Acute Onset of Generalized Anxiety Disorder Related to Chronic Orthopedic Pain in a Bernese Mountain Dog: A Case Study

In veterinary medicine, the link between pain and problematic behaviors is gaining widespread recognition. This case study documents a 4.5-year-old male neutered Bernese Mountain Dog with chronic orthopedic disease who experienced significant behavioral deterioration following acute pain exacerbation and highlights the importance of holistic treatment approaches, as well as early intervention in painful medical conditions. The case makes three key contributions: demonstrating the rapid onset of severe anxiety symptoms when pain management becomes inadequate in a previously stable patient; providing a framework for differentiating between primary anxiety and pain-induced behavior changes; and offering a practical model for integrated medical and behavioral management. By illustrating the critical connection between pain and anxiety, in particular how addressing both components is essential for successful case remission, this report provides both evidence and methodology for practitioners seeking to implement comprehensive treatment approaches for behavioral cases with underlying pain components.