How to Tell If Your Cat Is in Pain: The Quiet Cat Pain Scale

Quick answer

Cats are evolutionary masters at hiding pain to avoid showing vulnerability. Lea

Cats are evolutionary experts at hiding pain to avoid showing vulnerability to predators. To spot discomfort, you must look for subtle changes in their facial expressions (using the Feline Grimace Scale), posture shifts, and minor behavioral deviations like withdrawal or changes in grooming habits.

:::key-facts

• Cats hide pain as a survival mechanism to avoid appearing vulnerable.
• The Feline Grimace Scale focuses on ears, eyes, muzzle, whiskers, and head position.
• Sudden changes in grooming (over-grooming or neglect) often signal localized pain.
• Reluctance to jump or a hunched posture are classic signs of musculoskeletal discomfort.
  :::

Why it matters

In the wild, a cat showing signs of weakness, illness, or injury becomes an easy target for predators or rivals. Even though our domestic cats live in the safety of our homes, this deep-seated evolutionary instinct remains entirely intact.

Because they do not cry out, whine, or limp until their discomfort is severe, chronic conditions like osteoarthritis, dental disease, and urinary tract issues often go unnoticed for months or even years. Recognizing the quiet whispers of feline pain allows you to intervene early, preventing unnecessary suffering and dramatically improving your cat's quality of life.

What good looks like

A comfortable, pain-free cat moves with fluid grace and displays relaxed, open body language. When resting, their muscles are loose, and they sleep in stretched-out or curled positions rather than remaining coiled and tense.

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A pain-free cat will sleep in relaxed, stretched-out positions, showing loose muscles and slow, steady breathing.
:::

Their facial features are soft and neutral: ears point forward, eyes are round and bright, and their whiskers drape loosely down the sides of their face. A happy cat engages with their environment, grooms their entire body evenly, and seeks out social interaction with their human family.

Step-by-step

Veterinary behaviorists and pain management experts use the Feline Grimace Scale to objectively assess pain in cats. You can use this same method at home by evaluating five key facial action units. Observe your cat when they are resting quietly and not actively interacting with you.

Step 1: Evaluate the ears

• Score 0 (Relaxed): Ears are facing forward and upright.
• Score 1 (Mild/Moderate): Ears are slightly pulled apart, showing a wider gap between the tips.
• Score 2 (Severe): Ears are flattened, rotated outwards, or angled backward.

Step 2: Observe the eyes

• Score 0 (Relaxed): Eyes are comfortably open and round.
• Score 1 (Mild/Moderate): Eyes are partially opened, squinted, or appear heavy-lidded.
• Score 2 (Severe): Eyes are squinted shut or tightly closed (blepharospasm).

Step 3: Check muzzle tension

• Score 0 (Relaxed): Muzzle is relaxed, soft, and rounded.
• Score 1 (Mild/Moderate): Muzzle shows mild tension, appearing slightly flattened or oval-shaped.
• Score 2 (Severe): Muzzle is tense, pinched, and drawn tight.

Notice the soft, rounded muzzle and relaxed, downward-curving whiskers of a comfortable cat.

Step 4: Look at the whiskers

• Score 0 (Relaxed): Whiskers are loose, curved, and drape naturally downward.
• Score 1 (Mild/Moderate): Whiskers are slightly curved or starting to straighten and point forward.
• Score 2 (Severe): Whiskers are straight, bunched closely together, and stand pointing forward away from the face.

Step 5: Assess head position

• Score 0 (Relaxed): Head is held comfortably above the line of the shoulders.
• Score 1 (Mild/Moderate): Head is aligned with the shoulder line or slightly lowered.
• Score 2 (Severe): Head is tucked down below the shoulder line, with the chin pointing toward the chest.

