How to Tell if Your Cat Is in Pain: Signs and What to Do

By Dr Duncan Houston

Your cat no longer jumps onto the sofa, disappears at mealtimes or snaps when you stroke their back. These changes can be more useful clues to pain than crying or an obvious limp.

You do not need to find the painful spot yourself. What matters is noticing what has changed, checking for urgent warning signs and helping your vet understand what happens at home.

Quick Answer

Cats in pain may hide, move differently, groom less, eat less or become unusually defensive, but no single behaviour confirms pain or its cause. Contact your vet today about a new unexplained change, especially when several signs occur together. Difficulty breathing, collapse, major injury or repeated straining with little or no urine needs emergency care now. Never give human painkillers to a cat.

What does pain look like in a cat?

Compare your cat with their usual self, including small daily habits. Useful changes to report include:

Movement: hesitating before jumping, using several small steps to reach furniture, stiffness after resting or avoiding stairs.
Posture: sitting tightly hunched with the head lowered, guarding part of the body or repeatedly shifting without getting comfortable.
Grooming: a newly greasy or matted coat, difficulty reaching the back, or persistent licking of one area.
Interaction: hiding, reduced interest in play, unusual clinginess, or hissing during handling that was previously welcome.
Eating and toileting: approaching food then turning away, dropping food, eating less, or changing litter tray habits.

Acute pain can follow injury, surgery or sudden illness and may still be quiet and subtle. Chronic pain can change routines gradually. The ISFM feline pain guidelines recommend assessing behaviour, posture, facial expression and the clinical situation together.

Can you tell from your cat's face?

The Feline Grimace Scale, developed at Université de Montréal, assesses five facial features: ears, eye narrowing, muzzle tension, whiskers and head position. It is validated for acute pain and can help trained caregivers recognise discomfort.

Observe an awake, undisturbed cat and share a clear photo or short video with your vet. A sleepy expression or a single flattened ear is not a diagnosis. Fear, illness and medication can affect assessment, and a low facial score does not rule out pain, particularly a long-term mobility problem. Do not delay care to obtain a score.

How urgently does your cat need help?

What you notice	Why it matters	What to do
Gradual reduction in jumping or grooming, with normal breathing, eating and urination	A chronic painful condition is possible even without limping	Call today to arrange an examination. Record examples while awaiting the appointment.
New hiding with reduced eating, persistent limping, a sore eye or a marked behaviour change	Pain or another illness may need treatment promptly	Request a same-day veterinary assessment. Call sooner if signs worsen.
Breathing difficulty, collapse, major trauma, sudden inability to use the back legs, or straining with little or no urine	A life-threatening problem is possible	Contact an emergency clinic and leave for care now.

Do not use a blanket 24 to 48 hour waiting period for suspected pain. Tell the clinic if your cat is a kitten, recently had surgery, has a chronic disease or takes medication, because this can change the plan.

Could it be fear, illness or something other than pain?

Hiding and defensive behaviour can occur with fear as well as pain, and both can happen together. A change after visitors arrive gives useful context, but it does not explain away poor appetite, altered movement or difficulty toileting. Let your cat settle somewhere quiet without repeatedly testing their reactions.

Your vet will consider the pattern:

Difficulty jumping or grooming: joint pain is one possibility; weakness, injury and neurological problems also need consideration.
Dropping food or avoiding chewing: dental or mouth disease may hurt, while nausea can also reduce eating.
Repeated litter tray visits: bladder inflammation, stones or an obstruction may look similar. Do not assume the cat is constipated.
Licking, scratching or flinching: skin irritation, wounds and local pain can overlap.

An examination may include the mouth, eyes, abdomen, joints and nervous system. Urine testing, blood tests or imaging depend on the findings. A description online cannot reliably identify the cause or select a safe pain medicine.

When is this an emergency?

