Cats are built to appear unbothered. The qualities that make them feel so self-sufficient, the composure, the independence, the way they carry on without making a fuss, are the same qualities that make their pain so easy to miss.
If you have noticed something that you cannot quite name, a shift in her routine, a stillness that feels different from rest, a reluctance to do something she used to do without thinking, that observation matters. You know your cat better than anyone in her life.
This guide covers what pain looks like in cats: the obvious signs, the ones that take longer to see, and what to do once you have a sense of something is wrong.
Why cats hide pain even more than dogs
Dogs evolved as pack animals. A dog who was injured could rely on the group. Cats evolved as solitary hunters. In the wild, showing weakness with no pack nearby made them a target. The instinct to suppress and conceal pain is even stronger in cats than in dogs, and it runs deep.
A cat in significant discomfort will often continue eating, grooming, and moving through the house in a way that looks normal from a distance. She will come when called. She will sit in her usual window. The changes are in the quality of what she does, not always whether she does it at all.
By the time a cat’s pain becomes obvious enough to be unmistakable, it has usually been present for a while. You are not going to catch it by waiting for something dramatic. You catch it by knowing her baseline and noticing when something drifts from it.
Acute pain vs. chronic pain in cats
Pain in cats falls into two categories, and they present differently.
Acute pain comes on suddenly, from an injury, an infection, or a medical event. It tends to produce more visible responses: a cat who cries out when touched, stops moving abruptly, or cannot settle at all. Acute pain generally warrants prompt veterinary attention.
Chronic pain develops gradually. Arthritis is among the most common causes in older cats, though dental disease, kidney disease, cancer, and spinal conditions also produce long-term discomfort that builds slowly and quietly. Studies suggest that up to 90% of cats over twelve have some degree of joint change visible on X-ray, but the condition is severely underdiagnosed because the signs do not look like the limping most people expect. A cat with arthritis does not usually limp. She hesitates. She changes her route. She stops doing certain things.
Chronic pain is the type that is most likely to be explained away as aging. Some of it is. But a lot of it is not, and the distinction matters.
Signs your cat is in pain
Behavioral changes
Behavior shifts before most physical signs appear. Before you can see the pain, you will often feel it in how your cat is relating to you and to her environment.
- Withdrawal and hiding. She is spending time in places she did not use before: under the bed, in a closet, on a high shelf out of reach. Cats in pain retreat. It is one of the most consistent behavioral signals, and one of the easiest to misread as ordinary cat aloofness.
- Irritability when touched. A cat who has always tolerated being picked up or petted may suddenly growl, hiss, or swat when you touch a particular area. This is not a mood change. It is a pain response.
- Restlessness or an inability to settle. She lies down, shifts, gets up, lies down again. A cat in pain often cannot find a position that is comfortable, and you can see the searching in how she moves.
- Reduced interest in play or interaction. The toy she used to chase is now being ignored. She is watching from across the room where she used to come sit beside you. Energy and engagement are two of the first things chronic pain quietly takes.
- Vocalization. More meowing than usual, growling when approached, or hissing when handled. Some cats become unusually quiet rather than louder. Both directions are worth noticing.
Physical and body language signs
- Hunched posture. An arched back with a tucked abdomen and all four paws pulled close together. The cat is guarding her midsection.
- The prayer position. Front paws on the floor, rear end elevated. This is a classic sign of abdominal pain in cats.
- Rigid or unusual sleeping positions. A cat who used to sleep sprawled or curled loosely may now sleep in a tight, tense ball, or lie completely flat in a way that looks effortful rather than relaxed.
- Reluctance to jump. She stands at the bottom of the cat tree and then walks away. She used to reach the windowsill in one leap; now she takes two or three smaller ones. She stops going to a favorite high spot entirely.
- Moving more carefully. Every step looks considered. She goes around obstacles she used to step over. She pauses at thresholds.
- Favoring a limb or shifting weight. She sits with her weight distributed unevenly, or holds one paw slightly raised.
Grooming changes: both directions
Grooming is one of the most cat-specific pain signals, and it goes both ways.
