A cat in pain may hide, eat less, move stiffly, groom differently, avoid the litter box, or show a tense, squinting face. Because cats instinctively hide weakness, compare any change with your cat’s normal behavior — several subtle changes together matter more than one.
Is Your Cat in Pain? The Fastest Way to Check Right Now
A cat in pain may hide, eat less, move stiffly, groom differently, avoid the litter box, or have a tense, squinting expression. Compare what you see with your cat’s usual behavior. Many cats don’t cry out when they hurt.
If your cat is breathing with an open mouth, has collapsed, cannot stand, has suffered significant trauma, or is repeatedly straining to urinate with little or no urine coming out, call an emergency veterinarian and go now. Don’t delay to score your cat’s face.
Start with this chart, then look at the signs and facial features below. Several subtle changes together are more concerning than a single minor change, but one serious sign is enough to act.
| Triage tier | Signs you might see | What to do | Timeframe |
|---|---|---|---|
| Emergency | Open-mouth breathing or panting; collapse or unresponsiveness; inability to stand; repeated straining with little or no urine; significant trauma; pale or blue gums; uncontrolled bleeding; seizures; severe pain or crying out when touched | Call an emergency clinic, phone ahead if possible, and transport your cat safely | Immediately, including overnight |
| Vet soon | No food for about 24 hours; a persistent limp; new litter box avoidance without straining; significant hiding; drooling or dropping food; squinting; repeated vomiting; a concerning facial pain score | Call your vet for triage. Eye symptoms, vomiting with lethargy, or an elevated pain score may need a same-day visit | Call today; the clinic will set the appointment time |
| Monitor briefly | One mild change, such as a new sleeping spot or slightly less play, in a cat otherwise eating, moving, and using the litter box normally | Record observations and set a recheck time; call sooner if you’re unsure | Recheck within 48 hours; call if unchanged, worsening, or joined by another sign |
Triage signs take priority over a facial score. If your cat appears seriously ill or you can’t tell whether it’s passing urine, contact an emergency veterinarian now.
Why Cats Hide Pain and What That Means for What You Look For
Cats have an instinct to conceal weakness, which can make pain easy to miss. [#N] Your clue may be something your cat has stopped doing: jumping onto a favorite chair, greeting you at the door, or grooming its back.
Think about your cat’s usual routine: where it sleeps, how much it eats, and how readily it climbs, plays, and uses the litter box. A change from that individual pattern is more useful than a comparison with someone else’s cat.
Acute vs. chronic pain: how the signs differ
Acute pain starts suddenly, such as after an injury or procedure. You might notice limping, guarding, or an abrupt change in behavior. Chronic pain develops or persists over time and may show up as a gradual decrease in movement, grooming, or social contact. Both can be subtle. A quiet cat can have either kind of pain.
Can a cat be in pain while sleeping or resting?
Yes. A cat that is asleep or resting can still have a painful condition. Watch for an unusually tense or hunched resting posture, difficulty settling, or reluctance to get up afterward. Don’t wake or handle your cat just to test it. Sleepy eyes and a lowered head can also make facial expressions misleading, so assess the face while your cat is calmly awake.
Signs a Cat Is in Pain: A Categorized Checklist
Use this checklist to organize your observations. Note when each change started and whether it’s getting better or worse. Signs in one category don’t prove pain, but a pattern can give your veterinarian more useful information.
Posture and movement
- A hunched back, lowered head, tucked abdomen, or unusually tense loaf position.
- Stiffness after rest, limping, a shortened stride, or difficulty using stairs.
- Hesitating before jumping, missing a familiar jump, or choosing lower places.
- Guarding a limb, shifting weight, or resisting movement.
A cat that can’t stand, or one showing severe pain after an injury, needs emergency care.
Appetite, drinking, and grooming
- Eating less, approaching food but walking away, dropping food, or chewing on one side.
- Drinking noticeably more or less than usual.
- Excessive grooming or repeated licking of one area.
- Grooming less, leaving the coat greasy, tangled, or matted, especially over the back.
Changes in eating or drinking can reflect illness as well as pain. Tell your vet about both, even if your cat is still eating some food.
