As a general rule, most cats are excellent at hiding their pain. Fortunately, there are lots of signs you can look for that indicate possible pain in your cat. Know what to look for so you can prevent your cat from suffering in silence.
Cats are masters at disguising pain. It's a survival instinct.
Signs of Pain in Cats
Chances are that while caring for your cat, these signs will be more obvious to you (even when they're subtle) if you have a good idea of your cat’s “normal.” This includes their normal attitude, energy level, gait, appetite, thirst, sleep patterns, and other physical and behavioral patterns. After all, if you don’t know what’s “normal” it’s much more difficult to recognize what’s not.
*Important note: When evaluating your cat for potential pain, there is a chance that you or someone helping could get bitten or scratched, so remember to be careful. Even if your cat would never normally bite or scratch, the mere fact that you’re checking them for pain gives them the idea that something's up!
- Biting and Scratching: Cats in pain are more likely to bite and scratch. And they are not discriminatory so even familiar people will either get teeth or claws - or both! This is particularly true when a person touches or moves the painful area, or if the cat anticipates you touching or moving the painful area.
- Breathing Changes: There's the possibility of a faster and more shallow breathing pattern than normal. They may also pant. You may even notice a change in the movement of the stomach and chest muscles, since both are involved in breathing.
- Heart and Pulse Changes: Cats with discomfort will often have an increased heart/pulse rate. The rate often noticeably speeds up when the painful area is touched or moved. Take a pet first aid course, or ask your veterinarian or one of the clinic's nurses to show you how to check and measure your cat’s heart and/or pulse rate.
- Purring: Just because your cat is purring does not mean they aren't in pain. If your cat is purring while showing any of the other signs here, the purring may be pain related. In fact, purring may actually increase in a cat experiencing pain.
- Eye Changes: The eyes can be very telling in cats with pain. This is true both for eye pain itself and for pain elsewhere in their body. Often times pain elsewhere in the body will result in larger (dilated) pupils, while pain in the eye(s) can result in either larger or smaller (constricted) pupils – depending on the underlying injury or disease process, and whether one or both eyes are affected. Squinting may indicate pain, either in the squinting eye(s) or elsewhere in the body. Similarly, a “bloodshot” appearance can indicate pain in the affected eye(s).
- Food and Water Changes: You may find them eating and drinking less. When they do eat and drink, if the cause of their pain is their teeth or some other part of their mouth, they may drop food and/or water out of their mouth.
- Grooming Changes: You may notice an overall decreased amount of self-grooming in a cat experiencing generalized or illness. However, a cat with a wound may excessively groom the area.
- Energy Level Changes: Most cats in pain will generally be less active. This often results in a cat who sleeps more, but may also reduce the amount the cat runs or jumps. Many cats will hide when in pain – choosing to spend time under beds or couches, or in closets. Be sure to check frequently for hiding, as it’s often a very telling sign.
- Mobility Changes: Cats experiencing pain often move around less. But depending on what hurts, they may still move around the same amount, just differently. They may move with a limp, or go more slowly up or down the stairs, or be less eager (or able) to jump the way they used to. If you've noticed any changes in your cat's mobility, and you think your cat might be suffering from arthritis (LOTS of cats are!), you can start by adding some joint mobility and fish oil supplements to their food. These don't require a prescription and can help begin to decrease the pain and inflammation associated with arthritis to help your cat start to feel better.
- Bathroom Changes: Cats who have back pain, for any reason, may have trouble getting in position to go poop. Because of this struggle to go to the bathroom, they will sometimes become constipated. However, the pain specifically can also lead directly to constipation, as the flexibility of their intestines is reduced. Cats with joint or bone pain may also have difficulty getting into their litter boxes, so they may start urinating and/or defecating outside of their boxes.
- Body Contour Changes: Swelling on your cat’s legs, body, or face could be an indication of a painful condition such as a cat bite or tooth root abscess, inflammation, cancer, or something else.
Thanks to Dr. Duncan Lascelles, one of the foremost experts on pain in cats (No, really! Dr. Lascelles is a cat pain guru!), and his team at North Carolina State University College of Veterinary Medicine there is now a whole website dedicated to assessing and addressing pain in cats. Dr. Lascelles' website even includes a helpful questionnaire to help you determine if your cat might be "suffering in silence" from pain. Below is a short video they produced that takes you through some of the aspects of cat pain.
Conditions That Are Often Painful for Cats
Five Things to Know About Cat Pain:
- Cats often hide their pain, so look for subtle signs.
- Cats in pain are more likely to bite, so be careful!
- Behavior, breathing, heart rate, and even appearance can all change when your cat is in pain.
- Always call your veterinarian if you suspect your cat is in pain.
- Never give your cat medication unless instructed to do so by your vet.
While it’s quite obvious and intuitive that a broken bone, gaping wound, or surgical procedure will likely be painful to your cat, those aren’t the only reasons for pain. There are lots of other common conditions that cause pain that often goes unrecognized by cat owners and therefore untreated by their veterinarians.
If your cat has been diagnosed with any of the conditions below, be sure to speak with your veterinarian to make sure that any painful aspect of the condition is being treated properly. In fact, if your cat is diagnosed with any medical condition, it is always a good idea to ask your veterinarian if there is any pain component. If there is, ask what options there are for treating the pain.
- Cancer – especially bone cancer, squamous cell carcinomas of the mouth, any type of cancer that enlarges a capsular organ (e.g. a kidney or the spleen) and tumors that press on important internal structures
- Kidney or bladder stones
- Bladder inflammation (“cystitis”)
- Urethral obstruction
- Ear infection – these can be very painful for cats, especially if the infection has been going on for a long time and/or it involves the middle or inner ear
- Inflammation of the pancreas (“pancreatitis”) and/or the stomach (“gastritis”) and intestines (“enteritis”)
- Digestive tract obstruction, including linear foreign body obstructions
- Inflammation of a joint (“arthritis”) – could be the hip(s), elbow(s), or any other joint(s) (*Note that cats develop arthritis far more often than people realize, meaning that many cats are living with the pain of undetected and untreated arthritis)
- Periodontal disease or tooth fracture
- Resorptive tooth lesions (often called FORLs or “neck lesions”)
- Eye problems such as glaucoma, uveitis, or corneal ulcers
- Feline Aortic Thromboembolism, or FATE
It’s important to talk with or see your veterinarian any time your cat is in pain, or at least you think they are. Not only is it important so that the underlying cause of the pain can be determined and appropriately treated and managed, but also to avoid tragedy. Many pet owners – even pharmacists and "human" doctors and nurses – have inadvertently caused toxicity or further injury to their cat by self-prescribing medications without first checking with their veterinarian. That is certainly a pain and heartbreak you don’t want to bring upon your cat and yourself!
Additional Resources for Cats in Pain
Cats Hiding-Hide and Seek is a Bad Game
Arthritis and Other Mobility Issues in Older Cats-How You Can Help
Cats & String: To Pull it or Not
Tooth Root Abscess-My Cat's Face is Swollen
Your Cat Is Thirsty — Find Out Why
My Cat Won’t Eat! How to Stimulate Your Cat’s Appetite