Chronic pain is endemic in older cats and severely underdiagnosed, with validated assessment tools and modern multimodal analgesia now enabling effective welfare management for painful conditions.
Chronic pain in cats represents one of the most significant welfare failures in companion animal medicine — not because conditions cannot be treated, but because they consistently go undiagnosed and untreated. The evolutionary suppression of pain behaviour in cats (which evolved as solitary predators who cannot afford to show vulnerability) means that owners and even experienced clinicians systematically underestimate feline pain burden. A cat that has stopped jumping, plays less, grooms more slowly or seems "old" may be in significant chronic pain that owners interpret as normal ageing. The FGS provides an objective tool: orbital tightening, muzzle tension, ear position and whisker changes create a reliable pain portrait that bypasses subjective owner interpretation. Effective multimodal analgesia — combining NSAIDs, gabapentinoids, environmental modification and sometimes acupuncture or physiotherapy — can dramatically improve quality of life in painful cats. The welfare cost of untreated chronic pain accumulated over years is enormous and largely preventable.