Litter box changes
Watch for frequent trips, crying or straining in the box, urine outside the box, or reluctance to climb over the sides. Arthritis can make a high-sided box hard to enter, but urinary problems can cause similar avoidance.
Repeated straining with little or no urine is an emergency. Urinary straining can be hard to distinguish from constipation, so call an emergency clinic if you can’t tell.
Vocalization and body language cues
A cat in pain may growl, hiss, yowl, cry when touched, or sound different from usual. It may instead become unusually quiet. Look for squinting, ears held out to the sides, a tense muzzle, dilated pupils, and rapid or labored breathing. Breathing difficulty requires immediate care.
Hiding and personality changes
Hiding, lethargy, restlessness, increased clinginess, or swatting when approached can all be relevant changes. Don’t press a suspected sore area to confirm it. Note what happened and tell your veterinarian.
Is Purring a Sign of Pain? Myths vs. Facts About Misread Cat Signals
Myth: Purring always means a cat is happy. Cats can also purr when stressed, sick, or in pain. Consider purring alongside posture, appetite, and behavior rather than reading it as a sign of comfort on its own.
Myth: A hurting cat will cry out. Many cats are quiet. Silence doesn’t rule out pain.
Myth: A cat that still eats cannot be in pain. Some cats continue to eat despite discomfort. Check movement, grooming, and litter habits too.
Myth: An older cat that slows down is simply aging. Reduced activity can have several causes, including treatable pain. It deserves a conversation with a vet.
Myth: A cat that suddenly hisses when touched is just grumpy. It may be guarding a painful area. Note the circumstances without repeating the touch.
How to Use the Feline Grimace Scale at Home, Step by Step
The Feline Grimace Scale is an acute pain assessment tool based on five facial features: ear position, eye narrowing, muzzle tension, whisker position, and head position. Each feature is scored from 0 to 2. [#N] The scale can help you describe what you see, but it can’t diagnose the cause or replace a veterinary examination.
Step 1: Set up a calm observation
Watch your cat from a short distance in a well-lit room while it’s awake and undisturbed. Don’t force it into position or touch its face. If practical, take a clear front-facing photo and a short video to share with your vet. A side view may help you see head position.
Step 2: Score the five facial features
Compare what you see with the descriptions below. A score of 1 means the feature is moderately changed or you’re unsure whether it’s clearly normal or markedly changed. If you can’t see a feature, leave it unscored rather than guessing.
| Facial feature | Score 0: absent | Score 1: moderate or uncertain | Score 2: marked |
|---|---|---|---|
| Ears | Ears facing forward | Ears slightly pulled apart | Ears flattened and rotated outward |
| Eyes | Eyes open | Eyes partially closed | Eyes tightly shut |
| Muzzle | Muzzle relaxed and rounded | Muzzle mildly tense | Muzzle tense and flattened or elliptical |
| Whiskers | Whiskers loose and curved | Whiskers slightly curved or straight | Whiskers straight and moving forward |
| Head | Head above the shoulder line | Head aligned with the shoulders | Head below the shoulder line or tilted down |
The five features and the 0–2 scoring system are part of the Feline Grimace Scale. Compare the expression with your cat’s usual awake face, and use the official scale’s reference images when available.
Step 3: Total the score and decide what it means
Add the visible feature scores. When all five are visible, the total is out of 10. For example, ears 1, eyes 1, muzzle 0, whiskers 1, and head 1 gives 4 out of 10.
In the clinical tool, a score of 4 out of 10 is a threshold used to consider additional pain relief. It isn’t a home diagnosis or a directive to give medicine. If your awake cat scores 4 or higher, call your vet promptly and describe the other signs. A high score, a rapidly worsening cat, or any emergency sign warrants an urgent call rather than waiting for an appointment.
If a feature isn’t visible, tell the vet which features you could score and their values. Don’t count a missing feature as zero. A lower score doesn’t rule out pain, especially chronic pain.
