Chronic Pain in Cats: Recognition, Assessment and Treatment

Chronic pain in cats, particularly from osteoarthritis, is significantly underdiagnosed and undertreated. Recognising subtle pain behaviours and pursuing treatment dramatically improves feline quality of life.

Key Facts

Osteoarthritis affects an estimated 40% of cats over 6 years and over 90% of cats over 12 years
Cats rarely vocalise in response to chronic pain — unlike acute pain — making detection difficult
Key behavioural signs include reduced grooming, decreased jumping height, altered sleeping position and activity change
The Feline Grimace Scale allows objective pain scoring from facial muscle tension patterns
NSAIDs must be used cautiously in cats due to renal sensitivity — newer options including meloxicam have improved safety
Gabapentin is increasingly used as a multimodal pain management adjunct in cats
Environmental modifications including ramps, lower-sided litter trays and raised food bowls improve quality of life

Welfare Considerations

Chronic pain in cats represents a major hidden welfare burden in companion animal medicine. Cats are stoic pain hiders — an evolutionary adaptation against predator detection — meaning owners and even veterinarians routinely miss signs of significant ongoing pain. The prevalence of feline osteoarthritis is extraordinary: the majority of middle-aged and elderly cats have radiographic evidence of joint disease. Untreated pain causes chronic suffering, reduces activity, impairs grooming and social behaviour, and may contribute to cognitive decline. The good news is that effective treatment is available: NSAIDs (with renal monitoring), gabapentin, environmental modifications and increasingly novel therapies like anti-NGF monoclonal antibodies offer genuine pain relief. Regular veterinary pain assessment for cats over 7 years should be standard.

What You Can Do

Take cats over 7 years for a pain assessment with a vet familiar with the Feline Grimace Scale
Watch for subtle behaviour changes — reduced jumping, hiding, altered grooming — as pain indicators
Modify your home environment with ramps, lower litter tray sides and accessible food and water stations
Ask your vet about multimodal pain management options if osteoarthritis is diagnosed