Cat Chronic Pain: Recognition and Management in Older Cats

Chronic pain is pervasive in older cats but profoundly underdiagnosed and undertreated. Improving pain recognition and management is one of the highest-impact cat welfare interventions.

Key Facts

Chronic pain affects a large proportion of older cats — osteoarthritis alone is detectable radiographically in over 90% of cats over 12 years.
Unlike dogs, cats rarely limp with arthritis — they modify behavior to avoid pain, making recognition much harder.
Behavioral indicators of chronic feline pain include reduced jumping, hesitancy on stairs, reduced grooming, altered sleep patterns, and withdrawal.
The Feline Grimace Scale (FGS) is a validated tool for assessing acute pain in cats using facial expression changes.
The MUSCULOSKELETAL pain screening guidelines (MOSS checklist) help vets and owners identify mobility-related chronic pain.
Meloxicam (an NSAID) is licensed for long-term use in cats in many countries and is effective for musculoskeletal pain.
Newer targeted therapies including frunevetmab (anti-NGF monoclonal antibody) offer effective pain relief with minimal side effects.

Welfare Considerations

Chronic pain in older cats represents one of the largest unaddressed welfare burdens in companion animal medicine. Most cats with osteoarthritis are never diagnosed, and most of those diagnosed receive inadequate long-term pain management. The behavioral changes caused by chronic pain — including reduced activity, reduced grooming, altered social behavior, and sleep disruption — are commonly misinterpreted as normal aging. This represents a profound welfare failure: millions of cats living in chronic pain that is treatable but untreated. Annual senior wellness examinations that specifically assess mobility and pain indicators, combined with owner education about what normal vs. pain-modified behavior looks like, would dramatically improve the quality of life of older cats. The evidence base for effective feline chronic pain management is now strong.

What You Can Do

Schedule bi-annual veterinary check-ups for cats over 10 years, specifically asking about pain assessment.
Learn the behavioral signs of feline chronic pain — reduced jumping, changes in grooming, altered behavior are key indicators.
Ask your vet about long-term NSAID therapy or anti-NGF monoclonal antibody treatment for chronic pain.
Modify your home for arthritic cats: ramps, lower litter box sides, raised food bowls, and warm sleeping spots.
Use the Feline Grimace Scale to assess your cat's pain at home and communicate observations to your vet.
Never assume behavioral changes in older cats are "just aging" — have them assessed for pain as a first step.