What the scale can’t tell you
Sleepiness, fear, medication, and differences in facial shape can make an expression hard to interpret. The scale can’t tell you whether a cat has arthritis, a urinary blockage, or another condition. Compare observations over time and share photos or video with your veterinarian, but never delay emergency care to obtain them.
What Your Cat’s Signs Might Point To: A Sign-to-Likely-Cause Map
These are possible causes to discuss with a veterinarian, not conclusions. Signs overlap, and a cat can have more than one problem. The urgency column assumes no emergency signs beyond those described; when in doubt, call.
| Sign or sign combination | Possible causes; vet must confirm | Urgency | What to tell your vet |
|---|---|---|---|
| Repeated litter box trips, straining, little or no urine, crying, or genital licking | Urinary blockage or bladder inflammation | Emergency if straining with little or no urine, or if you can’t tell whether urine is passing | Last normal urination, observed urine amount, and when the trips began |
| Drooling, dropping food, one-sided chewing, mouth pawing, bad breath, or avoiding hard food | Dental disease, a damaged tooth, a mouth injury, or an ulcer | Call today, especially if eating is reduced | Which foods your cat accepts and when the change began |
| Hesitating to jump, stiffness after rest, difficulty on stairs, a poorly groomed back, or avoiding a high-sided box | Arthritis or another joint problem; litter box avoidance can also have urinary causes | Schedule a visit; call sooner for worsening signs or urinary changes | Changes in jumps, stairs, grooming, and box use; bring a short walking video |
| Limping, swelling, guarding a limb, a wound, or sudden hiding | Injury, fracture, bite wound, or abscess | Emergency after significant trauma, inability to stand, or severe pain; otherwise call promptly | When the change began and any possible fall, fight, or accident |
| Weight loss, increased thirst, vomiting, poor appetite, or lethargy | Kidney disease, other organ conditions, or other illness; discomfort may or may not be present | Call today for vomiting with lethargy or markedly reduced eating; otherwise arrange an exam | Appetite, drinking, weight changes, vomiting, and energy level |
| A lump, nonhealing sore, persistent weight loss, or gradual withdrawal | A mass, cancer, or another chronic condition | Arrange a veterinary exam; call sooner if your cat is worsening or not eating | When you noticed the change and whether a lump or sore is growing |
| Hunched posture plus repeated litter box straining | Possible urinary obstruction or another painful urinary problem | Emergency when little or no urine is passed or the amount is unclear | Last normal urination and all observed litter box behavior |
| Hiding, restlessness, a tense face, altered voice, or licking one spot | Pain from an injury, dental problem, joint disease, or another condition; stress is also possible | Call promptly if marked, persistent, worsening, or combined with other changes | Onset, location of licking, triggers, and changes in eating or movement |
Dental pain
A cat with a painful mouth may still approach food but drop pieces or favor one side. It may also have bad breath or paw at its mouth. These signs warrant an exam; don’t force the mouth open.
Urinary pain and blockage
Urinary obstruction is an emergency for any cat, although male cats are particularly at risk. Repeated box visits and straining with little or no urine are more urgent than a simple change in box preference. A few drops don’t reliably rule out an obstruction.
Arthritis and joint pain
Signs of arthritis in cats can look like a shrinking daily routine: fewer jumps, less climbing, or less grooming in hard-to-reach places. A low-sided litter box may make access easier while you arrange a veterinary assessment, but it doesn’t replace one.
Injury, organ disease, and cancer
If you’re asking why your cat is limping, that limp or a guarded area may point to an injury. Weight loss and drinking changes can occur with organ disease, while a lump or nonhealing sore needs investigation. None of these signs identifies the cause on its own, and not every illness is painful.
Emergency, Vet Soon, or Monitor? A Three-Tier Triage Guide
Go to the emergency vet now
Go immediately for breathing difficulty, collapse, seizures, uncontrolled bleeding, inability to stand, significant trauma, pale or blue gums, severe pain, or suspected urinary obstruction. Call ahead if you can do so without delaying departure.
See a vet within a few days
Call today if your cat hasn’t eaten for about 24 hours, has a persistent limp, is hiding significantly, has new litter box avoidance, or shows mouth pain. A squinting eye can be urgent: call the same day rather than waiting to see whether it clears. Repeated vomiting with lethargy also needs prompt advice. Your clinic can decide whether your cat needs to be seen today or can safely wait.
