It isn't always easy to tell when a cat is unwell or in pain. You might expect it to be obvious, but even the most attentive owners often don't realize there's a problem until it's well advanced. Cats are remarkably good at concealing their symptoms, and by the time signs are unmistakable, whatever is going on has usually been going on a while.
Hiding pain is natural for a cat. As your veterinary team, we'd like to explain why they do it, and point out some of the subtler signs that your cat may be hurting—because those are what you'll notice first, if you know to look for them.
Why Do Cats Hide Pain?
It's an evolutionary holdover. In the wild, a small predator showing weakness is also a target, so animals who concealed injury and illness fared better than those who advertised it. Domestic cats have inherited that instinct even when their greatest daily concern is choosing between two sunny spots.
There may be a social element too. Cats sharing space with other animals may be reluctant to appear vulnerable around them, and a cat who feels they're competing for food, resting places, or attention has reason to keep any weakness to themselves.
Whatever the reason, the practical consequence is the same: your cat is unlikely to tell you they're in pain, so noticing what's changed is largely down to you.
Often-Overlooked Signs of Pain in Cats
However well a cat conceals pain, there are almost always subtle signs. Here's what to watch for—and please get in touch if you notice any of them.
Decreased Appetite
Do book an appointment if your cat stops eating or drinking, or is eating noticeably less food than usual. A reduced appetite is often the earliest sign that something is wrong—it might be dental pain, an injury, or an illness elsewhere in the body.
Don't leave this one long. A cat who eats nothing for more than a day or so can develop a serious liver condition called hepatic lipidosis, which complicates whatever the original problem was. Signs worth mentioning include approaching the bowl and walking away, chewing on one side, dropping food, or eating more slowly than usual.
Decreased Activity
You probably wouldn't fancy a long walk if you were in real pain, and cats are no different. A cat who is hurting tends to spend more time lying about, and often loses interest in things they used to enjoy—playing with you, or with the other pets in the house.
Sleeping more is easy to write off, particularly in an older cat. It's worth mentioning to us rather than accepting.
Changes in Grooming or Appearance
Has your usually fastidious cat stopped looking after their coat? Or started licking one area obsessively? Both can indicate pain.
Reduced grooming happens for two reasons: a cat who feels unwell loses interest, and a cat who is stiff or sore physically can't reach parts of themselves any more. That's why mats tend to appear first along the back and near the tail base—the areas that need the most flexibility to reach.
Overgrooming one spot often means discomfort underneath it, whether that's a skin problem, a joint, or pain further inside. Bald patches, broken hairs, or irritated skin all warrant a look.
Nails are worth checking too. A cat who has stopped using their scratching post—because stretching up to it hurts—will develop overgrown claws, and in an older cat those can curl round into the pads. Have a look at your cat's nails now and then, particularly if they're elderly.
Reluctance to Jump or Climb
This is one of the most useful signs there is, and one of the most commonly missed. Cats with joint pain rarely limp the way a dog does—they simply stop doing the things that hurt.
So a cat who used to sleep on the windowsill and now sleeps on the floor, or who now takes the stairs one at a time, or who hesitates before jumping down, is telling you something. Please don't put it down to age alone—old age isn't a disease, and arthritis is extremely common in older cats and badly under-diagnosed. There's a great deal we can do to make an arthritic cat more comfortable, and it makes a real difference to how they live.
Behavior Changes
Has a cat who has been affectionate for years suddenly decided they don't want to be petted? Is a friendly cat now swiping or hissing when touched? Has a sociable cat started spending their days under the bed?
Changes like these are common signs of pain, and aggression in particular is worth taking seriously rather than treating as a change of temperament—a cat who objects to being handled is very often sore somewhere. You know your cat better than anyone, so any shift in behavior or personality is worth mentioning to us, even if it seems minor.
Changes in Litter Box Habits
Cats rarely stop using the litter box without a reason. If you have enough boxes, keep them clean, and haven't changed litter recently, a change in habits deserves proper investigation.
Sometimes it's mechanical—an arthritic cat may struggle to climb into a high-sided box, and switching to one with a low entry solves it. Sometimes it's that urinating has become painful and your cat now associates the box with that discomfort. Either way, this is one we'd rather see than guess at.
One situation is a genuine emergency. If your cat is straining to urinate—in the box or out of it—and producing little or nothing, they may have a urinary blockage. This affects male cats most often and can be fatal within a day or two. Please contact us or your nearest emergency hospital immediately rather than waiting to see whether it settles.
Other signs your cat may be in pain:
- Difficulty getting up after lying down, or looking stiff when they first move
- Lethargy
- A hunched posture, or sitting with their feet tucked tightly under them
- Changes in gait, or shifting weight off one leg
- Squinting, flattened ears, or a tense expression around the muzzle
- Purring in circumstances where they wouldn't normally, since cats also purr to self-soothe when distressed
- Unusual vocalizing, particularly at night
- Weight loss
- Flinching or pulling away when touched in a particular spot
How We Can Help
When you bring your cat in, we'll start with a careful physical examination, feeling along joints and limbs and looking in the mouth—dental pain is a common and easily missed cause. We'll also want to hear what you've noticed, since your observations at home tell us things no examination can.
From there we may recommend diagnostic tests—bloodwork, urinalysis, or imaging such as radiographs—and we'll always discuss what we're suggesting and why before going ahead.
Treatment depends on what we find, and there's more available for feline pain than there used to be. Depending on the cause, that might mean treating an underlying illness, dental treatment, prescription pain relief, joint supplements, newer treatments developed specifically for arthritis in cats, or straightforward changes at home—steps up to a favorite perch, a low-sided litter box, a softer bed somewhere warm.
One important note: please never give your cat human pain medication. Acetaminophen is highly toxic to cats and even a single tablet can be fatal, and ibuprofen and aspirin are dangerous too. Cats also process many drugs differently from dogs, so a medication left over from your dog isn't safe either. If you think your cat is in pain, call us—there are options, and we'd rather prescribe something appropriate than treat a poisoning.
Contact us today if you have any reason to think your cat may be in pain. Cats hide it well, so if your instinct says something has changed, that's usually worth acting on.