Your 12-year-old domestic shorthair, Luna, has been eating less lately. She's reluctant to jump onto the couch or bed—she used to leap up easily. She spends more time sleeping and seems less interested in play. When you look closely at her face, her ears seem slightly flattened and her eyes might be more squinted than usual. You wonder: is she in pain?
Cats are masters of masking discomfort. In the wild, showing weakness attracts predators. This evolutionary trait means cats often show subtle, easy-to-miss signs of pain: decreased activity, reluctance to jump, changes in grooming, hiding, reduced appetite, or altered facial expression. By the time a cat is obviously painful (vocalizing, limping), the pain may be severe.
The Feline Grimace Scale (FGS) is a validated tool for assessing acute pain in cats. It evaluates five facial action units:
| Action Unit | Relaxed (0) | Moderate Pain (1) | Obvious Pain (2) |
|---|---|---|---|
| Ear position | Forward | Slightly flattened | Clearly flattened/rotated |
| Orbital tightening | Open eyes | Mild squint | Clearly narrowed |
| Muzzle tension | Relaxed | Mild tension | Clearly tense |
| Whisker position | Relaxed | Slightly pulled back | Clearly pulled back |
| Head position | Above shoulder | At shoulder level | Below shoulder |
Each unit is scored 0-2; total score 0-10. A score of 4 or higher suggests pain requiring intervention. The Pain Scale AI can help you learn FGS scoring from a photo—upload a clear image of your cat's face for educational assessment.
Degenerative joint disease (DJD), or osteoarthritis, is present in approximately 90% of cats over 12 years of age. It often affects the spine, hips, and elbows. Cats may show subtle signs: difficulty jumping, reluctance to use stairs, decreased grooming (especially over the back), litter box avoidance (if sides are high), or irritability when touched. The Geriatric Care Specialist discusses pain assessment and management options—including gabapentin, NSAIDs (with careful screening), and supplements like omega-3s and glucosamine.
Pain management in cats often combines multiple approaches: environmental modifications (ramps, low-sided litter boxes, heated beds), weight management, physical therapy, and medications. Gabapentin is commonly used for chronic pain. NSAIDs like robenacoxib can be used in cats with proper screening (kidney function, hydration). Solensia (frunevetmab) is a monthly injectable monoclonal antibody for osteoarthritis pain in cats—a newer option that avoids daily pills.
The Pain Scale AI supports learning FGS scoring from photos—veterinary evaluation is essential for treatment.
- Cats hide pain. Subtle signs—reduced jumping, appetite changes, facial expression—matter.
- Feline Grimace Scale helps objectify pain assessment. Score 4+ warrants intervention.
- DJD affects 90% of cats over 12. Assume pain in senior cats with mobility changes.
- Multimodal approach works best: environment, weight, supplements, medications.
- PetMed AI Pain Scale supports learning—veterinary evaluation is essential for treatment.