The Complexity of Feline Pain: Common Signs Cats Could be in Pain 

Cats are often seen as stoic creatures that hide their discomfort, but like dogs, cats experience pain. Unfortunately for cats, the signs of pain may go unrecognised or be attributed to aging so recognising and addressing pain in cats can be challenging for pet owners, veterinarians, and researchers alike. 

Managing pain is important because uncontrolled pain can lead to physiological and welfare problems including chronic stress, reduced quality of life and lowered immune function. Cats in pain may experience physical and emotional suffering, making it crucial for owners to seek veterinary care to identify and address the source of pain as soon as possible. 

This article explores the common signs and causes of feline pain and how to manage feline pain.  

Concealed suffering

Cats are unique as they are both predators and prey in the wild. This means that in nature, displaying signs of weakness can result in becoming prey. As a result, domestic cats have retained the instinct to hide their pain. This means that rather than make a dramatic announcement about their pain, they may attempt to mask it or avoid being seen at all, which can make it harder to know they may be in distress.  

The first thing to consider is that in most cases, problems that you would find painful would also be painful for your cat. So, if you observe an overt sign of disease or injury on your cat, such as wounds or injuries, signs of vomiting or nausea, limping or ambulatory changes, constipation or straining to go to the toilet, your cat could be in discomfort just as you might be if you were suffering from the same symptoms.  

Common signs of pain in cats

Unlike dogs, who may whine, yelp, or seek attention, cats tend to exhibit more subtle signs of discomfort. Some common indicators of pain in cats include: 

• Changes in grooming behaviour 
• Changes in whisker position or facial expression
• Changes in appetite 
• Hiding or isolating themselves 
• Aggression, irritability and/or reluctance to be handled 
• Lethargy or sleeping more often 
• Changes in mobility or changes in posture and movement 
• Vocalisations such as excessive meowing or growling when handled 
• Reduction in playing or interacting with other pets or family members 
• Changes in litter tray behaviour 

Causes of feline pain

Understanding the sources of pain in cats is crucial for prevention and treatment. Some common causes of pain in cats include: 

• Dental issues like gingivitis, tooth decay, and gum disease can cause pain in cats. They may struggle to eat or groom themselves properly, leading to further complications. As they have small mouths, cats may not let you check their teeth and gums easily, so you may not immediately notice dental disease in cats.  
• Cats can develop arthritis, which is characterised by inflammation and pain in the joints. This condition can severely impact their mobility and overall quality of life.  
• Accidents, falls, or physical injuries can cause acute pain for cats. It’s vital to seek immediate veterinary care if you know or suspect your cat may have been involved in a traumatic incident.  
• Urinary tract diseases like interstitial cystitis in cats causes pain through bladder wall inflammation, leading to symptoms such as straining to urinate, frequent urination, blood in the urine, and behavioural changes. Managing pain can provide great relief for a cat suffering from bladder inflammation. 
• After any surgical procedure, including desexing, cats may experience post-operative pain. In most cases the veterinarian will have prescribed or administered pain relief medication, but like humans, cats may experience pain differently, and respond to medications differently.  

• Conditions like cancer, kidney disease, and pancreatitis can cause chronic pain in cats, making it essential to address both the underlying disease and the pain it generates. 

If you suspect your cat is in pain, reach out to your veterinarian. Similarly, many conditions such as dental disease and arthritis can be detected early during regular six-monthly check-ups with your veterinarian.  

Managing pain in cats

There can be additional challenges in administering medications in cats, as there are many cats who reject pills or are too clever to be fooled by attempts to hide medications in food. This can pose a hurdle to effectively managing pain in feline patients. Thankfully, there are more options now available such as flavoured medications, transdermal gels, injections and even compounded medications tailor-made for the individual patient.  

It’s also important to understand and treat, where possible, the underlying cause of pain. This is why it is vital to consult with your veterinarian before giving your cat any medication and to follow your veterinarian’s instructions on dose rates, frequency, and things like whether your cat is eating and drinking before giving them any medications. 

Medications that might be recommended for pain in cats include:  

• Prescription Non-Steroidal Anti-Inflammatory Drugs (NSAID). Common options include robenacoxib (for short-term and chronic pain) and meloxicam (which may be used post-operatively and in feline patients with chronic pain and kidney concerns). 
• Opioids may be used for more severe pain especially when NSAIDs aren’t sufficient, or recommended for another reason which may include patient unsuitability for NSAID use. These include drugs like buprenorphine, tramadol, and fentanyl patches. 
• A monthly injectable monoclonal antibody therapy offers a new way to help manage feline arthritis pain without having to tackle regular tablets.  
• Your veterinarian may recommend medications that were not necessarily developed specifically for pain relief but may help your cat’s particular symptoms. This could include gabapentin, maropitant, amantadine, and amitriptyline.  

• Supplements might be used alongside pain relief for managing arthritis, including glucosamine, chondroitin, Adequan, and omega-3 fatty acids.  

Kidney health is a significant concern when it comes to pain relief in cats, as some medications can impact kidney function. Veterinarians will often assess a cat’s kidney health before prescribing medications and tailor their treatment protocol depending on the findings. R 

It’s essential for cat parents to work closely with their veterinarian to find the most suitable and safe pain management plan tailored to their feline friend’s unique needs. 

Recognising the subtle signs, understanding causes, and addressing the challenges in identifying and managing feline pain are essential to the wellbeing of felines. Regular veterinary check-ups, maintaining a watchful eye on behavioural changes, and seeking prompt veterinary attention when needed can ensure felines lead a happy and pain-free life. 

References

Item generation and design testing of a questionnaire to assess degenerative joint disease–associated pain in cats 

Acute pain in cats: Recent advances in clinical assessment 

The lack of analgesic use (oligoanalgesia) in small animal practice 

Turner, Dennis C (Ed), Bateson P. P. G (Ed), 2017, The domestic cat: the biology of its behaviour, Third Edition, Cambridge University Press.  

SOLENSIA™  

Evaluation of Client-Specific Outcome Measures and Activity Monitoring to Measure Pain Relief in Cats with Osteoarthritis 

Multimodal analgesia for perioperative pain in three cats  

Frunevetmab, a felinized anti-nerve growth factor monoclonal antibody, for the treatment of pain from osteoarthritis in cats 

Facial expressions of pain in cats: the development and validation of a Feline Grimace Scale 

Acute pain in cats: Recent advances in clinical assessment 

Long-term pain in cats: how much do we know about this important welfare issue? 

Facial expressions of pain in cats: the development and validation of a Feline Grimace Scale (supplementary material) 

Facial expressions of pain in cats: the development and validation of a Feline Grimace Scale