:::pro-tip
Take a quick, clear photo of your cat's face when they are resting quietly. Compare it directly to the Feline Grimace Scale criteria to remove your own bias or worry.
:::

Signs something's wrong

Beyond facial expressions, pain manifests in subtle behavioral shifts. If you notice several of these 15 signs, your cat is likely dealing with hidden discomfort:

1. Squinting or half-closed eyes: A persistent squint, especially in one eye, indicates localized eye pain or systemic discomfort.
2. Ears rotated outwards: Often referred to as "airplane ears," this indicates tension or distress.
3. Bunched, straight whiskers: Whiskers that flare forward and lose their natural downward curve.
4. A pinched muzzle: The cheeks and muzzle look tight and less plush than usual.
5. Hunched posture: Sitting in a tight "loaf" position but with the head tucked low, shoulders raised high, and paws tucked tightly underneath.
6. Reluctance to jump: Hesitating before jumping onto a favorite windowsill or choosing to climb up furniture step-by-step instead of leaping.
7. Stiff gait: Walking with a rigid, less fluid motion, or showing a slight limp when first waking up.
8. Over-grooming a specific spot: Licking a single area (like the lower belly, a specific joint, or the base of the tail) until the hair is gone and the skin is raw.

A hunched posture, where the head is held low and the back is tightly curved, is a common sign of abdominal or musculoskeletal pain.

9. Neglecting grooming: A greasy, matted, or dandruff-flaked coat, particularly along the lower back and hindquarters where it is painful to bend and reach.
10. Sudden aggression: Hissing, growling, or swiping when you touch a specific spot, such as their lower back or hips.
11. Hiding in unusual places: Spending hours in dark, low, or hard-to-reach areas like the back of a closet or under a low bed.
12. Decreased appetite: Hesitating at the food bowl, dropping kibble, or chewing on only one side of the mouth, which often points to severe dental disease.
13. Litter box misses: Urinating or defecating right next to the litter box because climbing over a high entry lip hurts their arthritic joints.
14. Constant, tense purring: Purring that occurs while the cat is tense, hunched, or hiding; this is a self-soothing mechanism used to cope with pain.
15. Subtle vocalizations: Making quiet, low growls, sighs, or unusual meows when shifting positions or being picked up.

:::ask-boo
"My cat is purring but hiding under the bed. Could they still be in pain?"
:::

When to call your vet

If you notice subtle changes in your cat's facial expressions, grooming habits, or willingness to jump, schedule a routine veterinary appointment. Keep a log of the behaviors you observe and take short videos of your cat moving, jumping, or eating to show your veterinarian.

:::warning
If your cat is open-mouth breathing, completely unable to use their hind legs, crying out continuously, or has not urinated in 24 hours, this is a life-threatening emergency. Go to an emergency vet immediately.
:::

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Hesitating at the food bowl, dropping kibble, or shaking the head can point to hidden dental pain.
:::

Common mistakes

Assuming purring always means happiness

Many owners believe a purring cat is a happy cat. While cats purr when content, they also purr to self-soothe when experiencing intense pain, fear, or physical trauma. Always look at the rest of the body and face to interpret a purr correctly.

Dismissing slowing down as "just old age"

When older cats stop jumping onto high counters, sleep more, or become less active, owners often chalk it up to normal aging. In reality, up to 90% of cats over the age of twelve suffer from osteoarthritis. This is a painful, treatable condition, and your vet can prescribe safe, highly effective modern pain therapies to restore their mobility.

:::ask-boo
"What are the safest pain relief options my vet can prescribe for my older cat's arthritis?"
:::

Missing dental pain because they are still eating

Cats have an incredibly strong drive to survive, meaning they will continue to eat dry kibble even while suffering from severe dental disease, broken teeth, or painful oral ulcers. Do not assume your cat's mouth is healthy just because their food bowl is empty.

Quick FAQs

Can I give my cat human pain medication like paracetamol or ibuprofen?

No, never give your cat human pain medications. Drugs like paracetamol (acetaminophen) and ibuprofen are highly toxic to cats and can cause fatal liver failure, kidney damage, and red blood cell destruction even in tiny doses.

How do veterinarians assess pain in cats?

Veterinarians use validated pain assessment tools, including the Feline Grimace Scale and the Glasgow Composite Measure Pain Scale. They combine these visual assessments with a physical exam, checking for joint tension, localized heat, and behavioral responses to gentle palpation.

How long can a cat hide chronic pain?

Cats can hide chronic pain, such as the discomfort caused by osteoarthritis or slowly progressing dental disease, for months or even years. Often, owners only realize their cat was in pain after veterinary treatment is started and they see a dramatic increase in the cat's energy and playfulness.