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There are a variety of other situations that can complicate the assessment and management of pain in animals.

 Age: young, still‐growing patients have enormous “plasticity” in their CNS, and early painful experiences can elicit permanent alterations embedded in the CNS and can manifest as increased pain sensitivity later in life. Older patients are often beset by chronic inflammatory processes (OA, gingivitis, otitis, dermatitis) which can elicit a neuropathic component, and whose spinal cord is a “smoldering ember” of hypersensitization upon which a subsequent acutely painful event can cause greatly exaggerated pain.

 Obesity: adipose tissue is the body's largest endocrine organ and secretes a witch’s brew of proinflammatory cytokines and mediators that circulate systemically and sensitize nociceptors. In humans, excess abdominal fat will double the risk for a chronic pain condition later in life [7].