How to Tell If a Cat Is In Pain

Introduction

Do you know how to tell if your cat is in pain? The cat who used to greet you may suddenly be hiding more, grooming less, and generally seeming “off.” Cats have evolved to hide signs of pain—a survival mechanism that makes it notoriously difficult to notice discomfort until it’s advanced. Let’s explore how to tell if a cat is in pain, so we can prevent long-term suffering. We’ll cover the physical and behavioral changes, causes, and next steps to piece together the puzzle.

Fast Facts on Cats in Pain

• Cats mask pain as an evolutionary survival instinct to avoid appearing vulnerable to predators in the wild.
• Common signs of pain in cats include behavioural, postural (physical stance), and vocal changes.
• Call your vet if you notice that your cat suddenly refuses to eat or move around, persistently hides, obviously limps or vocalizes, shows unexplained behavior changes, or signs of acute distress, including open-mouth breathing, collapse, and crying.
• Remember that pain can be acute (in the short term, such as a traumatic injury or following surgery) or chronic (over the long term, such as arthritis, dental disease, and internal illness).

Why Cats Hide Pain

Due to feline evolution, cats mask pain remarkably well. As both predators and prey, they instinctively conceal weakness to avoid becoming targets. Even now, domestic cats have retained this instinct, passed down through generations. This makes the role of cat parents in detecting discomfort especially challenging. Assessing whether your cat is suffering can be difficult. They put on a “brave face”, often continuing to eat, walk, and act “normally” despite significant discomfort. In fact, cat behavioural changes often reveal pain more than overt limping or crying.

How to tell if your cat is in pain - Physical signs:

Changes in Movement or Posture

You may notice your cat sits differently or avoids certain movements they previously did with ease. Arthritis symptoms in cats can include appearing slower, stiffer, hunched, or hesitant to jump and climb.

Altered Grooming Habits

Your cat may groom more or less in certain areas. Cats may neglect grooming altogether if they feel uncomfortable. Arthritic cats may dismiss stretching to groom far-flung areas, such as their back. Equally, grooming more in one region can highlight a specific area that is sore, such as a wound.

Facial Expression Changes

Squinted eyes, a furrowed brow, and flattened ears can all indicate pain. Aside from muscle tension, cats in pain may lower their head and straighten their whisker position. Take a look at the Feline Grimace Scale to score your own cat.

Eating or Drinking Less

Nausea from internal disease can cause your cat to eat and drink less. Dental pain can reduce how much they eat, and dry food is especially uncomfortable to chew, so you may see that they have a preference towards softer wet food.

Litter Box Changes

Entering the litter box, or squaring up to toilet, can be uncomfortable for cats with joint pain, so they may avoid using the box altogether. You may notice straining or more frequent visits in cats with urinary pain.

Weight Shifts or Limping

Cats with joint pain may distribute weight differently when standing or strolling around. Lameness can be subtle but telling. Watch how your cat moves normally, so you can detect the abnormal.

Behavioral Signs of Pain

Cat pain tends to show up emotionally and behaviourally, before physically. The tell-tale signs include:

• Increased hiding or sleeping, to avoid appearing vulnerable.
• Irritability or aggression when touched, especially near a painful spot. It is their instinctive defense mechanism, as they can’t understand what is causing their discomfort.
• Decreased interaction or play due to lower energy levels or discomfort.
• Changes in vocalization, including more meowing, growling, or even silence.
• Withdrawal from household activity, as they may alter their routine when sore.
• Restlessness or frequent position changes - this inability to settle can signal internal or joint pain that worsens with pressure and will not dissipate.

These behaviors often appear gradually, so trust your gut if you notice something “feels off”.

Common Causes of Pain in Cats

Cats show generalized signs of pain, common causes of these include:

• Arthritis and Joint Degeneration: where the normal cartilage in joints is worn away, causing sore bone-on-bone rubbing.
• Dental Disease: including feline odontoclastic resorptive lesions - a painful condition where the tooth is eroded within the socket, gingivitis - inflammation of the gums (caused by poor dental hygiene or viruses), and abscesses - frequently secondary to tooth fractures, which lead to bacterial infections.
• Injury or Trauma: such as muscle sprains, bone fractures, and soft tissue pain (relating to skin, muscles, ligaments, and tendons).
• Post-Surgical or Post-Vaccination Pain: relating to the natural inflammation produced by the body from a healing surgical wound, or following vaccination, as the immune system kicks in.
• Internal Illness: including kidney disease, pancreatitis, and urinary tract issues
• Cancer or Growths: which can cause pressure and discomfort internally or externally

Please bear in mind that this list is not exhaustive, and professional assessment is essential in determining the cause of your cat’s pain.

How Veterinarians Diagnose Pain

Given that cats won’t typically “show” pain, your vet will need to thoroughly assess your pet. This starts with a full physical examination and thorough palpation of their body, including their abdomen, joints, and lymph nodes, to further localize the affected region. They may use pain scoring systems, such as the Feline Grimace Scale and activity monitoring, to assess the extent of your cat’s pain. It is likely that your vet will need to conduct further diagnostic investigations, including bloodwork to rule out underlying illness, and imaging such as X-rays and/or ultrasound, to screen for structural disease.

Treatment and Comfort Strategies

Remember that it takes marked pain for a cat to show even subtle signs. Treating pain, such as arthritis in cats, can hugely improve their quality of life. Act early, do not wait until the pain becomes severe to seek help.

There are several categories of relief, which should be chosen and monitored carefully with veterinarian oversight. Cat-specific pain medications can safely be used under veterinary guidance. Never give your cat human medication, as this can be toxic and will cause more harm than good. If your cat has arthritis, veterinarian-prescribed anti-inflammatory medications and recommended joint supplements can be used when appropriate. Environmental adjustments can make your house more cat-friendly, such as ramps with anti-slip mats, soft bedding, and easy-to-access litter boxes. Calm, inviting spaces with pheromone diffusers can encourage your cat to engage with their environment and reduce stress, using gentle handling, especially around painful regions of their body.

Monitor your cat’s response to adjustments. If you feel progress is not being made, adjust the treatment with guidance from your veterinarian. Rest assured, even small iterations can make a world of difference to your cat's comfort levels.

Important note: Pain management isn’t just about medication; it’s about helping your cat live comfortably and confidently again.

When to Call Your Veterinarian

Reach out to your veterinarian immediately if you notice your cat: suddenly refusing to eat or move, hiding persistently, obviously limping or vocalizing, showing unexplained aggression and/or withdrawal, or signs of acute distress, including open-mouth breathing, collapse, crying, or seizures. Cats rarely “just get better” from pain without help, so act promptly before the problem escalates.

FAQs

Conclusion

Cats hide pain, but small changes can speak volumes. You know your cat the best of anyone, so act early if you notice any concerning signs or differences in your cat’s behaviour. Observe their normal behaviour and patterns, and be sure to consult your veterinarian if you notice any changes. The earlier any pain is detected, the sooner the cause can be investigated and addressed, leading to better outcomes for your cat living a longer, happier life.

Bio

Dr Grace Mee BVSc MRCVS

Grace graduated from the University of Liverpool in 2022. She works as a small animal vet in London and has published research in the Veterinary Record. She enjoys consulting and operating on dogs, cats, and exotic pets. Beyond clinical practice, she applies her expertise as a veterinary writer and mentors aspiring veterinary students.

Photo: Istockphoto