Cat in Pain – Signs of Pain in Cats

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  • Cats are hardwired to hide signs of and discomfort, which serves a useful evolutionary purpose. Larger predatory animals seek out the young and the weak, therefore hiding signs of pain is a way to avoid being singled out as an easy target. As pet owners, however, a cat’s stoic nature can make it difficult for us to determine if our cat is in pain.

    There are cues we can take from our cat, and the diligent pet owner should always be watchful for small changes in behaviour, which may indicate an underlying problem.

    Signs of pain in cats

    Changs in behaviour:

    • Hiding
    • Loss of appetite (anorexia)
    • Aggression, especially when touched
    • Hissing, spitting and biting
    • Decreased responsiveness
    • Restlessness
    • Reluctance to move
    • Loss of interest in things your cat usually enjoyed such as playing, being petted, greeting you at the door
    • Hissing
    • Purring or excessive meowing
    • Changes in litter box habits, such as going to the toilet outside the litter tray or crying in the litter tray
    • Stiff posture or gait
    • Tail flicking

    Physical signs:

    Face and head

    Researchers at the University of Montreal have established five ‘action units’ known as the feline grimace scale. Each AU is scored from 0 to 2, with a maximum score of ten. Analgesics are recommended when the final score is 4/10 or above.

    0 = AU – Normal 1 = AU – Moderately present 2 – AU – Markedly present
    Ears Facing forward Slightly pulled apart Flattened and rotated outwards
    Eyes Open Partially open Squinted
    Muzzle Relaxed (round shape) Mildly tense Tense (elliptical shape)
    Whiskers Loose and curved Slightly curved or straight Straight and moving forward
    Head Above the shoulders Aligned with the shoulder line Head below the shoulder line (chin pointed to the chest)



    • Unkempt or fluffed up coat
    • Absence of grooming or focused grooming on one specific area
    • Hunched up position
    • Tucked up belly
    • Rigid and hunched appearance
    • Avoiding bearing weight on a particular limb (this is common in arthritis)

    Pain serves a useful purpose; it helps the animal to protect against further damage. For example, if a cat is lying by a fire, the pain will alert him to the fact that his skin is being burned, and he will move away. If he has a broken leg, he will avoid standing on it, preventing further damage.

    Pain can be split into acute (sudden onset) or chronic (slow and progressive) — the Glasgow Feline Composite Measure Pain Scale. Composite measure pain score (CMPS) helps veterinarians determine the extent of pain. Read more about the composite measure pain score.


    What should you do for a cat in pain?

    Seek veterinary assistance immediately. Do NOT medicate a cat at home using human medications as they are extremely toxic to cats.

    A cat in pain needs veterinary attention where he will be assessed to determine the cause of the pain, and then the correct painkillers can be administered.


    The veterinarian will perform a complete physical examination and obtain a medical history from you, including how long symptoms have been apparent.

    The location of the pain (if known) can help your veterinarian to determine the cause. If your cat is showing vague and non-specific symptoms, he will need to run some diagnostic tests to help him determine what the problem is.

    Diagnostic workup:

    • Biochemical profile, complete blood count, and urinalysis to evaluate the overall health of your cat and look at kidney and liver function, signs of infection (increased white blood cells), anemia etc.
    • Xrays or ultrasound are useful diagnostics to evaluate the internal organs, bones and look for foreign bodies or tumours.
    • Additional tests will depend on your veterinarian’s index of suspicion.


    Once the cause of the pain has been determined, the veterinarian can administer analgesics (painkillers) to relieve discomfort as well as address the underlying cause. Cats are considerably more sensitive to drugs than humans, and even dogs and any medications must be given as per your veterinarian’s instructions.

    It is important to note that just because a cat may not necessarily show outward signs of pain, doesn’t mean he is not feeling it. If you have a cat with a known injury or sickness, even if he appears to be happy, speak to your veterinarian.


    • Julia Wilson, 'Cat World' Founder

      Julia Wilson is the founder of Cat-World, and has researched and written over 1,000 articles about cats. She is a cat expert with over 20 years of experience writing about a wide range of cat topics, with a special interest in cat health, welfare and preventative care. Julia lives in Sydney with her family, four cats and two dogs. Full author bio