Signs Your Cat Is in Pain: The Subtle Clues and When to Call the Vet

Cats are skilled at hiding pain, so the signs are usually changes in behavior rather than crying out. Common clues include hiding, grooming less (or over-grooming one spot), eating less, avoiding jumping, litter box changes, a hunched posture and a tense facial expression with squinted eyes and flattened ears. If you notice these, contact your veterinarian; some signs, such as straining to pee or open-mouth breathing, are emergencies.

This article helps you notice possible pain. It cannot tell you the cause, which only a vet can determine.

Why cats hide pain

Cats are both predators and prey animals, and showing weakness can make an animal vulnerable. Many cats keep eating, purring and greeting their owners while in real discomfort. Veterinarians at the Cornell Feline Health Center and elsewhere describe cats as notoriously good at concealing illness and pain. That is why small changes matter, and why chronic pain, such as arthritis or dental disease, often goes unnoticed for a long time.

Behavior changes that can signal pain

A 2016 study in which veterinary experts reached consensus on pain behaviors in cats identified 25 signs. No single sign was required, but several together made pain more likely. Many of them are things owners can see at home:

• Hiding or withdrawing from family members and other pets
• Less grooming, leading to a scruffy or greasy coat, or excessive licking of one area
• Reduced appetite or changes in how the cat eats, such as chewing on one side
• Avoiding jumping up or down, or taking stairs slowly
• Litter box changes: going outside the box, straining, or difficulty getting in and out
• Less play and activity, or sleeping in unusual places
• Irritability, hissing or swatting when touched, especially in one area
• Reluctance to be picked up or stroked
• Changes in vocalizing, such as growling, more meowing or unusual quietness

Posture and facial expression

Researchers at the Université de Montréal developed the Feline Grimace Scale, which scores five features of a cat’s face to assess acute pain. It is designed for veterinary use, but the features it looks at are useful for owners to know:

Body posture also offers clues: sitting hunched with feet tucked under, lying in a tight ball, holding up a paw, or not lying on one side. Our guide to cat body language explains everyday postures.

Common sources of hidden pain

Arthritis

Joint pain is common in older cats but easily mistaken for “just slowing down.” The Cornell Feline Health Center notes that most arthritic cats do not limp obviously. Watch for a cat that no longer jumps onto favorite spots, uses a chair as a step, struggles with the litter box or grooms less over the back and hips.

Dental pain

Drooling, bad breath, pawing at the mouth, dropping food or preferring soft food can point to mouth pain.

Urinary problems

Frequent trips to the litter box, small amounts of urine, peeing outside the box or crying while peeing can indicate bladder discomfort.

Emergency signs: call a vet right away

• Straining in the litter box with little or no urine, especially in male cats. A urinary blockage can become life-threatening quickly and is often mistaken for constipation.
• Open-mouth breathing, panting or breathing difficulty
• Sudden inability to use the back legs, often with crying and cold paws
• Not eating for more than a day or so. Cats that stop eating are at risk of serious liver problems.
• Repeated vomiting, collapse or unresponsiveness
• Injury from a fall, a car or a fight
• Any suspected poisoning, including lilies or human medicines

What to do if you think your cat hurts

1. Write down what you notice and when it started. Short videos of limping, litter box visits or unusual behavior can be very helpful to your vet, since cats often behave differently at the clinic.
2. Call your veterinarian to describe the signs and book an appointment.
3. Make things easier at home while you wait: a low-sided litter box, food, water and bedding on the ground floor, and a quiet place to rest.
4. Never give human pain medicine. Common pain relievers such as acetaminophen and ibuprofen are dangerous to cats. Only use medicine prescribed for your cat.
5. Do not wait it out if your cat stops eating or any emergency sign appears.

Supporting a cat with long-term pain

If your vet diagnoses a chronic condition such as arthritis, there are many ways to help alongside any treatment your vet prescribes: ramps or steps to favorite spots, a litter box with a low entry, warm and padded beds, and keeping your cat at a healthy weight. Our guides on senior cat care and how to tell if your pet is overweight cover these in more detail.

Bottom line

Cats rarely show pain in obvious ways. Watch for hiding, grooming changes, appetite changes, reluctance to jump, litter box problems and a tense, squinting face. Call your vet when you notice them, and go to a vet immediately if your cat strains to pee, breathes with its mouth open, cannot use its legs or stops eating.

FAQ

Do cats purr when they are in pain?

They can. Purring is not always a sign of contentment; some cats purr when stressed, unwell or in pain. Look at other signs as well.

Is my older cat just slowing down?

Possibly, but reduced jumping, stiffness and less grooming are also common signs of arthritis. A vet check can tell the difference.

Can I give my cat something for pain at home?

Not without your vet. Many human and dog pain medicines are toxic to cats. Your vet can prescribe options that are safe for cats.

Why is my cat peeing outside the litter box?

It can be a sign of pain, a urinary problem, stress or a box setup issue. Rule out medical causes with your vet first, and treat straining with little urine as an emergency.