On the surface, it may seem like it’s easy to tell if a living thing is in pain, but when it comes to cats, it’s much harder than you think. Knowing a cat’s behavior will be your biggest indicator if a cat’s in pain or if there’s a problem. Let’s take a look at why they’re master’s of disguise regarding pain, and them move onto the signs to look for to determine if your cat’s in pain or sick.
Hiding Pain: Evolution & Adaptation
Obviously, they are nonverbal, which is the first obstacle, but the main problem is they are a prey species. This means they will adapt to pain and anything that can make them vulnerable to a predator. Since they’ve recently been domesticated (over thousands of years as opposed to dogs who’ve been bred over tens of thousands of years), so they really are remarkably unchanged from solely living and surviving outside.
Physical Exams & Diagnostics Don’t Always Detect Pain
A physical exam and palpitating different parts of the body may or may not show a problem area in cats. And while diagnostics can give important information, they won’t always answer our questions. This leaves changes in behavior as the main determining factor that pain exists. Your observations are likely the first and most obvious indicator of a problem.
Assumption: If It Hurts Us, It Hurts Cats
One important assumption made when working with cats is if it would cause us pain, then it likely hurts them. This includes surgeries, illness, and injuries. However, the way a cat expresses pain is likely different than how we would. We’ll get into all of this shortly.
Side Note 1: Beware of Anthropomorphism
Anthropomorphism is when we apply human characteristics to animals. It more applies to human emotion than pain, but I still see them as connected. For example if a cat needs a full mouth extraction or a leg amputated, they’ll have post-op pain that’s managed with meds, but their emotions will be stable. Humans post-op would likely go through a rollercoaster of emotions. You can apply the rule of what physically hurts us probably hurts them, but remove the emotion from it.
Side Note 2: Stress’ Role in Health
There is a clear tie between stress and health conditions in cats. For example, overly anxious or stressed cats often have GI (gastrointestinal) issues. This makes it even more important to remain aware of your cat’s routine, especially around stressful situations, like adding a new family member, moving, going to the vet, remodeling your home, etc.
10 Signs of Pain, Injury or Illness
We’re about to review signs that your cat may be in pain, injured, or sick. Just remember that these do not 100% mean there is a problem, but they are indicators of possible pain. We’ll look at each behavior along with examples.
#1 Change in Routine
Keep in mind that any change in routine might indicate a problem. Even if a behavior itself isn’t concerning, if it’s different from what your cat normally does, there’s a possible issue. For example, a cat suddenly always peeing in the corner of a litter box itself isn’t a bad thing, but if it’s outside of how the cat normally behaves in the box, it might mean something.
One of my foster cats went to a different spot for breakfast, and that was the first thing that concerned me. He soon was eating less and eventually turned jaundice. Although those last two signs were more obvious, him changing he normal mealtime spot was actually the first sign of a problem before anything else showed up. (He was treated and has since recovered.)
#2 Change in Temperament
Whereas routine is systematic events that take place throughout the day, temperament is more a cat’s personality. A cat that’s suddenly hiding is definitely a cause for concern, and is likely in pain. Cats that avoid petting or handling or even solicit it (especially if they don’t normally), could be in pain. And if a cat is overly aggressive or an overly aggressive cat is more tolerant, they might be in pain. A decrease in interest of their surroundings or a hyper-aware cat could also indicates something is wrong.
A decrease or increase in eating or drinking could mean there is a problem, but specifically a decrease in eating could be a sign a cat is in pain. There are many illnesses that cause an increase in drinking (and urination), so while this alone may not mean your cat is in pain, they may have another medical problem.
Also, some medications impact appetite and thirst, so always ask your vet about the side effects to any prescribed medication. One common example is the steroid prednisolone causes an increase in thirst.
The way your cat is eating could additionally indicate a problem. Food falling from their mouth, leaving lots of crumbs behind, or excessive drooling may point to a tooth or other mouth issue.
Avoiding the litter box is usually a sign of a problem and possibly pain tied to an injury or illness. Even if your cat doesn’t have noticeable diarrhea or constipation, an unwillingness to go in the box alone is enough to point at a possible issue. At the same time, frequent box visits or box visits accompanied by straining or yowling are signs of a medical condition, the most serious being a urinary blockage.
