How to Tell if a Cat Is in Pain

Identifying that a cat is in pain is no small task. Their instincts cause them to hide signs of pain even when they’re a well-socialized, indoor-only housecat with no predators to trick. Realizing that your cat is hiding or isolating may be the first hint that they are in pain. Other signs to watch for include changes in grooming habits, litter box use, appetite, and personality. 

Cats can exhibit more obvious signs of pain as well, such as body-posture changes, limping, or crying. They keep us on our toes, though, because other signs of pain can be as subtle as not jumping to their usual resting spot as often, a small change in their breathing rate, or just being a little spicier during playtime. 

Since their instinct is to hide signs of pain, if you start to notice some, it’s always good to speak with a veterinarian.

How can you tell if a cat is in pain?

The most important thing to know about identifying pain in your cat is to watch for any physical or behavioral changes. Each cat is unique, so how much they groom or vocalize, how well they use the litter box, and how active or sporty they are will be specific to them. If your cat is more or less chatty than usual, is having more issues using the litter box successfully, or is overgrooming or undergrooming, they may be experiencing pain. 

Some changes will be more noticeable than others. Acute pain comes with sudden changes that are likely to be more obvious. However, chronic pain may develop slowly, leading to small changes over time. You may not realize anything is changing unless you compare your cat’s behaviors to previous weeks, months, or years. Even then, it can be challenging to figure out if those are normal, age-related changes or signs of a bigger issue. 

Once you suspect there are changes in your cat’s physical or behavioral health, consult a veterinarian to identify the source of the pain and to start treating it. 

Physical signs your cat is in pain

• Ears are lowered, flattened, or positioned outwards or backwards

• Tense facial muscles

• Whiskers pinned close to the face, instead of outward

• Squinted eyes

• Head held at or below the shoulders, possibly tucked into the chest

• Consistently crouching or hunching/curving the back

• Tail flicking when you approach

• Jaw chattering

• Panting or increased breathing rate

• Limping

• Tail stays at or below hip level

• Muscle twitches along the back when not touched

• Flicking the head repeatedly to look at a specific area of the body

Behavioral signs your cat is in pain

Changes in grooming habits

Cats notoriously like to keep themselves clean. You’ve probably seen your cat grooming themselves multiple times a day, which is normal. A cat in pain, however, may start changing their grooming routine. 

When a cat overgrooms, you can usually tell because they start to damage the hair in the area they’re paying too much attention to. Common examples are their belly and legs. If they overgroom these areas, the hair coat may look shorter, rougher, or even bald. Although stress can be a cause of overgrooming, pain is the other common culprit. A cat with joint pain may over-lick and overgroom their legs, while a cat with bladder pain may overgroom their belly.

The hair coat of a cat who is undergrooming or not grooming effectively will start to get matted. This happens most commonly in long-haired breeds, but can still occur in very short feline coats. The cause of this can be dental pain or loss of mobility. If they can’t reach an area of their coat anymore due to pain, then the area will start to look unkempt, greasy, full of dandruff, and eventually matted. 

Appetite changes

Dental pain in a cat can often go unnoticed until they stop eating well. Just like us, moments of extreme stress or pain can also leave a cat with no appetite. After an acute injury, it’s very common for cats to refuse to eat. Since they may try to disguise their pain by hiding a limp, understanding why a cat may not eat is very helpful for identifying pain.  

If your cat isn’t eating well or refusing food entirely, it’s very important that they see a vet, because eating too little can cause liver damage. 

Chatty catties

Since your cat sees you as part of the family, they will often seek you out for comfort even if they’re otherwise hiding that they’re in pain. They may be more cuddly than usual, but this can also include being more vocal. 

Vocalizations include more meowing, chattering, and yowling. You may also catch on that they’re purring more than usual and at abnormal moments when you don’t expect them to be happy. We think they purr while in pain to soothe themselves. 

If your cat is more sensitive while in pain, you may also hear hissing or growling. They may do this and avoid you — or they may seek you out more, just to hiss if you touch them or give them attention. This can be distressing for pet parents and sometimes escalates to cat aggression. So if you’re struggling with this dynamic in your home, talk to your vet about possible underlying pain. 

Instead of more or less vocalizations from your cat, you may hear their volume or tone change. If there’s more urgency or distress, they can become raspy from meowing so much, or they can even sound congested if they become sick due to the stress. 

Aggression

Cats in pain can become more defensive and quicker to attack. This may start as hissing and growling, but can escalate towards scratching, swatting, and biting. (Cat bites always need immediate medical attention to prevent life-threatening infections.) Aggression in a pained cat may be triggered when a certain part of their body is touched. Or they may seek you out from across a room if your presence or movements cause them stress.

Litter box struggles

Stress is the number one cause of litter box issues. This is because being in pain is stressful for cats. 

If your cat’s litter box has tall sides, is top loading, isn’t clean, or is too small, it can be difficult to use when your cat has any limb or joint pain. This may cause them to start going outside the box or to choose a separate area entirely for relieving themselves. Make sure to provide them with multiple large or wide boxes with low sides in different areas of the home, so they can use the litter box comfortably.

When pain is causing too much stress for a cat, it may trigger some secondary, stress-related urinary concerns. Signs of this include vocalizing while urinating, straining to urinate, going to the litter box more frequently, only urinating small amounts at a time, and urinating and/or defecating outside the litter box. If you see signs like this, consider it an emergency, and take them to the vet, the veterinary urgent care, or a pet emergency room. 

Mobility issues

Cats in pain often struggle with jumping, playing, running, scratching, using their cat tree, climbing stairs, and more. Aging cats will usually demonstrate more of these issues as they develop progressive arthritis in their joints. Ask your vet about available arthritis treatments. You can also adapt your house to your cat’s needs by using more ramps, stairs, and rugs to help them get to where they need to go. 

When to seek veterinary care for your cat

Since cats are experts at hiding signs of pain, once you notice any of those signs, take them to a vet. Some signs of pain are more of an emergency than others, such as limping, open wounds, and going to the litter box more frequently, especially if they’re passing very little to nothing when they go. 

Subtle signs of pain can trick you into thinking their pain isn’t significant, but untreated pain can lead to irreversible changes in behavior. That’s why it’s important to take any signs of pain in cats seriously, and have them assessed by a vet as soon as possible. 

Commonly asked questions

Do cats purr when they are in pain?

Yes, cats can purr when they’re in pain. They seem to purr out of an effort to soothe themselves.

Are cats in pain while in heat?

Although a cat’s behavior in heat can be very dramatic, this is, fortunately, not because they are in pain. These behavioral changes are due to rapid hormone-level changes. 

References

Frank, Diane. “Recognizing Behavioral Signs of Pain and Disease.” Veterinary Clinics of North America: Small Animal Practice, vol. 44, no. 3, May 2014, pp. 507–524, doi.org/10.1016/j.cvsm.2014.01.002. 

Mills, Daniel S., et al. “Pain and Problem Behavior in Cats and Dogs.” Animals, vol. 10, no. 2, 1 Feb. 2020, p. 318, www.mdpi.com/2076-2615/10/2/318, doi.org/10.3390/ani10020318.