Cat Chronic Pain Recognition: Improving Welfare Through Better Assessment

Chronic pain in cats is systematically underrecognised and undertreated due to their stoic nature, with validated assessment tools now enabling earlier intervention and improved welfare.

Key Facts

Chronic pain in cats is most commonly associated with degenerative joint disease (osteoarthritis), dental disease, and feline interstitial cystitis
Studies using CT scanning suggest over 90% of cats over 12 years old have radiographic evidence of joint changes, but clinical signs are often absent or subtle
Cats conceal pain as an evolutionary survival strategy — signs are indirect: reduced grooming, changed posture, reluctance to jump, altered facial expression
The Feline Grimace Scale (FGS) is a validated tool measuring orbital tightening, muzzle tension, whisker position, and ear orientation to assess acute pain
The FMPI (Feline Musculoskeletal Pain Index) and related owner questionnaires detect chronic pain through activity changes
Analgesic trials in cats suspected of chronic pain often reveal significant improvement in activity and grooming — retrospective evidence of prior pain

Welfare Considerations

Chronic pain represents one of the most significant and underaddressed welfare issues in companion cats. Because cats naturally conceal pain, owners and even veterinarians frequently miss chronic pain for months or years. An old cat that jumps less, grooms less, or hides more may be suffering chronically from joint or dental pain rather than simply ageing. The development of validated pain assessment tools like the Feline Grimace Scale and owner questionnaires is transforming this — making it possible to detect and quantify pain that would previously have been missed. Effective analgesics including meloxicam, buprenorphine, and gabapentin are available for cats, but their use is constrained by underdiagnosis. Improving pain recognition is the most important step in improving chronic pain welfare outcomes.

What You Can Do

Learn the signs of chronic pain in cats: reduced grooming, reluctance to jump, changed facial expression, social withdrawal
Discuss pain assessment with your vet for any cat over 10 years, even if no obvious signs are present
Ask your vet about the Feline Grimace Scale and validated chronic pain questionnaires for regular welfare monitoring
Consider an analgesic trial for older cats showing subtle behavioural changes — improvement confirms prior pain
Support development and dissemination of feline pain assessment tools through veterinary school research donations