Too little grooming: A cat with joint pain or spinal discomfort may stop being able to reach certain parts of her body. Grooming requires significant flexibility. A cat who cannot twist to reach her lower back or hind legs will develop a matted or unkempt coat in those areas. If her fur looks different along the spine, over her hips, or on her lower legs, that is worth noticing.
Too much grooming: A cat who returns repeatedly to lick or chew at one specific area is trying to soothe the pain source. The skin in that area may become raw, thinned, or bald over time.
A change in either direction, more grooming or less, concentrated in one area or lost from an area entirely, is meaningful.
Litter box changes
Missing the litter box, eliminating just outside it, or avoiding it in favor of another spot is a common pain signal that often gets attributed to behavioral issues or spite. In most cases, it is neither.
A standard litter box with high sides requires a cat to step over a threshold to enter. For a cat with arthritic hips or joints, that step can be genuinely painful. The posture required to squat and eliminate, holding still for several seconds with the core engaged, is also difficult with back or abdominal pain. A cat who starts missing the box is often telling you that using it correctly has become too uncomfortable.
A low-sided box, or a box with one side cut lower as an entry point, can make a significant difference while you work on identifying the underlying cause.
Reading your cat’s face for pain: the feline grimace scale
Veterinary researchers at the Université de Montréal developed a validated pain assessment tool specifically for cats, called the Feline Grimace Scale. The insight behind it: because cats suppress behavioral signs of pain so effectively, their faces carry more information than their actions do. Cats cannot choose to keep their faces neutral the way they can choose to keep moving.
The scale evaluates five areas of the face. Each one shifts when a cat is in pain:
- Ear position. A comfortable cat holds her ears forward, slightly to the side, and at a natural angle. A cat in pain pulls the ears apart, rotates them outward, or flattens them against the head.
- Orbital tightening (eyes). A relaxed cat has fully open, soft eyes. A cat in pain squints, half-closes the eyes, or holds them in a tight, tense way, as though the light feels wrong.
- Muzzle tension. A pain-free muzzle is round and soft. In pain, the muzzle tightens: it appears flatter, drawn, or pinched around the nose and mouth.
- Whisker position. Relaxed whiskers curve gently forward or outward. In pain, whiskers flatten against the face or pull backward, closer to the cheeks.
- Head position. A comfortable cat holds the head above the shoulders with easy, natural balance. A cat in pain lowers the head, sometimes tucking the chin toward the chest.
No single feature tells the full story. But when two or three of these appear together, especially in combination with any of the behavioral changes above, it points to something worth acting on.
The Feline Grimace Scale was designed to be used by both veterinarians and cat owners at home. You do not need clinical training to use it. You need to know what your cat’s relaxed face looks like, which you already do, and to notice when it changes.
What about purring?
Most people associate purring with a cat who is content. A cat who is purring seems fine. This assumption delays recognizing pain more often than almost anything else.
Cats purr for many reasons. Contentment is one of them. Stress, anxiety, and pain are others. Purring appears to be a self-soothing behavior, a way a cat regulates her own nervous system when something is wrong. Some researchers believe the vibration frequency of purring may even have a mild analgesic effect, which would explain why cats in pain often do it.
What matters is context. A cat purring in your lap while she kneads a blanket is content. A cat purring under the bed, who has not come out to eat and whose face is tight and low, is telling you something different. The purring is the same sound. The meaning is not.
When purring appears alongside any other sign on this list, pay attention to the full picture.
Signs of pain that are easy to miss
These are the changes that tend to be explained away, by aging, by a shift in preference, by the idea that cats just do what they want. Sometimes they are minor. But patterns of them together point to something real.
- No longer jumping to favorite spots. The cat tree she used every morning is being ignored. The windowsill she used to monitor the street from is empty. She may have tried once or twice and found it too painful, and stopped trying.
- Taking a different route through the house. She used to step over the threshold between rooms. Now she walks around it. She used to take the direct path to her bowl. Now she approaches from the side. Small route changes often reflect an effort to avoid a particular movement that hurts.
