How to Tell If Your Cat Is in Pain: 8 Signs Owners Miss

Cats are quiet about pain. It is not stubbornness or stoicism in the way we romanticise it; it is survival instinct. A cat that shows weakness in the wild is a target. That instinct does not switch off at home, which means by the time most owners notice something is wrong, their cat has often been uncomfortable for days or weeks.

This post names 8 specific signs of pain that cats show, why each one is easy to miss, and what to do when you spot them. This is general information. Your vet should examine your cat before any conclusions about diagnosis or treatment are drawn.

Why Cats Hide Pain So Effectively

Cat pain behaviour is shaped by evolutionary pressure. Prey species broadcast vulnerability; predators suppress it. Domestic cats sit in an odd position on that spectrum: they are small enough to be prey themselves, so hiding illness is deeply wired.

Research published in the *Australian Veterinary Journal* and summarised by the WSAVA identifies two broad categories of feline pain expression: acute pain (injury, post-surgical) and chronic pain (arthritis, dental disease, kidney disease). Acute pain tends to produce visible, dramatic signals. Chronic pain is the harder one, because cats adapt to it gradually, and owners adapt along with them without realising anything has changed.

Senior cats, roughly those aged 10 and older, are at highest risk. Studies suggest more than 90% of cats over 12 have radiographic evidence of degenerative joint disease, yet the majority of owners do not identify it before a vet raises it.

The 8 Signs Owners Miss

1. A Change in Where They Rest

Cats are creatures of habit. When a cat that used to sleep on the couch starts sleeping on the floor, or vice versa, it is usually for a reason. A cat moving to lower surfaces may be avoiding the jump because it hurts. A cat retreating to a high spot may be seeking safety because it feels vulnerable.

Note what changed, not just that something changed.

2. Subtle Facial Tension

The Feline Grimace Scale, developed by researchers at the Université de Montréal and validated by WSAVA guidelines, identifies five facial action units that indicate pain in cats: orbital tightening (squinting), ear position (flattened or rotated outward), muzzle tension, whisker change (bunched forward), and head position (lowered below the shoulder line).

A cat in mild chronic pain often carries a faint squint and a subtly tense muzzle. It does not look distressed. It looks tired, or grumpy, or old. Many owners attribute it to personality.

3. Reduced Grooming, or Overgrooming One Spot

Pain affects grooming in two directions. A cat with generalised joint pain or dental pain may groom less, resulting in a coat that looks dull, matted, or greasy, particularly along the lower back and base of the tail (areas they cannot reach without twisting).

Conversely, a cat with localised pain, a sore tooth, an arthritic hip, a wound, may overgroom that specific area. Licking a spot to baldness is pain behaviour, not a quirk.

4. Litter Box Changes

A cat that starts eliminating outside the litter box is often labelled as badly behaved. Pain is a more common explanation. Arthritis in the hips or spine makes stepping over a high-sided tray uncomfortable. Dental disease, urinary tract pain, and kidney disease can all make the act of toileting feel associated with discomfort.

If a previously reliable cat starts missing the tray, assume pain before assuming behaviour.

5. Changes to Appetite, Without Obvious Cause

Dental disease is one of the most common sources of chronic pain in cats and one of the most commonly missed. A cat with sore teeth may stop eating hard kibble, switch to eating on one side of the mouth, drop food while chewing, or simply eat less overall.

Appetite reduction is often attributed to pickiness or aging. When it appears alongside any of the other signs on this list, it warrants a physical exam.

6. Reduced Interaction on Their Terms

This is a nuanced one. A cat in pain may withdraw from family contact, or it may seek more contact than usual. The signal is a change from baseline, not a specific direction.

A cat that used to greet you at the door and no longer does, or a cat that used to sleep alone and now follows you from room to room, is showing a shift in behaviour. Pain is one of the most common causes of those shifts in cats with no recent household changes.

7. Altered Movement Patterns

You may not see a limp. Cats compensate for joint pain with subtle weight redistribution, shorter strides, and avoidance of certain movements rather than the obvious three-legged gait you might expect.

Watch for: hesitation before jumping, landing more heavily than usual, reluctance to use stairs, sitting with one leg extended rather than tucked, and a slightly hunched posture when standing. These are feline signs of pain in the musculoskeletal system and are especially common in senior cats with undiagnosed arthritis.

8. Vocalisation Changes, Especially at Night

Increased vocalisation in an older cat, particularly yowling or crying at night, is not normal aging. It can indicate pain, cognitive dysfunction syndrome (feline dementia), hypertension secondary to hyperthyroidism or kidney disease, or several other conditions that become more common in cats aged 12 and older.

A cat that was quiet and has become vocal, or one that vocalises when touched in a particular area, is telling you something directly. The message is worth acting on.

Senior Cats and Chronic Pain: What Is Often Going On

In cats aged 10 and above, the most common sources of chronic pain are:

• •Degenerative joint disease (osteoarthritis), especially in the hips, elbows, and spine
• •Dental disease, including tooth resorption, periodontal disease, and fractured teeth
• •Chronic kidney disease (CKD), which can cause nausea and generalised discomfort
• •Hyperthyroidism, which causes agitation and can mask or exacerbate pain
• •Hypertension, often secondary to CKD or hyperthyroidism, which can cause neurological symptoms and apparent distress
• •Cancer, unfortunately common in cats over 10, with lymphoma and oral squamous cell carcinoma among the more frequent presentations

None of these conditions are diagnosed by observing behaviour alone. A physical exam, and often bloodwork, is needed. This post exists to help you recognise that something is worth investigating, not to replace that investigation.

What to Do When You Spot These Signs

If your cat is showing two or more of the signs above, especially if they are a senior cat, book a vet assessment. You do not need to wait until the signs are dramatic.

An At Home Consultation with At Home Vetcare means a vet comes to your home in Melbourne, where your cat is calm and in their own environment. Cats who are anxious in clinics often show pain more clearly at home, and the assessment is more accurate for it.

If your cat has a known serious illness and you are trying to understand their quality of life and comfort, a Quality of Life Consultation is structured for exactly that. It uses the HHHHHMM framework (Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More good days than bad) to give you a clear picture of where your cat is and what the options are.

When to Call Us

If your cat is showing the signs described above and you would like a vet to assess them at home, the At Home Consultation is the right starting point. If you are managing an already-diagnosed condition or want a structured quality-of-life review, the Quality of Life Consultation covers that directly. We visit across metropolitan Melbourne, including Brunswick, South Yarra, Hawthorn, Doncaster, and Cheltenham.