Cats are well known to be independent creatures, and do not always demonstrate their thoughts and feelings well. They have a strong survival instinct, and are very good at masking signs of discomfort or pain. However, there are plenty of subtle signs to look for. Getting to know these markers can help discover their pain sooner, and therefore get them the help they need. 

Acute vs chronic pain

A cat who has just injured themselves and is suffering from a sudden onset of pain may demonstrate this quite obviously. For example, a cat bitten on the tail by another cat may hold their tail awkwardly, vocalise loudly and frequently and become very reluctant to let you touch the affected area. This is acute pain, which is a relatively easy type of pain to diagnose. 

Cats in chronic pain (such as arthritis) are more difficult to spot. These cats may show very little outward signs of pain, or very non-specific signs, until the disease is quite severe. Chronic pain can be highly distressing, having multiple long-term effects on behaviour as well as physical health, so it is important that we learn to recognise early signs so that intervention can be sought. 

What can cause pain?

Acute pain can be caused by many incidents: falls and fights can result in wounds, broken bones and internal injuries, for example. Road traffic collisions are also sadly frequent. 

Chronic pain in older cats is often caused by degenerative joint disease (arthritis). A 2002 study found that a huge 90% of cats over the age of 12 had signs of arthritis on x-rays. Other orthopaedic disorders, and chronic soft tissue injuries can also cause long-term pain. Dental disease is also a very common culprit for chronic pain, with a recent estimate putting at least 85% of cats over 3 years having some form of problem with their teeth. Various malignant cancers are a source of chronic pain, as is any condition that affects the nerves or causes chronic inflammation.

Recognising signs of pain

Cats are all individuals, and will display pain in different ways. Cat owners will always know their pet best, and so are best suited to pick up on subtle changes in behaviour and actions. Cats display pain in two main ways – behaviour and body language (including facial expression). 

Behavioural signs

Cats experiencing chronic pain may show their discomfort in many small ways. Here are some subtle signs to look for. There may be only one or two of these signs, or a combination of many of them. 

  • General lethargy, sleeping more – cats sleep a lot, but you know your own cat’s habits best. Are they sleeping or resting at times they would usually be more active?
  • Reduced appetite – most cats in pain will eat less than usual. If they are arthritic, they may struggle to access a food bowl if it is positioned in a high place. Dental pain will not stop them eating, but they may salivate more when eating, chew awkwardly and drop bits of food from their mouths. They may also prioritise softer food such as gravy coverings and jelly. 
  • Toileting outside the litter box – if your cat usually uses a litter box, or toilets outside, and starts toileting in inappropriate places inside, this may be because it is painful for them to access their usual spot
  • Hiding away, interacting less with their owner and/or other pets – cats who are sore may choose not to play as much, or hide away rather than sitting with their owners
  • General irritability – pain can often lead to irritability and even aggression
  • Decreased grooming and self-hygiene – they may groom for less time, or fail to groom some hard to reach areas. This may result in matted clumps of hair and scurfy coat. Some cats will overgroom at painful areas, resulting in hairless, red and sore patches of skin. 
  • Decreased play behaviour and going outside – cat-flaps can be tricky to navigate for arthritic cats, and they may choose to be less active in order to keep their joints comfortable
  • Avoiding being handled, or actively resenting stroking/handling/grooming
  • Avoiding jumping, e.g., onto beds or up stairs – you may find that your cat’s preferred areas, such as windowsills and beds, become less popular and they choose to remain in areas more accessible
  • Increased vocalisation – loud meowing, groaning, growling and hissing can be heard in painful cats.  

Body language changes

Cats are well versed in using small changes in body language to communicate. Learning to read your cat’s body signals can be hugely informative. Here are some common signs to look for.

  • Tense body even when apparently relaxing
  • Hunched or crouched posture
  • Lowered head
  • Facial signs – squinting, flattened ears, compressed and tense cheeks and mouth

What can I do if I think my cat is hiding pain?

If you notice any of these signs, or think that your cat may be in pain, please do contact your veterinary surgeon. They’ll be able to perform a thorough exam to look for a source of these changes. If you think your cat may be in pain, it is always best to intervene early to discover if anything is wrong, and what can be done to help your pet. 

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