Cat Pain Recognition in Clinical Practice: Improving Feline Pain Management

Cats are chronically undertreated for pain in veterinary settings due to their stoic nature. Validated assessment tools are improving pain recognition and treatment rates.

Key Facts

Cats underreport pain through evolved stoicism — this makes clinical pain assessment significantly more challenging than in dogs
The Feline Grimace Scale (FGS) encodes acute pain through five facial action units: ear position, orbital tightening, muzzle tension, whisker change, and head position
Studies show FGS scores correlate with analgesic requirements in cats after surgery with good validity and reliability
Post-operative analgesia in cats has historically been administered less than in dogs for equivalent procedures — FGS use is narrowing this gap
Acute pain in cats can be assessed remotely from photographs and video using the FGS — enabling home monitoring
Chronic pain assessment uses different tools including owner questionnaires (Musculoskeletal Pain Index) and locomotion analysis

Welfare Considerations

Feline pain recognition and management is one of the highest-priority welfare issues in companion animal veterinary medicine because the gap between actual pain prevalence and pain treatment rates is particularly large in cats. Cats experience the same painful conditions as dogs — surgery, dental disease, arthritis, trauma, cancer — but their behavioral concealment of pain means these conditions are less frequently recognized and less aggressively treated. The Feline Grimace Scale has been a transformative tool because it makes pain assessment learnable and standardizable — any trained observer can score a cat's pain level from facial expression rather than requiring interpretation of complex behavioral changes. The normalization of pain assessment as a routine veterinary practice alongside vital signs measurement represents a culture shift with significant welfare implications. Home FGS use by trained owners enables early detection of pain emergence between veterinary visits.

What You Can Do

Learn the Feline Grimace Scale — downloadable freely from the University of Montreal FGS website
Ask your veterinarian to assess your cat's pain score at every visit, particularly after procedures
Never assume a cat is not in pain because they are eating or appear functional — stoicism masks significant suffering
Photograph your cat periodically to create baseline facial expression references for comparison when illness is suspected
Advocate for pain assessment training and FGS use as standard components of veterinary education curricula