Chronic pain in cats — most commonly from degenerative joint disease — is vastly under-recognised and under-treated, with cats' stoic nature masking significant welfare harm that evidence-based assessment tools can now detect.
Chronic pain in cats represents one of the largest welfare gaps in companion animal medicine. The scale of the problem is clear from radiographic studies: the vast majority of older cats have radiographic changes consistent with DJD, but only a small fraction are identified clinically because cats mask pain so effectively. The evolutionary logic is clear — a cat that shows vulnerability is a cat that risks predation — but in domestic settings, this masking works against welfare. The development of validated feline pain assessment tools, including behavioural scales and the Grimace Scale based on facial expression changes, provides veterinarians and owners with objective methods to detect pain that clinical observation misses. Treatment has historically been limited by NSAID safety concerns in cats — their reduced hepatic glucuronidation capacity makes many human and canine NSAIDs toxic. Feline-licensed meloxicam at appropriate doses is safe long-term with monitoring, and new targeted anti-NGF therapies (frunevetmab) provide effective pain relief without the renal and hepatic concerns of NSAIDs. Home monitoring using owner-completed activity questionnaires tracks treatment response objectively.