Pain management in cats requires specific attention because cats are masters of concealing pain, many analgesic options used in other species are toxic to cats, and chronic pain conditions are prevalent in the feline population.
Cats evolved as both predator and prey—showing weakness would make them targets for larger predators. This evolutionary pressure created a species that suppresses pain behaviour even when experiencing significant chronic pain. Cats with severe osteoarthritis may continue eating, grooming, and interacting normally while experiencing pain that reduces their quality of life substantially. Recognising subtle behavioural changes as pain indicators rather than "personality" or "age" is critical for welfare.
Cats have reduced glucuronidation capacity compared to dogs and humans—the liver pathway that metabolises many drugs including some NSAIDs. This makes cats more susceptible to NSAID toxicity and requires careful selection and dosing of analgesic medications. Meloxicam at very low doses (0.01-0.02 mg/kg every other day or every 3 days) can be used long-term with regular renal monitoring in cats without severe CKD. Gabapentin is well-tolerated and effective for neuropathic pain. Buprenorphine provides effective opioid analgesia.
Osteoarthritis is extremely prevalent in older cats—affecting the majority of cats over 12 years—yet severely undertreated. Validated treatment approaches include: low-dose meloxicam with monitoring; gabapentin for central sensitisation component; environmental modifications reducing joint loading; weight management; and bedinvetmab (anti-NGF monoclonal antibody) which is licensed for feline OA pain management in some countries and provides excellent welfare outcomes.
Optimal pain management in cats combines pharmacological and non-pharmacological approaches. Environmental modifications (ramps, accessible litter trays, warm bedding) reduce pain triggers and support function. Physiotherapy adapted for cats provides gentle joint mobilisation and muscle support. Acupuncture has evidence for OA pain in cats. Omega-3 fatty acid supplementation reduces inflammatory mediators. These complementary approaches reduce required analgesic doses while improving overall welfare outcomes.