Signs of Pain in Cats
Reviewed by Dr. Robin Teague, DVM (Colorado); Dr. Tracey Decter, DVM (Florida); Dr. Caroline Garrett, DVM, DACLAM (Utah); and Rob Twyning, PEP (Wisconsin) – The Pet Loss at Home Medical Advisory Team
“Gomez”
Passed peacefully in 2022 in the comfort of their own home with the help of Pet Loss at Home.
Key Takeaways:
- Cats are exceptional at hiding pain. By the time signs are obvious, discomfort is often significant.
- Feline pain is expressed through stillness, hiding, and subtle changes, and not always through vocalization.
- Changes in grooming, litter box use, and social behavior are key early indicators.
- A quality of life consultation should be scheduled at the first sign of behavioral change, not when decline is severe.
- In-home euthanasia eliminates the stress of a clinical visit for cats who are already struggling.
Cats don’t ask for help the way dogs do. If your cat has become quieter, more withdrawn, or simply different, then you’re right to pay attention.
Of all companion animals, cats are perhaps the most skilled at concealing vulnerability. This is not a personality trait. It is a deeply wired survival mechanism. In the wild, a cat who showed weakness became prey. That instinct remains, even in the most pampered indoor cat, and it means that by the time a cat’s pain becomes obvious, it has often been present for some time.
Recognizing feline pain requires a different kind of attention than recognizing pain in dogs. It is less about dramatic signs and more about noticing what is absent: the purr that has gone quiet, the jump that no longer happens, the greeting at the door that stopped weeks ago.
What Is Pain for Cats?
Pain in cats is any physical or psychological discomfort that alters a cat’s normal behavior, movement, or engagement with their environment. Cats experience both acute and chronic pain through the same neurological pathways as humans and other mammals. Because cats mask pain instinctively, veterinary assessment is often necessary to identify discomfort that is not immediately visible.
Behavioral Signs of Pain in Cats
- Hiding in unusual locations or spending significantly more time alone
- Withdrawal from human interaction in a cat who was previously social
- Reduced or absent purring in a cat who previously purred regularly
- Increased vocalization such as yowling, crying, or growling, especially at night
- Aggression or defensive reactions when touched in specific areas
- Changes in appetite or complete disinterest in food and water
- Altered sleep patterns or restlessness at night
- Loss of interest in previously enjoyed activities or environments
- Glazed expression, reduced awareness, or failure to respond to their name
Physical Signs of Pain in Cats
- Changes in grooming like over-grooming a specific area, or a matted, unkempt coat from under-grooming
- Reluctance to jump, altered landing when jumping, or avoidance of previously used high surfaces
- Changes in gait like limping, stiffness, or an uneven or cautious walking pattern
- Changes in litter box behavior such as missing the box, straining, or avoiding it entirely
- Squinted or partially closed eyes, particularly when resting
- Flattened ears, tense facial muscles, or a drawn, tight expression around the muzzle
- Labored breathing, rapid breathing, or open-mouth breathing
- Visible weight loss, muscle wasting, or a dull, thinning coat
- Hunched posture – like sitting in a tight, rounded position rather than relaxed
“Cats often tell us they’re in pain by doing less... less movement, less interaction, less of everything that made them themselves. That absence is the signal.”
Rob Twyning, PEP Owner of Pet Loss at Home
Reading a Cat’s Face
Veterinary researchers have developed the Feline Grimace Scale as a standardized tool for assessing pain in cats based on facial expression alone. Five key markers are evaluated: ear position, orbital tightening (squinting), muzzle tension, whisker position, and head position.
A cat in significant pain will often show multiple markers simultaneously: ears flattened or rotated outward, eyes narrowed or closed, whiskers pulled back, and a tense, drawn muzzle. Families who are familiar with their cat’s normal expression are often the first to notice these subtle changes.
Pain in Senior Cats
Osteoarthritis is significantly underdiagnosed in cats. Studies suggest that the majority of cats over age twelve have some degree of degenerative joint disease, yet many owners, and even veterinarians, miss it because cats rarely limp in the classic sense. Instead, they simply stop jumping, stop climbing, and gradually withdraw from activities that require mobility.
If your senior cat is moving less, grooming less, or engaging less with the household, a quality of life assessment is appropriate regardless of whether overt pain signs are present.
Speak With a Pet Loss at Home Veterinarian
Call (877) 219-4811 or use the ZIP locator at the top of the page to find a vet near you.
Frequently Asked Questions
How do I know if my cat is in pain?
Look for behavioral changes first: hiding, withdrawal, changes in grooming, altered litter box use, or reduced purring. Physical signs include labored breathing, changes in posture, facial tension, and changes in movement. Because cats mask pain effectively, consistent changes over time are more meaningful than any single sign.
Do cats purr when they are in pain?
Cats sometimes purr when they are stressed or in pain, in addition to when they are content. However, a cat who has stopped purring entirely, particularly one who previously purred often, may be signaling significant discomfort. Context matters: consider the full picture of your cat’s behavior, not purring alone.
What is the Feline Grimace Scale?
The Feline Grimace Scale is a validated veterinary tool that assesses pain in cats based on five facial markers: ear position, orbital tightening, muzzle tension, whisker position, and head position. Veterinarians and trained observers can use it to identify pain that may not be expressed through vocalization or movement.
My cat seems fine sometimes and in pain other times. Is that normal?
Yes. Many chronic conditions, including arthritis and cancer, cause fluctuating discomfort. Cats may have relatively comfortable periods followed by more difficult ones. This variability does not mean pain is absent on the better days — it means the condition is affecting your cat inconsistently. A quality of life assessment looks at the pattern over time, not a single moment.
How We Created This Guide
This page was developed in collaboration with licensed veterinarians who specialize in end-of-life pet care. All clinical guidance has been reviewed for medical accuracy. Our editorial process prioritizes compassion, clarity, and evidence-based information to help families navigate one of the hardest decisions they will ever face.