Seek emergency veterinary care immediately for:

Open-mouth breathing at rest, obvious effort to breathe, or blue, grey or very pale gums.
Collapse, inability to stand, severe distress or rapidly worsening weakness.
A road accident, major fall, serious wound or uncontrolled bleeding.
Sudden dragging of the back legs or inability to use them, particularly with distress.
Repeated straining with little or no urine, especially in a male cat.
Known or suspected ingestion of a human painkiller.

Cornell's guidance on feline urinary disease identifies urethral obstruction as an emergency requiring immediate treatment. Passing a few drops does not make repeated straining safe to watch at home. If you cannot tell whether your cat is passing urine, call an emergency clinic now.

Keep handling and noise to a minimum during transport. Call ahead for safe lifting advice after trauma. Do not press the abdomen, manipulate a painful limb or force food, water or medication into a distressed cat.

What should you do next?

Call with specific observations. State when the change started, whether it is worsening, and what your cat has eaten, passed in the tray and been able to do.
Make essential resources easy to reach. Offer a quiet resting area, non-slip footing and an accessible litter tray. Keep food and water nearby but separate from the tray. Prevent unnecessary jumping until assessed.
Record ordinary activity. A short video of walking or using steps can be useful. Do not make your cat jump or touch a sore area to demonstrate pain.
Use only the current veterinary prescription. Do not borrow another animal's medication, restart leftovers or increase a dose. After surgery, follow the discharge instructions and contact the operating clinic if your cat remains uncomfortable.
Agree on follow-up. Ask what improvement should look like, when it should occur and which changes require an earlier call. Recheck urgently if your cat becomes more withdrawn, stops eating or develops any emergency sign.

Never give paracetamol, also called acetaminophen, to a cat. It can be fatal. Ibuprofen, naproxen and other human pain relievers can also cause serious harm. The FDA's advice on pet pain medicines explains why cats cannot be treated as small people or small dogs.

What are the most common mistakes?

Waiting for crying, limping or complete refusal of food before taking a change seriously.
Calling stiffness or poor grooming “just old age”.
Punishing hissing or litter tray accidents instead of checking for discomfort.
Repeatedly squeezing, stretching or massaging a painful area.
Assuming quietness after medication means pain is controlled without checking normal function.

How can you support long-term comfort?

For a cat with arthritis, the aim is comfortable daily activity. The Feline Veterinary Medical Association's arthritis guidance highlights changes in jumping, grooming and social behaviour that can be overlooked.

Work with your vet on prescribed pain relief, appropriate weight management and practical changes such as stable steps, accessible beds and low-entry litter trays. Track a few meaningful activities, such as reaching a favourite resting spot or grooming the back, and review them at follow-up appointments.

Once your vet confirms what is comfortable, offer gentle play and enrichment within your cat's abilities. Introduce new toys or experiences gradually, maintain predictable routines and provide places to retreat from noise or other animals. Routine examinations and dental care help identify problems, although they cannot prevent every painful condition.

Frequently Asked Questions

Can a cat purr when in pain?

Yes. Purring does not prove that a cat is comfortable. Assess appetite, posture, movement and usual behaviour together.

Does a cat in pain always stop eating?

No. Some cats continue eating despite discomfort, including dental pain. A change in how they eat can matter even when the bowl still empties.

Is hiding always a sign of pain?

No. Fear, environmental change and other illnesses can cause hiding. New or persistent hiding deserves a veterinary discussion, particularly with another change.

What can I give my cat for pain at home?

Only medication currently prescribed for that cat and situation. Keep them comfortable while arranging care, and never substitute a human painkiller.

Will treatment help an older cat with chronic pain?

Many cats become more comfortable with an individual treatment plan. The response depends on the cause and other health conditions, so measure everyday function and keep scheduled reviews.

Trust changes in your cat's normal routine

You do not need to prove that your cat is hurting before contacting your vet. A clear account of what has changed is enough to start the conversation. Act immediately on emergency signs, and seek a plan for quieter changes before discomfort becomes your cat's new normal.

For help making sense of changes in your cat's wellbeing, ASK A VET™ offers supportive guidance. Breathing difficulty, suspected urinary blockage and other emergencies need immediate hands-on veterinary care.