Could your cat be in pain? None of us want that to be the case, but knowing how to identify pain is key to supporting your cat’s well-being.
There is No Test for Pain
There is no test or diagnostic that your vet can run to definitively rule out pain. This includes bloodwork, urine testing, x-rays and other imaging, etc.
These diagnostics can be, of course, extremely valuable. They can identify sources of pain, if present, and medical issues that need to be addressed. But normal results do not rule out pain.
Treatment for pain doesn’t rule out continued or re-occurring pain either. Maybe the treatment helped in the moment but the issue returned. Or maybe the treatment was insufficient. Unfortunately, pain can be complex to treat and our first attempts aren’t always successful. This does not mean pain isn’t present.
Behavior is usually the best indicator you will have. Observing your cat and knowing what is normal for them is a key indicator of how they are feeling.
Sources of Pain
Pain is difficult to diagnose in cats because they tend to hide the signs and there are many possible sources. This includes:
- Dental disease, broken teeth, and other mouth issues
- Gastrointestinal disease or disorders
- Skin conditions (including itchiness/allergies)
- Problems with ears and eyes
- Orthopedic conditions
- The presence of masses/tumors
- And more
Chronic Pain
Most people know what “acute” pain looks like – the cat who suddenly isn’t themself. Signs are usually distinct and obvious. Acute pain is new – typically due to an injury or illness, but possible after a surgery or painful medical procedure. If your cat has a sudden change in behavior, call the vet immediately. You can learn more about some of the signs and how to make vet visits as low stress as possible here.
Chronic pain is different. This is pain that remains longer term. It can have more subtle but still problematic effects. Chronic pain may linger after a normal recovery period or after your cat has “recovered” from an injury or illness. Some conditions, such as arthritis or GI disease, can cause chronic pain.
Cats with chronic pain often show more subtle changes, possibly only behavioral changes. Because these creep in over time or because the original acute condition has been treated, this pain is more easily missed. Behavior changes associated with chronic pain frequently get mislabeled, even by skilled professionals, as behavioral only.
By understanding the effects of chronic pain and potential sources, you can advocate for your cat and get them the support they need.
Signs of Pain
A general exam may not be enough to identify pain, particularly if the cat is fearful at the vet. To support your cat and vet, you’ll need to be prepared with all of your observations.
Include:
- Behavior issues or concerns
- Even if they are “normal” for your cat
- Especially if you remember a time when your cat was different
- Irritability or avoidance
- Especially if it is just sometimes or your cat goes through “moods”
- Changes in energy
- Even in an older cat, “slowing down” may be a sign of a treatable condition
- Fluctuating appetite or elimination habits
- Variable interest in food that cycles over the course of days or weeks
- Stool quality that changes/gets worse and then better, even without diet changes
- “Random” periods of litter box avoidance
- Skin changes or abnormalities
- Twitching skin
- Scratching or licking, in general, but especially if it’s focused on one area
- Slowness/caution jumping on and off of things
- Look for these signs
What To Do Next
Identifying and addressing pain in cats is an ongoing journey. If you are concerned, stick with it!
- Keep observing
- Track signs in a journal to determine frequency and patterns.
- Take video to show to your care team.
- Ask for next steps
- If the currently recommended tests/treatments don’t show anything, what does your vet recommend next?
- Even if nothing is found, if the signs are still present, your vet should keep working with you.
- Get a second opinion or specialist evaluation
- Getting a second opinion from another vet isn’t a sign of mistrust or dislike of your vet. It’s just bringing more brains to a tricky situation.
- Most vets have some knowledge about a huge range of topics (that’s what general practice requires), but specialist skills may be needed to go deeper into particular areas. Again, not a sign that there’s anything wrong with your vet’s skills.
- Be patient and persistent
- Answers can be slow, treatment can require multiple trials – it’s worth it!
Remember: There is no test that can rule out pain in any individual. You need to observe your cat and keep observing. If you are concerned, be persistent. Your cat will thank you!
If you need help collecting observations and talking to your vet or if your cat has a behavior problem that you need help solving, consider scheduling a private behavior consultation.