Glasgow Composite Measure Pain Scale for Dogs: Items, Scoring and the Intervention Score
How to use the Glasgow CMPS-SF in dogs: the six categories, every descriptor and score, the 0 to 24 range, and the 6/24 or 5/20 intervention level.
The Glasgow Composite Measure Pain Scale short form (CMPS-SF) scores acute pain in dogs across six behaviour categories, for a maximum of 24 points, or 20 when mobility cannot be assessed. A total of 6 out of 24 or higher, or 5 out of 20 or higher, is the published point at which the dog should receive more analgesia. The scale is a structured observation that supports, but does not replace, clinical judgement.
Quick Reference
- Six categories: vocalisation, attention to wound, mobility, response to touch, demeanour, posture and activity.
- Maximum score: 24, or 20 if the mobility section is skipped.
- Analgesic intervention level: 6/24 or higher, or 5/20 or higher.
- Validated for acute postoperative pain in dogs, not for chronic pain or cats.
- Use the scale exactly as published. Changing items or the cut-off removes its validity.
What the Glasgow CMPS-SF Is
The Glasgow scale was developed at the University of Glasgow School of Veterinary Medicine. The original long form was built with psychometric methods, the same approach used to build questionnaires in human medicine. The short form was published in 2007 by Reid and colleagues so that the tool would be fast enough for routine clinical use.
The short form was tested in 122 dogs receiving postoperative care at three veterinary schools: Glasgow, University College Dublin and North Carolina State University. Veterinarians scored each dog and then answered one question: does this dog need analgesia? Dogs judged to need analgesia had a median score of 7. Dogs judged not to need it had a median score of 3. That difference was used to set the intervention level that makes the scale useful at the cage side.
The scale is distributed for clinical and research use by NewMetrica Ltd under licence from the University of Glasgow. Its developers state that it is an adjunct to clinical judgement. A high score tells you to act. A low score in a dog that still looks uncomfortable is a reason to look again, not a reason to withhold treatment.
The Six Categories and How Each Is Scored
The short form has 30 descriptors grouped into six categories. You pick the one descriptor in each category that best fits the dog, then add the numbers. Descriptors are ranked from least to most painful, so a higher number always means more pain.
| Section and item | Descriptors (score) | Range |
|---|---|---|
| A (i) Vocalisation, dog in kennel | Quiet (0), crying or whimpering (1), groaning (2), screaming (3) | 0 to 3 |
| A (ii) Attention to wound or painful area | Ignoring (0), looking at (1), licking (2), rubbing (3), chewing (4) | 0 to 4 |
| B (iii) Mobility on a lead | Normal (0), lame (1), slow or reluctant (2), stiff (3), refuses to move (4) | 0 to 4 |
| C (iv) Response to touch | Does nothing (0), looks round (1), flinches (2), growls or guards area (3), snaps (4), cries (5) | 0 to 5 |
| D (v) Demeanour | Happy and content or happy and bouncy (0), quiet (1), indifferent or non-responsive to surroundings (2), nervous, anxious or fearful (3), depressed or non-responsive to stimulation (4) | 0 to 4 |
| D (vi) Posture and activity | Comfortable (0), unsettled (1), restless (2), hunched or tense (3), rigid (4) | 0 to 4 |
Add the six item scores to get the total. The maximum is 24. When section B is skipped, the maximum falls to 20.
How to Use the Glasgow Pain Score in Dogs, Step by Step
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The order of the steps matters. The scale moves from hands-off observation to interaction, so that handling the dog does not change the behaviour you are trying to record.
- Look at the dog in the kennel (section A). Before you open the door, note whether the dog is quiet, crying, groaning or screaming, and what it is doing with the wound or painful area.
- Decide whether mobility can be assessed. The form tells you to skip section B for spinal, pelvic or multiple limb fractures, or where the dog needs help to walk. Tick the box on the form and move to section C.
- Put a lead on the dog and lead it out of the kennel (section B). Watch the dog rise and walk. Score normal, lame, slow or reluctant, stiff, or refuses to move.
- Apply gentle pressure about 2 inches around the wound or painful area (section C). This includes the abdomen after abdominal surgery. Record whether the dog does nothing, looks round, flinches, growls or guards, snaps, or cries.
- Make the overall assessment (section D). Score demeanour and then posture and activity, based on everything you have seen.
- Add the scores and compare the total with the intervention level. Record the total, the time and any analgesic given.
Glasgow Pain Score Range and the Intervention Level
The full range is 0 to 24 when all six items are scored, and 0 to 20 when section B is skipped. The published analgesic intervention level is a total of 6 out of 24 or more, or 5 out of 20 or more. At or above that score, the dog should be reassessed by the veterinarian and given additional analgesia according to the treatment plan.
Watch the wording on exam questions
The threshold is "greater than or equal to" 6/24 or 5/20. Some printed copies of the form say "greater than 5" or "greater than 4 when section B is not done", which means the same thing in whole numbers. A 2021 review of 114 studies found that about a third of them had changed the intervention level, often without supporting data. On the VTNE and in practice, use 6/24 or 5/20.
Worked example 1: all sections scored
A dog four hours after a cranial cruciate repair is quiet in the kennel (0) and licking the incision (2). On the lead it is slow and reluctant (2). It flinches when you press near the incision (2). It is quiet (1) and unsettled (1). The total is 0 + 2 + 2 + 2 + 1 + 1 = 8 out of 24. That is above 6/24, so the dog needs more analgesia. Report the score to the veterinarian and rescore after the next dose.
