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Pain in cats, especially older ones, is often subtle and can be challenging to detect. Unlike dogs, cats tend to hide their discomfort, making it difficult for owners to recognize when their feline companions are in pain. Common causes of pain in cats include conditions like arthritis, dental disease, and even inflammation from injuries or infections. Many of these conditions can significantly impact a cat’s quality of life but are often underdiagnosed. Understanding the signs of pain and taking proactive steps to manage it is essential for ensuring that your cat remains comfortable and happy as they age. In this guide, we’ll explore the different types of pain in cats and how to recognize subtle signs and holistic remedies that can provide relief, helping your cat live a pain-free, fulfilling life.

Understanding Pain in Cats

Pain can be classified into two categories: acute pain and chronic pain. Acute pain occurs immediately after an injury or surgery as the body works to heal. Chronic pain, on the other hand, arises from conditions like arthritis or complications after procedures such as declawing. Declawing often causes chronic pain for the lifetime of a cat, which is part of the reason it is illegal in many countries, including where I practice. Chronic pain is a pervasive issue in cats and is often underdiagnosed.

Chronic Pain in Older Cats.

Research from Texas A&M University revealed that 90% of cats over the age of 10 showed x-ray evidence of painful arthritis, even though their owners were unaware of the issue. Chronic pain often presents itself through subtle behavioural changes, making it vital to monitor your cat closely. Pain can result from many causes, including surgery, injury, inflammation, or infection. Still, the key takeaway is simple: if something would be painful for you, it’s likely painful for your cat, too. No animal should suffer in silence, so recognizing the signs and consulting a veterinarian are essential steps.

Signs of Chronic pain include:

1. Increased resting and sleeping time
2. Withdrawal or grumpy behaviour
3. Reduced playfulness and interactivity
4. Difficulty jumping, climbing stairs, or hesitating to reach higher places
5. Vocalizing or showing aggression when picked up or near others
6. Litter box issues, such as missing the tray or using other sites
7. Preference for horizontal scratching surfaces over vertical ones
8. Lack of grooming or excessive grooming in certain areas
9. Loss of appetite, weight loss, jaw chattering, or pawing at the mouth (signs of oral pain)

Help cats with chronic pain.

1. Incorporate environmental enrichment to distract cats from focusing on chronic pain.
2. Engage cats in activities like searching for food hidden in puzzle toys, such as Kongs.
3. Spend quality time with the cat to provide stimulation and reduce idle time.
4. Involve owners in treatment through range-of-motion exercises and massage, which benefits both the cat and the owner.
5. Ensure accessibility to favourite spots like windowsills and countertops by building ramps or providing easier access.
6. Maintain a three-dimensional living space to support a cat’s natural habits.
7. Focus on creating a fulfilling and engaging environment to support the cat’s overall well-being.

Subtle Signs of Pain in Cats.

Cats display pain in more subtle ways than dogs, and their discomfort is often under-treated as a result. Unlike dogs, cats may appear very still and frozen in a veterinary clinic due to nervousness, which makes it challenging for veterinarians to evaluate their pain. To help your veterinarian, it’s essential to take videos of your cat at home, especially if you notice changes in their behaviour, such as hesitation when jumping up or down or avoiding specific movements. These videos can serve as valuable tools to advocate for your cat’s well-being.

Changes in Attitude or Temperament.

A cat in pain often exhibits changes in attitude or temperament. A once playful and social cat may become withdrawn, defensive, or even aggressive toward people or other pets in the household. Pain can also lead to:

• Decreased interest in playing.
• Increased hypersensitivity to noises.
• Nervousness or anxiety, which are commonly linked to discomfort.

Changes in Grooming Habits.

Pain in cats often causes changes in grooming and litter box habits. Cats in pain may groom less due to discomfort, resulting in a rough, unkempt coat or mats in hard-to-reach areas, especially in long-haired breeds. Conversely, overgrooming at a specific location may indicate pain from conditions like arthritis or bladder discomfort. Pain can also affect litter box behaviour; if climbing into the box is uncomfortable, a cat may go outside of it. Additionally, pain can slow intestinal motility, leading to constipation.

Negative Reactions to Touch or Handling.

Cats in pain may hiss, swat, or guard painful parts of their bodies. If your cat usually enjoys being scratched or petted in certain areas but suddenly reacts negatively, it may indicate discomfort.

Changes in Posture.

Posture can also provide important clues about pain in cats. Cats in pain often appear hunkered down, tense, or “scrunched,” and they may stay in a loaf-like position for extended periods. In contrast, comfortable cats typically lie on their sides or adopt a relaxed, croissant-shaped position, signalling ease and contentment. Recognizing these differences in posture can help identify when a cat may be experiencing discomfort.

Vocalization and Facial Expressions.

Cats in pain might vocalize differently, such as meowing or crying more. However, they may also purr, which is thought to be a self-soothing mechanism or a way to aid healing through the vibration of purring. When assessing pain, pay attention to your cat’s facial expressions. Comfortable cats have forward whiskers, bright open eyes, and upright ears. Cats in pain often have slanted or narrowed eyes, tense whiskers pulled back, and ears that are rotated or tucked back.

Mobility and Physiological Changes.

