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25 Red Flags That Spell 'Pain!'

cat in pain

Story at-a-glance -

  • A cat’s behavior is always a good gauge of how she’s feeling, and a group of veterinary experts has identified 25 signs that are reliable indicators of feline pain
  • If you think your cat might be hurting, the first thing you should do is make an appointment with your veterinarian to determine what’s causing the pain
  • If the pain is caused by a treatable underlying condition, treating the condition should also resolve the pain
  • In the case of a chronically painful condition like arthritis, while there are few pharmaceutical painkillers that are safe for cats, there are many other natural remedies available to alleviate pain
  • One of the best ways to keep your cat pain-free as she ages is to keep her slim and well-conditioned through daily exercise

By Dr. Becker

If there’s a cat in your life, you’re probably well aware of how masterful our feline companions can be at keeping their aches and pains hidden from us. But what you might not realize is this is by design.

While cats in the wild are accomplished hunters, smaller wildcats are also prey for larger animals. Showing illness, pain or any vulnerability in that setting invites predation. That’s why your cat, and all cats, are wired to appear “normal” while dealing with significant illness or discomfort.

To complicate things further, since kitties tend to hide or keep to themselves when they’re not feeling well, it’s easy to misinterpret or simply overlook signs your furry family member is hurting.

Your Cat’s Behavior Is a Window to His Pain

Fortunately, the subject of feline pain has received more attention in the veterinary community in recent years. Funding for veterinary studies has historically favored dogs, so it’s nice to see a growing body of research on feline-related issues.

One recent study headed up by researchers at the School of Life Sciences at the University of Lincoln in the U.K. investigated signs of pain in cats.1 Signs of feline pain are primarily behavior-related (which is why I always encourage cat guardians to observe kitty’s behavior for signs he’s not feeling up to snuff).

The U.K. researchers surveyed an international panel of 19 veterinary experts across a variety of disciplines. The experts were first asked to list disorders they considered to be consistently, inherently painful in cats. Next, they were asked to evaluate pain-related behavior in cats according to the following criteria:

  • Presence of the behavior in acute and/or chronic conditions and/or conditions not known to be painful
  • Reliability of the behavior as an indicator of pain
  • The likelihood the behavior would be present in a cat who is experiencing a low level of pain
  • The likelihood the behavior would be present in a cat who is experiencing a high level of pain

Based on survey results, the researchers identified 25 signs considered sufficient to indicate pain. However, no single sign of the 25 was considered necessary for a cat to actually be in pain.

25 Signs Your Cat Is Hurting

The 25 behavioral signs considered by veterinary experts to be “reliable and sensitive for the assessment of pain in cats, across a range of different clinical conditions” are:


Hunched-up posture

Difficulty jumping

Shifting of weight

Abnormal gait

Licking a particular body region

Reluctance to move

Lower head posture

Reaction to palpation

Blepharospasm (eyelid contraction)

Withdrawn or hiding

Change in form of feeding behavior

Absence of grooming

Avoiding bright areas

Playing less


Appetite decrease


Overall activity decrease

Eyes closed

Less rubbing toward people

Straining to urinate

General mood

Tail flicking


The researchers concluded:

“These results improve our knowledge of this topic, but further studies are necessary in order to evaluate their validity and clinical feasibility (especially in relation to different intensities of pain) to help vets and caregivers of cats recognize pain in this species effectively and as early as possible to maximise cat welfare.”2

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I Think My Cat May Be in Pain. What Do I Do Now?

How your kitty’s pain is managed depends on what’s causing it, so it’s crucially important to make an appointment with your veterinarian for a thorough exam. If, for example, an infection is causing pain, resolving the infection should also alleviate the pain.

But what if your vet determines your cat has a chronic painful condition such as arthritis, which is very common in older kitties? Felines are physiologically unique and there are few effective pharmaceutical pain relievers that can be safely given long-term to control the pain of chronic conditions like arthritis.

However, there are a number of things you can do to alleviate your kitty’s pain and improve mobility. These include:

There are also some newer therapies I’ve used with good success, including the Assisi Loop, a form of pulsed electromagnetic field therapy.

There are also certain supplements you can add to your cat’s diet that provide the raw materials for cartilage repair and maintenance, including glucosamine sulfate, MSM and egg shell membrane; homeopathics, based on your kitty’s symptoms, but may include Rhus Tox and Arnica, ubiquinol, turmeric, spirulina and astaxanthin and natural anti-inflammatory formulas, EFAC complex and krill oil.

I recommend working with a holistic or integrative veterinarian to determine how to best treat the inflammation and pain caused by your pet’s arthritis, as well as how to nourish remaining cartilage. Also ask your vet about Adequan injections, which can stimulate joint fluid very rapidly in pets with arthritis.

The Importance of Exercise in Keeping Kitties Pain-Free

Keeping your cat slim and well conditioned is key in helping her be less painful as she ages. Daily exercise is the best thing to promote kitty’s muscle strength, joint flexibility and overall health. Here are some suggestions for getting and keeping your cat active from veterinary journal dvm360 and Dr. Kara Amstutz:3

Have feathers on a stick or laser pointers on hand for your cat to chase. Start with five minutes per day and work up to 15 minutes of active playtime. This can be all at once or spread throughout the day. Cats are often more active at night, so try working a 15-minute exercise plan into your evening routine.

Take kitty’s daily food portion and divide it into several bowls placed around the house. She’ll have to go from room to room to find the food. Also consider placing food dishes on elevated platforms that will require mental and physical challenge.

Start by adding just one extra bowl so she gets used to the idea of “hunting” for food.

Encourage your cat to play by keeping toys available. Change them up to keep it exciting.

Have a cat tree or other apparatus to climb up to help to your cat strengthen his muscles.

Use treats sparingly to get your cat to jump up on a chair and back down again.