- Sleeping in new positions. She no longer stretches out on her side. She sleeps curled tighter than before, or in a more rigid posture. A cat who cannot relax fully into sleep is often protecting something.
- Unkempt fur along the spine or hind legs. She cannot reach those spots to groom them anymore, not without pain. It tends to show up as dullness or slight matting along the lower back first.
- Less time in shared spaces. She used to be in the room with you in the evenings. Now she is somewhere quieter, somewhere she does not have to move or interact. Pain is exhausting, and cats conserve accordingly.
- Muscle loss along the spine and rear legs. When a cat has chronic pain in her hips or back, she shifts her weight forward to compensate. Over weeks and months, the hind leg muscles shrink. In a cat, this shows up as a visible narrowing or bonier look along the hindquarters.
These are the silent triggers: the small shifts that each seem explainable on their own, but together describe a cat whose world is slowly getting smaller. A cat who used to own every room and now stays in one. That pattern, taken as a whole, is worth a conversation with your veterinarian.
When to act right now
Some signals mean: do not wait. If your cat is showing any of the following, contact your primary veterinarian or an emergency clinic immediately.
- Crying out repeatedly and cannot be calmed
- Sudden inability to use one or more limbs
- Straining in the litter box, especially without producing urine (a urethral obstruction in male cats is a life-threatening emergency)
- Visible distress, rapid breathing, or open-mouth breathing at rest
- Collapse or inability to rise
- Pale, blue, or white gums
Sudden, severe pain is a medical emergency. Loved is not an emergency service. We work alongside families navigating longer stories: chronic illness, a terminal diagnosis, or the slow changes that come with age. If that is the situation you are in, keep reading.
What to do if you think your cat is in pain
Document what you see before the appointment
Cats behave very differently in a veterinary clinic than at home. The stress of the visit can suppress pain behaviors almost entirely, making it genuinely difficult for a veterinarian to assess what you are seeing in her daily life. Video is one of the most useful things you can bring to an appointment.
Record her getting up from the floor. Record her walking to her food bowl. Film the moment she hesitates at the stairs or stands at the base of her cat tree without going up. Write down when you first noticed something, what has changed since, and whether anything makes it better or worse. These observations are the evidence your vet needs.
Talk to your vet and ask the right questions
Your veterinarian can help identify what is causing the pain. To get the most from that conversation, consider asking:
- Is this acute or chronic?
- What is the underlying cause, and is it treatable?
- What pain management options are safe for cats specifically?
- What should I watch for at home that would tell me the pain is getting worse?
- At what point should we start talking about quality of life?
That last question is one many families hesitate to raise. You should not hesitate to ask it. Asking it is an act of love, not an admission of defeat.
A word on medication safety
Cats metabolize medications very differently from dogs or humans. Acetaminophen (Tylenol) is fatal to cats. Many NSAIDs that are safe for dogs are toxic to cats. Even medications prescribed for cats can cause serious harm at the wrong dose or given too frequently. Never give your cat any pain medication without explicit veterinary guidance, and always specify that you are asking about a cat, not a dog, when discussing options. The differences matter.
Assess their quality of life
If your cat’s pain is ongoing, part of arthritis, kidney disease, cancer, or another chronic condition, a quality of life assessment gives you a way to understand the full picture: pain alongside appetite, mobility, hygiene, happiness, and daily function together. It is the difference between knowing your cat hurts and understanding how much that pain is shaping her days.
You can start with Loved’s free quality of life self-assessment, a guided tool that takes a few minutes and gives you a clearer sense of where your cat stands today. If you want a professional evaluation in your home, Loved’s in-home quality of life assessment brings a veterinarian into your cat’s own environment, where the full picture is visible and nothing is masked by the stress of a clinic visit.
For more on how quality of life shapes care decisions, read: Love isn’t letting go too soon: how quality of life guides care decisions.
Make their home more comfortable
While you work on identifying and treating the source of pain, there is a meaningful amount you can do at home to reduce what pain demands from your cat every day.
- Low-sided litter box. Replace the standard box or cut a low entry point into one side of the existing one. The goal is to eliminate the step-over threshold that makes entering painful for arthritic joints.