For kittens, cats with existing illness, or cats recovering from a procedure, contact the vet sooner about reduced food intake or other changes. Don’t wait for a full day if your cat is worsening.
Monitor at home, with a plan
Brief monitoring is for one mild change in an otherwise well cat—not for an emergency sign or obvious pain. Set a 48-hour recheck, and call sooner if the change worsens, another sign appears, or you’re uncertain. If the change hasn’t clearly improved by the recheck, call your vet.
48-hour observation log: Copy the following entry for each check, roughly every eight hours while you’re awake. You don’t need to disturb a sleeping cat solely to complete it.
Cat: __________________ Start date/time: __________________
Recheck deadline: __________________ Vet phone: ______________
Check time: __________
Eating: normal / some / refused Amount: ______________
Drinking: normal / more / less
Urine: normal / less / straining / none observed
Stool: normal / changed / none observed
Movement: normal / hesitant / limping / unable to stand
Posture and resting place: ______________________________
Grooming: normal / less / licking one spot: ______________
Facial features or score, if visible: ____________________
Other changes, including vomiting or voice: ______________Record what you actually see. “None observed” isn’t always the same as “none passed,” especially in a multi-cat home. Repeated straining or uncertainty about urine output calls for immediate advice, not a completed log. Any emergency sign overrides the recheck deadline.
Pain, Illness, Old Age, or Stress? How to Tell the Difference
Pain and illness overlap. Reluctance to move, a changed posture, or a reaction to handling may suggest discomfort; vomiting, diarrhea, increased thirst, or discharge may suggest illness. Either group of signs can occur with the other, and an owner can’t reliably separate them at home. Report the whole pattern.
Is my senior cat in pain or just slowing down?
An older cat may spend more time resting, but don’t dismiss a new inability or reluctance to do familiar things as normal aging. Compare your cat’s current movement with its own past routine: notice whether it can still reach its favorite resting spot, step into the box, and groom its back comfortably.
Stiffness, missed jumps, and withdrawal can be signs of arthritis pain in cats, although other conditions can cause them too. Bring videos of ordinary movement to the appointment and ask whether a mobility assessment or an owner questionnaire would help.
Pain vs. stress or a behavior problem
A move, new pet, or change in routine can contribute to hiding or litter box avoidance. Note whether the timing fits a change at home and whether the behavior improves when the trigger is removed. Stress and pain can coexist, though, and urinary or mobility problems can look behavioral. Arrange a vet check for a persistent or significant change; use the emergency rules for straining regardless of the suspected trigger.
How to tell if a cat is in pain after surgery or dental work
After a spay, neuter, other surgery, or dental procedure, some sleepiness and mild tenderness may occur early in recovery. Follow the discharge instructions your clinic gave you. Expected recovery depends on the procedure and your cat.
Call the surgical team if pain appears to worsen, your cat repeatedly licks the incision, the incision becomes increasingly swollen or opens, or your cat refuses food. Ask the clinic when it expects your cat to eat and when it wants an update; don’t wait beyond the first day without advice. After dental work, call about ongoing difficulty eating, bleeding, swelling, or worsening mouth discomfort.
Ask what comfort level is expected, which changes require an urgent recheck, and what to do if prescribed pain control seems insufficient. Don’t add or change medication without the veterinarian’s direction.
What to Do Tonight: Safe Steps, What Never to Give, and What the Vet Will Do
What never to give a cat in pain
Never give ibuprofen or acetaminophen (Tylenol) to a cat. Aspirin and naproxen can also be dangerous. Don’t give leftover pet medication or any human medicine unless a veterinarian specifically directs you to do so. If your cat has already received one, call a veterinarian or emergency clinic immediately; don’t wait for symptoms. [#N]
While waiting for advice or an appointment, give your cat a quiet, warm place with easy access to water, food, and a low-sided litter box. Limit access to stairs and high perches if movement is difficult. Don’t force food, apply home remedies, massage a suspected injury, or repeatedly handle a painful area.
