felt the adrenaline rush as I stood there afterward. And my future behavior changed due to the bump. I was already being careful about how I moved; now I had to widen my awareness to avoid even lightly bumping into something. I learned to avoid the coffee table.
I quickly thought of Lewis’ response to noises. If he experienced pain as well as fear, he would have a reason to believe that whatever made the noise was what hurt him.
Fear Conditioning and Pain
Pain and fear have been shown to be closely related in many animals, including dogs. I think it’s well enough accepted that I don’t need to do a lit review, but I’ve included some resources below. Also, the startle response has been shown to condition fear and “avoidance of the source of danger” (Götz & Janik, 2011, p.8). That’s exactly what happened to Lewis—and to me.
Instead of covering the literature, I’m focusing on my personal experience that is in keeping with what the science suggests. I learned that tensing up from a startle exacerbated my existing pain to the extreme. I’m sure my friends with chronic pain have experienced it, as well. And I’m thinking about the possibility of that happening to Lewis and so many dogs with sound phobias. While I didn’t develop a coffee table phobia, the avoidance behaviors tumbled directly in.
When I originally wrote about Lewis’ sound phobia, I wrote that “two vets had checked him out for pain.” I have since learned that palpation and manipulation are not validated diagnostic methods, and we are still working on getting to the bottom of what is happening with Lewis. X-rays were clear; more imaging is coming up.
Currently he is on meds for both phobias and pain. His fearful behaviors have decreased, and there are behavioral indications (gait and posture) that he is in less discomfort. I hope to write more about his situation when we know more. In the meantime, thank you to Greta Kaplan, Kate Woods, Judith Anne, and Anna Lee Sanders for their empathy and for helping me navigate this situation.
And even though it caused pain, I’m grateful for my bump against the coffee table for teaching me about something that Lewis probably already knows.
Limitations
Check out this linked document to read about some of the assumptions that underlie my comparison of Lewis’ and my startle experiences.
Copyright 2026 Eileen Anderson
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References and Resources
Götz, T., & Janik, V. M. (2011). Repeated elicitation of the acoustic startle reflex leads to sensitisation in subsequent avoidance behaviour and induces fear conditioning. BMC neuroscience, 12(1), 30.
Gruen, M. E., Lascelles, B. D. X., Colleran, E., Gottlieb, A., Johnson, J., Lotsikas, P., … & Wright, B. (2022). 2022 AAHA pain management guidelines for dogs and cats. Journal of the American Animal Hospital Association, 58(2), 55-76.
Lopes Fagundes, A. L., Hewison, L., McPeake, K. J., Zulch, H., & Mills, D. S. (2018). Noise sensitivities in dogs: an exploration of signs in dogs with and without musculoskeletal pain using qualitative content analysis. Frontiers in Veterinary Science, 5, 17. [Note from Eileen: This paper does not provide evidence of a correlation between pain and noise sensitivities, although that is not disputed. The subjects for the study were pre-selected to have sound phobia either with identified pain or without. The researchers found that the dogs with pain responded well to treatment for phobia after the pain was ameliorated.]
Malkani, R., Paramasivam, S., & Wolfensohn, S. (2024). How does chronic pain impact the lives of dogs: an investigation of factors that are associated with pain using the Animal Welfare Assessment Grid. Frontiers in veterinary science, 11, 1374858.
Mills, D. S., Demontigny-Bédard, I., Gruen, M., Klinck, M. P., McPeake, K. J., Barcelos, A. M., … & Levine, E. (2020). Pain and problem behavior in cats and dogs. Animals, 10(2), 318.
Zheng, A., & Schmid, S. (2023). A review of the neural basis underlying the acoustic startle response with a focus on recent developments in mammals. Neuroscience & Biobehavioral Reviews, 148, 105129.
Link to the literature on the acoustic startle response or reflex for the person who told me I made it up.
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