Any urinating or defecating outside the box may indicate a problem. This includes spraying, which is often a sign of stress, insecurity, a cat’s need to mark their territory, or a combo of all of those things. Stress marking specifically may have an underlying component. Urinary crystals can could inflammation in the bladder and urethra and pain, causing the cat to feel stressed and then mark as a coping mechanism.
#5 Grooming & Scratching
Excessive grooming, licking, rubbing, or biting is a way that cats might try to self soothe. This is most noticeable after a surgery, where they may lick or bite their wound. Another example is cats with upper respiratory infections (URIs), snotty noses, or watering eyes tell to rub them a lot.
Cats with flea, food, or environmental allergies are often known to overgroom and scratch because they’re itchy. Even if they are in pain, they will scratch their skin raw or even open sometimes because they are so uncomfortable.
Cats mostly vocalize to communicate with us, their young, or threats. An increase in yowling, hissing, growling, and whining could mean your cat’s in pain. At the same time, frequent meowing and even purring are other ways cats express pain. While purring is usually a sign of contentment, it’s also a way cats comfort themselves. In fact, queens purr during labor.
Vocalization is usually tied to another sign. V0calization in the middle of the night might point to dementia in an older cat, but vocalization accompanied by litter box issues could mean a urinary tract infection (UTI).
#7 Lameness & Gait
If your cat is walking different or has lameness in a limb, they could have an injury or soreness. Minor injuries like limping may go away over a short time period. This is often seen in kittens, who jump and run all over the place and get themselves into trouble. If they don’t appear to be in horrible pain and are still able to walk, you may want to monitor for a bit to see if it subsides. You can also reach out to your vet and send a video to get their opinion before you schedule an appointment. Some kittens and cats may also limp for a short time after vaccinations.
Keep in mind that while change in gait and lameness both seem like good indicators of arthritis, most cats do not show any signs of joint issues. Shockingly, even radiographs can’t always show joint changes. These leads us to our next sign.
Both an increase and a decrease in activity are signs something might be off. Pacing or lethargy are both pain indicators, with reasons being anywhere from a non-serious hairball to a life-threatening bowel obstruction.
When it comes to arthritis, your observations are key to a diagnosis. Watch how your cat runs, jumps, and goes up and down steps. If they have slowed down or can’t jump as high, they may suffer from arthritis. In cats 10 years of age or older, it’s okay to assume there is some amount of arthritis. Now whether it’s impacting the cat’s mobility is something you’ll need to determine from observations and consulting with your vet.
Lethargy is particularly concerning in young cats, but especially kittens. These rambunctious fluffernutters play hard, nap hard, but if their activity level is non-existent, it’s important to get them evaluated. Kittens are at risk for dangerous viruses like panleukopenia, and are more likely to eat things they shouldn’t. Their tiny bodies are more sensitive so timely diagnosis and treatment of problems is crucial.
#9 Body Posture
A cat with a stiff, tense body is most likely experiencing stress or pain. Crouching over is another sign of pain. To feel tenseness, place your hand on your cat. If their body feels like a rock, they might be tense and in pain or even just stressed. Anxious or nervous cats will also tense so make sure you observe other behaviors and compare to how they normally are when examining their posture.
Other times, a cat in pain will sit “tight.” What I mean by this is their legs won’t be visible, their head will be low, and their tail curled tightly against their body. While this position sounds similar to how they sit when they’re not in pain, the key is the low position of the head and the tightness of the tail. Typically you’ll observe other signs in their face that there’s an issue, which we’ll get into next.
#10 Facial Expressions
Dilated pupils or squinting, as well as holding their head down are just a few ways you can see pain expressed on a cat’s face. Sometimes their eyes can look dull, where the iris color isn’t as vivid, and they also might not appear completely alert, and may have an unfixed gaze.
Know Your Cat
To wrap things up, make sure you are aware of your cat’s normal behavior. Make an extra effort to observe how they walk, eat, and act; where their favorite places are to nap; how they use their litter box; all of these things make it much easier to tell if something is off. And the sooner you detect a problem, the sooner you can resolve it.