How to safely transport a hurting cat
Call the clinic before leaving if possible. Prepare a secure carrier lined with a towel. If the carrier has a removable top, taking it off may make it easier to lower your cat inside without pushing it through a small door.
Move slowly. Use a towel to help lift or gently wrap your cat if necessary, support the whole body, and avoid pressure on a suspected injury. A cat in pain may bite or scratch, so protect yourself and don’t force handling. If you can’t move your cat safely, ask the clinic for transport advice. Keep the carrier stable and the car quiet and comfortably warm.
What to expect at the vet and your next-step checklist
The veterinarian will ask about the changes you’ve noticed, examine your cat, and assess comfort and movement. Depending on the findings, the clinic may recommend bloodwork, a urine test, X-rays, or a dental examination. Pain management may include veterinarian-prescribed medication, treatment of the underlying condition, dental care, joint management, or surgery. The right approach depends on the diagnosis and your cat’s health.
Costs vary substantially by location, urgency, and testing. Ask for an itemized estimate before non-emergency tests or treatment, and tell the clinic if you need to discuss priorities or payment options. Emergency stabilization may need to happen before a complete estimate is possible.
Before you call or leave:
- Check the emergency signs first. If one is present, call an emergency clinic and go now.
- Record what changed. Bring the observation log, relevant photos or videos, and the time of the last normal urination if urinary signs are present.
- Score the face only if it is safe and does not delay care. Share the visible feature scores with the vet.
- Bring the details. List your cat’s food, medications, recent procedures, and any possible exposure to human medicine.
- Agree on a follow-up plan. Ask when to call back, what worsening signs mean, and when your cat should be reassessed.
1Which of the following signs represents a critical veterinary emergency requiring immediate clinic transport rather than waiting to perform a pain score?
Urinary tract obstructions are life-threatening emergencies that require immediate intervention to prevent severe organ failure or death.
2In clinical settings using the Feline Grimace Scale (scored out of 10 visible points), what score serves as a key threshold to consider administering additional pain relief?
A cumulative score of 4 or higher across visible facial features indicates sufficient acute pain expression to consider veterinary-guided pain relief.
3Why is relying solely on purring unreliable when evaluating whether a cat is in pain?
Purring is not exclusively an expression of happiness; cats frequently utilize purring to comfort themselves during distress or physical injury.
4What is the primary danger of administering human over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen to a hurting cat?
Human nonsteroidal anti-inflammatory drugs and analgesics are highly toxic to feline metabolism and can rapidly lead to organ failure or death.
5Which set of subtle changes is most characteristic of chronic joint pain or arthritis in senior cats?
Chronic pain presents gradually through reduced mobility, reluctance to leap to elevated spots, and matted fur over inaccessible body areas.
6Which of the following facial features is evaluated as part of the five standard criteria in the Feline Grimace Scale?
Whisker position—noting whether whiskers are curved and relaxed versus straight and moving forward—is one of the five core facial indicators.
7How should an owner properly assess a cat for pain signs while the cat is resting or sleeping?
Monitoring resting posture for abnormal tension or unwillingness to settle provides useful clues without introducing stress or misleading facial expressions.
8A cat approaches its food dish with interest but drops pieces of food, chews strictly on one side, and paws at its mouth. What issue do these signs most likely suggest?
Approaching food with appetite while dropping kibble or favoring one side of the jaw is a classic pattern of oral or dental discomfort.
9What is a recommended safety practice when placing a painful or injured cat into a transport carrier?
Removing the carrier top allows you to place the cat inside gently with full body support, preventing struggle through a small front door.
10Under what circumstance is a 48-hour home observation period appropriate for evaluating a potential pain sign?
