Cats

How to know your cat is suffering: 25 most common signs of pain in cats

Cats are complicated creatures. They are much wilder than dogs. I’ve heard somewhere that humans domesticated dogs, and cats domesticated themselves. Cats are masters at hiding their pain. So if you are looking for signs of pain in cats, you need to be looking very closely and very carefully.

Some people say cats are too proud to show that they are in pain. I think this is just anthropomorphism. They are just genetically hardwired to hide any weakness. They might be the predators, but they are also the prey… And in nature, showing any kind of weakness can be deadly. So they became masters at masking any signs of pain.

For us vets, but also for you as the owner, it’s important to know when an animal is suffering. Pain does have a purpose – it is the body’s indicator that something is wrong. But leaving an animal to suffer is not just unethical, it has a direct impact on the healing process.

signs of pain in cats

What is pain and why is it important

Pain… it’s such a complex (and very hard to define) sensation…

The World Small Animal Association’s Global Pain Council has a nice way of describing it:

“Pain is a complex multi-dimensional experience involving sensory and affective (emotional) components. In other words, ‘pain is not just about how it feels, but how it makes you feel,’ and it is those unpleasant feelings that cause the suffering we associate with pain.”

As a veterinarian, I personally like the introduction to pain management guidelines done by the World Small Animal Veterinary Association (WSAVA):

“The ability to experience pain is universally shared by all mammals, including companion animals, and as members of the veterinary healthcare team it is our moral and ethical duty to mitigate this suffering to the best of our ability.”

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Pain as a warning mechanism

However, pain does have a purpose. It’s telling us that something is wrong. Pain is a natural warning mechanism.

There is a very rare genetic disorder called congenital insensitivity to pain or congenital analgesia. People who suffer from this condition don’t feel pain. They literally don’t know how it feels. This may sound awesome, but their life is far from that.

Pain is important in child development. Young children learn what they can and can’t do thanks to pain. They learn to navigate the world without injuring themselves, mostly by trial and error.

As a small child, you don’t know how to run, but you want to because it seems like so much fun. But after you fall and hurt yourself a few times you slow down and this helps you to learn properly. You bum into the table a few times and you learn to be careful around it. You learn not to bite your tongue or fingers, not to drink your tea when it’s too hot, not to touch the stove…

Without this warning signal, children often display self-mutilation and have recurrent injuries, which sometimes remain hidden. As teenagers, they are not afraid of hurting themselves, which leads to extremely reckless behavior. Most of the males accidentally kill themselves by doing dangerous things or from untreated injuries.

The importance of proper pain management

As you can see, pain is extremely important.

This is why pain management is so tricky. Unnecessary suffering releases stress hormones, increases the risk of infections, and prolongs the healing process. As we learned more and more about pain, it became obvious that pain management plays an important role in the healing process.

However, if your cat had a bad leg injury, the pain will stop her from standing on it. This is also important for healing. But if we give her pain medication, she might not let the leg rest as much as she should. So what to do? Well, that’s where you come in 🙂 If we take away the pain, it’s up to you to make sure your pet is resting.

Cats are masters at hiding their pain

Many owners think they would be able to recognize if their cat is suffering.

Unfortunately, cats are very very good at masking pain.

Recognizing when a cat is suffering is quite difficult except in extreme cases. We usually have to rely on behavioral changes as signs of pain in cats.

However, the absence of these behavioral changes does not mean the cat is ok. See? Difficult.

We usually have to rely on behavioral changes as signs of pain in cats.

As veterinarians, we need to know when an animal is in pain.
International veterinary experts in feline medicine participated in a study to help develop new guidelines on identifying signs of pain in cats – Behavioural Signs of Pain in Cats: An Expert Consensus

They identified 25 signs that were considered sufficient to indicate pain. However, as mentioned before, no single sign was considered necessary for it.

25 scientifically proven signs of pain in cats

So how do you know if your cat is in pain? Especially if cats don’t want you to know that they are suffering…

According to the veterinary consensus, these signs are a strong indicator of pain:

  • Lameness (limping)
  • Difficulty jumping
  • Abnormal gait
  • Reluctance to move
  • Reaction to palpation (touching)
  • Withdrawn or hiding
  • Lack of self-grooming
  • Playing less
  • Appetite decrease
  • Overall activity decrease
  • Rubbing themselves on people less
  • General mood change
  • Temperament change
  • Hunched-up posture
  • Shifting weight when standing, lying down, or walking
  • Licking a particular body region
  • Lower head posture
  • Squinting
  • Change in feeding behavior
  • Avoiding bright areas
  • Growling
  • Groaning
  • Eyes closed
  • Straining to urinate
  • Tail flicking 

As you can see, all these signs are very general, sometimes hard to spot, and even harder to evaluate. However, their absence doesn’t mean your cat is not in pain.

And to make things even more complicated, these symptoms can appear also in non-painful conditions.

Behavioral changes are an indicator that something is wrong

With cats, every change in behavior is important. Behavioral changes are the best indicator that something is wrong. However, it might not be a painful condition.

For example, a cat who has an abnormal gait might suffer from a neurologic non-painful condition. On the other hand, I’ve seen x-rays of cats with massive arthrosis where the owner reported only that “he used to sleep on the cupboard, he doesn’t do that anymore” 🤷‍♀️

Here is my personal story – our cat started to urinate on the bathroom rug and hide under our bed. Those were the only symptoms he showed. He was still eating, blood and urine analysis were normal, and he didn’t have a fever… Well, long story short, we found out he had bone cancer in his jaw, which must have been extremely painful.

Even with these signs of pain in cats, you cannot be certain the cat is really suffering. Your vet will need to do further diagnostic tests to determine if your cat is in pain or if there is some other problem.

Very few animals pass away peacefully in their sleep. Personally, I’m very grateful for the option to humanely end an animal’s suffering by putting him down. As a pet owner, I know it can be hard to recognize those “it’s time” signs. However, pain is one of the main factors to consider. You and your vet should be able to recognize signs of pain.

Cats are complicated and notorious for hiding their pain or discomfort. Most signs of pain in cats are behavioral. Therefore, you should always contact your vet when you see any behavioral or other changes.

Any behavioral change can be significant and should be addressed. Cats are difficult. They can react strongly even to small changes in your household, but not react at all when in pain. I’ve seen cats go completely inside when the owners changed their living room furniture. And I’ve also seen cats with almost no signs who must have been in a lot of pain.

If your cat is suddenly behaving differently, take her to a vet…just to make sure she doesn’t have an underlying health problem. Because you just never know with a cat… 🙂

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