Chronic Pain in Cats: Recognition and Management

Chronic pain from arthritis, dental disease and other conditions is widespread in cats but frequently unrecognised because cats suppress pain expression in ways that mislead owners and vets.

Key Facts

Studies using validated pain assessment tools estimate 90% of cats over 12 years old have radiographic evidence of arthritis
Cats with arthritis rarely limp — instead they show reduced jumping, decreased grooming of hindquarters and increased sleep as primary signs
The Feline Grimace Scale, validated in 2019, allows reliable pain scoring from facial photographs taken at home between vet visits
NSAIDs licensed for cats including meloxicam significantly improve activity and quality of life in arthritic cats with appropriate monitoring
Gabapentin is increasingly used as an adjunct for chronic feline pain, particularly for neuropathic pain conditions
Environmental modifications including steps to elevated resting spots, low-sided litter trays and soft bedding can substantially reduce the daily pain burden of arthritic cats

Welfare Considerations

Chronic pain in cats is a hidden welfare epidemic. The evolutionary pressure on cats to suppress pain expression — because visible weakness attracts predators and triggers social displacement — means cats with severe arthritis can appear broadly normal to their owners and even to veterinarians in the brief context of a clinical consultation. Validated pain assessment tools that analyse facial expressions from photographs are transforming this situation by enabling home-based pain monitoring between appointments. Recognising and treating chronic pain in cats is not a specialist intervention — it requires owner education, validated assessment tools and a veterinary culture that treats pain management as a priority in senior cat care.

What You Can Do

Use the Feline Grimace Scale photograph assessment to monitor your senior cat for pain between vet visits
Request an arthritis assessment from your vet for any cat over 10 years old showing reduced activity or changed behaviour
Discuss NSAID treatment and environmental modification with your vet for any cat with confirmed arthritis
Provide steps, ramps and low-sided litter trays to reduce the physical demands on arthritic cats in your home
Advocate for pain assessment training in veterinary education to improve early detection of feline chronic pain