Worked example 2: mobility skipped
A dog with a pelvic fracture cannot walk without help, so section B is skipped. It is crying (1), looking at the painful area (1), looks round when touched (1), is quiet (1) and comfortable (0). The total is 4 out of 20. That is below 5/20. Keep monitoring at the planned interval and recheck sooner if the dog's behaviour changes.
When and How Often to Score
Jacqueline Reid, one of the scale's developers, gives practical timing advice. Wait about 2 hours after extubation before the first assessment, adjusting for the individual case, because residual anaesthetic drugs change behaviour. In the early postoperative period, do not score more often than hourly. After that, assess every 3 to 4 hours, earlier if needed, and after each analgesic dose so you can see whether the treatment worked.
A few habits make the score more reliable:
- Have the same trained person score the same dog where possible. The 2021 review notes that agreement between inexperienced observers may be poor.
- Score before you treat, then again after the drug has had time to act.
- Write down the time and the score on the hospital sheet so the trend is visible to the next shift.
- Remember that sedation, fear and a dog's normal temperament can all affect demeanour scores. Use your judgement and tell the veterinarian when the number and the dog do not match.
What the Glasgow CMPS-SF Is Not For
The short form was validated for acute pain, mainly after surgery, in dogs. It is not designed to measure chronic pain such as osteoarthritis. Chronic pain is measured better with owner questionnaires that look at quality of life over days and weeks. See our guide to VTNE pain management for how acute and chronic pain differ.
It is also not a cat scale. Cats have their own Glasgow tool, the CMPS-Feline, with different items, a maximum of 20 and its own intervention level of 5/20. Do not score a cat with the dog form.
Finally, the scale is only valid when it is used as published. If a clinic removes an item, changes the wording or moves the cut-off, the number no longer means what the validation study says it means.
How the VTNE Tests the Glasgow Scale
Pain Management and Analgesia is one of the 10 VTNE domains, with 10 of the 150 scored items, or 7 percent of the exam, according to the AAVSB Candidate Handbook. One of the listed tasks is to "recognize need for analgesia in patient". Questions on pain scales usually test three things:
- Recognition: which behaviours count as pain indicators, such as guarding, licking or chewing the incision, a hunched or rigid posture, or reluctance to move.
- Thresholds: knowing that 6/24, or 5/20 without mobility, triggers more analgesia.
- Technician action: score, report to the veterinarian, give analgesia as ordered, then reassess.
A typical item gives a short case and asks for the next step. If the score is at or above the intervention level, the answer is to notify the veterinarian and give analgesia as ordered, then rescore. Waiting for the next scheduled check is the wrong answer. For more drills like this, try the pain management practice questions.
Related Resources: VTNE Pain Scoring Systems Overview · VTNE Pain Management Study Guide · Anesthesia Monitoring Guide · Surgical Nursing Study Guide
Frequently Asked Questions
How do you use the Glasgow pain score for a dog?
Observe the dog in the kennel, then lead it out to watch it walk, then press gently around the wound, then make an overall judgement of demeanour and posture. Choose one descriptor in each of the six categories and add the scores. Compare the total with 6/24, or 5/20 if you could not assess mobility.
What is the Glasgow pain score range for dogs?
The short form runs from 0 to 24. If the mobility section is skipped because the dog cannot walk safely, the range is 0 to 20.
What Glasgow score means a dog needs pain relief?
A score of 6 out of 24 or higher, or 5 out of 20 or higher when mobility is not assessed, is the published analgesic intervention level.
Is the Glasgow composite measure pain scale for dogs the same as the short form?
No. The long form came first and was built for research. The short form, CMPS-SF, is the six-category version used in clinics and the one most VTNE questions refer to.
Can the Glasgow canine scale be used for cats?
No. Use the Glasgow CMPS-Feline, the Feline Grimace Scale or another tool validated in cats.
Key Takeaways
- The CMPS-SF has six categories and 30 descriptors.
- Maximum score is 24, or 20 without the mobility section.
- Give more analgesia at 6/24 or higher, or 5/20 or higher.
- Observe first, then walk the dog, then touch, then judge overall.
- Use it for acute pain in dogs only, and use it exactly as published.
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- Reid J, Nolan AM, Hughes JML, Lascelles D, Pawson P, Scott EM. Development of the short-form Glasgow Composite Measure Pain Scale (CMPS-SF) and derivation of an analgesic intervention score. Animal Welfare. 2007;16(S):97-104. doi.org/10.1017/S096272860003178X
- Testa B, Reid J, Scott ME, Murison PJ, Bell AM. The short form of the Glasgow Composite Measure Pain Scale in post-operative analgesia studies in dogs: a scoping review. Frontiers in Veterinary Science. 2021;8:751949. PMC8515184
- Reid J. Pain assessment in the dog: the Glasgow Pain Scale. Royal Canin Academy. academy.royalcanin.com
- Reid J, Nolan AM, Scott EM. Measuring pain in dogs and cats using structured behavioural observation. The Veterinary Journal. 2018;236:72-79. doi.org/10.1016/j.tvjl.2018.04.013
- Gruen ME, Lascelles BDX, Colleran E, et al. 2022 AAHA Pain Management Guidelines for Dogs and Cats. Journal of the American Animal Hospital Association. 2022;58(2):55-76. doi.org/10.5326/JAAHA-MS-7292
- AAVSB. VTNE Candidate Information Handbook (content outline). aavsb.org