- Steps or ramps to favorite perches. If she still wants to reach her usual spots but jumping has become difficult, pet stairs placed next to the windowsill or couch let her get there without the impact of landing.
- Warmth. Cats in pain tend to seek warmth. A self-warming pad or a bed placed near a heat source (not a direct heat lamp) can ease joint stiffness. If you use an electric pad, choose one with an auto-shutoff: a cat with reduced mobility may not shift position to cool down the way a healthy cat would.
- Food and water close to where she rests. If walking across the house to eat has become an effort, bringing the bowl to where she spends most of her time reduces unnecessary movement during a difficult period.
- Minimal handling. Some cats in pain will still seek closeness. Let her come to you. Avoid picking her up unless necessary, and when you do, support her full body from underneath rather than gripping around the midsection. Cats with abdominal or spinal pain find pressure in those areas extremely uncomfortable.
When pain is part of a longer story
A diagnosis of arthritis, kidney disease, cancer, or another chronic condition changes the question your family is living with. It moves from “what is causing this?” to “how do we make the time she has left as good as it can be?”
That is different work. It does not end at a treatment plan. It requires ongoing attention, adjustment, and someone who can walk alongside you through the changes: the harder days and the steadier ones in between.
This is the stage Loved is built for. Our comfort care is designed for families with a diagnosis who are focused on quality of life. Loved’s quality of life scale can help you track how your cat is doing over time, giving you language for what you are observing and a point of reference as things change.
If you share your home with a dog who may also be in pain, our guide on recognizing pain in dogs covers the same questions for canine companions.
Frequently asked questions
How can I tell if my cat is in pain if they are not crying or vocalizing?
Cats rarely vocalize pain. Instead, watch for behavioral and physical changes: withdrawal to unusual spots, changes in grooming habits, reluctance to jump or climb, a changed posture or sleeping position, litter box avoidance, or any shift from their normal daily routine. If something feels different about your cat, it usually is.
Do cats hide pain?
Yes, and more effectively than most animals. As solitary hunters, cats had no pack to protect them if they appeared vulnerable. That instinct remains. A cat in pain will often continue moving through daily life appearing mostly normal until the discomfort is significant. You are more likely to catch the earliest signs at home, in ordinary moments, than a veterinarian would during a clinic visit.
Can a cat purr when in pain?
Yes. Purring is not only a sign of contentment. Cats also purr when stressed, anxious, or in pain, as a self-soothing response. A cat purring under the bed who has not come out to eat or interact is telling you something very different from a cat purring in your lap. Context matters more than the sound alone.
Is it normal for older cats to be in pain?
Pain is not a normal or inevitable part of aging, even though it is very common. Studies suggest that up to 90% of cats over twelve have some degree of joint change, but arthritis in cats is significantly underdiagnosed because the signs are subtle and easy to attribute to old age. A veterinarian or quality of life assessment can help clarify what you are seeing.
What should I never give my cat for pain?
Never give your cat acetaminophen (Tylenol). It is fatal to cats. Many NSAIDs that are safe for dogs are also toxic to cats. Always consult a veterinarian before giving any pain medication, and always specify that the patient is a cat when discussing treatment options. The differences from dogs and humans are significant.
What is the feline grimace scale?
The Feline Grimace Scale is a scientifically validated pain assessment tool developed by veterinary researchers at the Université de Montréal. It identifies pain in cats by evaluating five facial cues: ear position, orbital tightening (how open the eyes are), muzzle tension, whisker position, and head posture. Cat owners can use it at home by learning what their cat’s relaxed face looks like, and noticing when two or more of these features change together.
When does my cat’s pain become a quality of life issue?
When pain is frequent, difficult to manage, or starts affecting the things your cat values most, eating, grooming, exploring, resting comfortably, it becomes a quality of life question. A quality of life assessment evaluates pain alongside appetite, mobility, hygiene, happiness, and daily function, giving you a fuller picture of how your cat is doing overall. Loved offers a free self-assessment quiz and a professional in-home assessment for families who want both a starting point and a deeper evaluation.