Reduced mobility is often one of the first signs of pain in cats. You may notice your cat hiding more, being less active, or hesitating to jump onto favourite perches or climb stairs. This is especially common in older cats, where arthritis or other chronic conditions may limit movement. Unlike dogs, cats with arthritis often don’t limp because the condition is typically bilateral; instead, they may show a general slowing down or reluctance to move. Physiological changes, such as dilated pupils and increased breathing rates at rest, can also signal pain and should be discussed with your veterinarian.

Localized Pain and Behavior Changes.

Other signs of pain include a loss of appetite, excessive sleeping, or sleeping only in one position. Cats in pain might also become more vocal or exhibit changes in personality, such as increased irritability or crankiness. If your cat reacts negatively when you touch certain areas, this could signal pain. Remember, as their owner, you know your cat’s normal behaviour better than anyone else. When you visit the vet, they’ll rely heavily on your observations to help diagnose the issue.

Causes of Pain in Cats.

• Degenerative joint disease is the most common painful condition in cats and has only been recently recognized due to cats showing subtle signs.
• Dental disease is a massive problem in cats, including periodontal disease, resorptive lesions, and stomatitis.
• Spondylosis, previously thought to be non-painful, is now understood to cause significant pain in many cats.
• Constipation is a painful condition due to the involvement of nerve fibers.
• Diabetic neuropathy is another painful condition.
• Pancreatitis, though not as common, can cause acute flare-ups and intermittent discomfort, even in its chronic form.
• Heart failure and pleural effusion can also cause pain.
• Most cancers are painful, with severe pain often accompanying advanced stages.
• Feline lower urinary tract disease or feline idiopathic cystitis is a very painful condition.
• Eye or ear inflammation, such as lesions or otitis, can cause severe discomfort.
• For conditions like severe otitis, administering transmucosal buprenorphine before an exam can help alleviate pain and make procedures more manageable.
• In cases of severe periodontal disease or oral cancer, administering transmucosal buprenorphine prior to further examinations, such as oral exams or lab work, can provide significant relief.

Treatment of Pain in Cats.

The Importance of Pain Management Trials.

Because assessing pain in cats is challenging, it is considered the standard of care to conduct pain management trials whenever pain is suspected. This approach is crucial to avoid misdiagnosing a behaviour change or grooming issue as purely behavioural when it may actually be due to pain. Before starting behaviour medication, a veterinarian should first conduct a trial with pain relief medication, which typically needs to be given over several days to weeks, depending on the situation.

Painkillers and Veterinary Care.

It’s important never to give cats human painkillers. Cats metabolize drugs differently, and medications like ibuprofen can be toxic—even deadly—for them. There have been unfortunate cases where cats have been accidentally harmed because their owners self-prescribed human medications. Always consult your vet before giving your cat any medication. Some types of pain, such as those from wounds or infections, can be easily treated and resolved. However, chronic conditions like arthritis, especially in older cats, require careful long-term management.

Curcumin

Curcumin is one of the most researched herbal supplements for reducing pain and inflammation. A typical dose for a cat is about 100 milligrams per 10 pounds of body weight once or twice daily. These are 400 mg capsules, and based on Marie’s size, he would get about half a capsule a day. To make it easier for cats, it’s best to mix the curcumin into their food. It’s worth noting that curcumin can stain surfaces orange. When I mix half of a capsule with canned food for Marie, he eats it willingly, which is great to see.

Fish Oil.

Essential fatty acids, especially from fish oil, are beneficial for reducing inflammation. Typically, cats are given about 100 to 200 milligrams of fish oil daily, but studies suggest increasing the dose up to 1,000 milligrams per 10 pounds of body weight daily. The capsules I use contain 600 milligrams, so I give Marie two capsules daily. It can be easier to open the capsules and drizzle the oil into your cat’s food. When I drizzled fish oil onto Marie’s food, he was hesitant initially but eventually licked it up, which is fantastic.

DMSO (Dimethyl Sulfoxide).

DMSO is a liquid product I used to apply topically in veterinary clinics, especially after surgeries like knee surgeries for dogs and cats. Liquid DMSO costs about $10 per bottle. To use it, you apply a small amount, about one dropper full (1 mL), to the affected area, such as the spine or a specific joint. DMSO penetrates the skin quickly and acts as a natural anti-inflammatory. Additionally, it can carry other substances, like CBD or arnica, into a painful joint. For example, if Marie has a tender back, I apply DMSO with a dropper. It’s a clear liquid that isn’t irritating and provides relief.

Conclusion.

In conclusion, recognizing and addressing pain in cats, especially as they age, is crucial for their quality of life. Pain can manifest subtly through changes in behaviour, grooming habits, posture, and mobility, making close observation essential for early detection. Conditions like arthritis, dental disease, and chronic inflammation are common causes of feline discomfort, but with the right interventions, their pain can be effectively managed. Holistic remedies like curcumin, fish oil, and DMSO, along with veterinary-prescribed medications and pain management trials, play a significant role in providing relief. Always consult your veterinarian to ensure your cat receives safe and effective treatments. By understanding the signs of pain and taking proactive measures, you can help your feline companion lead a comfortable, happy, and fulfilling life.