Brief home monitoring with a log is designed for isolated, minor behavior shifts in a pet that remains fully functional.
| Observed Symptoms | Possible Causes | Urgency Level | Recommended Action | Information for Vet |
|---|---|---|---|---|
| Repeated litter box trips, straining, little or no urine, crying, or genital licking | Urinary blockage or bladder inflammation | Emergency if straining with little or no urine, or if you can't tell whether urine is passing | Call an emergency clinic immediately and go now (phone ahead if possible); transport safely and do not delay | Last normal urination, observed urine amount, and when the trips began |
| Hunched posture plus repeated litter box straining | Possible urinary obstruction or another painful urinary problem | Emergency when little or no urine is passed or the amount is unclear | Call an emergency vet clinic immediately and transport your cat | Last normal urination and all observed litter box behavior |
| Limping, swelling, guarding a limb, a wound, or sudden hiding | Injury, fracture, bite wound, or abscess | Emergency after significant trauma, inability to stand, or severe pain; otherwise call promptly | Call an emergency clinic immediately for severe trauma/inability to stand, or call vet promptly for persistent limp; transport safely using a towel without pressure on suspected injury | When the change began and any possible fall, fight, or accident |
| Drooling, dropping food, one-sided chewing, mouth pawing, bad breath, or avoiding hard food | Dental disease, a damaged tooth, a mouth injury, or an ulcer | Call today, especially if eating is reduced | Call your vet for triage and arrange a visit; provide a quiet, warm space with easy access to food and water; do not force the mouth open | Which foods your cat accepts and when the change began |
| Weight loss, increased thirst, vomiting, poor appetite, or lethargy | Kidney disease, other organ conditions, or other illness; discomfort may or may not be present | Call today for vomiting with lethargy or markedly reduced eating; otherwise arrange an exam | Call vet today for prompt advice or arrange an examination; do not force food | Appetite, drinking, weight changes, vomiting, and energy level |
| Hiding, restlessness, a tense face, altered voice, or licking one spot | Pain from an injury, dental problem, joint disease, or another condition; stress is also possible | Call promptly if marked, persistent, worsening, or combined with other changes | Call your vet for triage; provide a quiet, warm, comfortable space and avoid pressing painful or suspected sore areas | Onset, location of licking, triggers, and changes in eating or movement |
| Hesitating to jump, stiffness after rest, difficulty on stairs, a poorly groomed back, or avoiding a high-sided box | Arthritis or another joint problem; litter box avoidance can also have urinary causes | Schedule a visit; call sooner for worsening signs or urinary changes | Arrange a vet check or schedule a veterinary assessment; provide a low-sided litter box for easier access and limit access to stairs/high perches if movement is difficult | Changes in jumps, stairs, grooming, and box use; bring a short walking video |
| A lump, nonhealing sore, persistent weight loss, or meow/gradual withdrawal | A mass, cancer, or another chronic condition | Arrange a veterinary exam; call sooner if your cat is worsening or not eating | Arrange a veterinary exam for investigation; monitor for worsening | When you noticed the change and whether a lump or sore is growing |
FAQ
How do cats show pain?
Cats usually show pain through subtle changes rather than crying out: hiding, eating less, moving stiffly, grooming differently, avoiding the litter box, or showing a tense, squinting face. Any lasting change from your cat’s normal behavior is worth noting.
What does a cat in pain sound like?
Some cats growl, hiss, yowl, or cry, especially when touched or using the litter box, but many hurting cats are completely silent. A change in your cat’s usual voice, or sudden quietness, can be a sign too.
Can a cat be in pain and still eat?
Yes. Some cats keep eating despite pain, particularly with chronic conditions like arthritis, so normal appetite doesn’t rule pain out. Look at posture, movement, grooming, and litter habits as well.
How can I tell if my cat is in pain from kidney disease or cancer?
These conditions often cause vague, gradual signs such as weight loss, reduced appetite, increased thirst, lethargy, lumps, or withdrawal rather than obvious pain behavior. Only a vet exam and tests can tell them apart from other problems.
How can I tell if my cat is in pain after being spayed or neutered?
Mild tenderness and sleepiness are normal for the first day or so. Contact your vet if your cat hides, refuses food, cries, licks the incision, or if the incision looks swollen, open, or red.
Do cats need pain medicine for arthritis?
Many cats with arthritis benefit from vet-guided pain management, along with home changes like low-sided litter boxes and easy access to resting spots. Only a vet should choose and dose medications for cats.