Cats are not small dogs, and this is particularly true when it comes to pain and pain management. Cats are much less likely than dogs to show outward signs of pain, especially when they are suffering from chronic (long-term) pain. Fortunately, veterinarians have made excellent progress in understanding cat pain and how to manage it.
Most cats instinctively hide their pain as a survival mechanism, which led experts to presume that cats do not feel pain the same way humans do. Veterinarians now know that cats have a nervous system very similar to that in humans, and we know better how to recognize and manage their pain.
What is pain?
Pain is subjective and difficult to measure, and there are as many manifestations of pain as there are injuries, conditions, and individuals. Cats instinctively hide their pain to prevent potential predators from targeting them when they are injured, so pain assessment in cats can be challenging. Demonstrations of pain vary widely among cats, and are particularly elusive in cats. It is important to recognize that a cat can be in pain even if it does not cry, limp, or show other obvious signs. In general, if something would hurt a human, it would hurt a cat.
How can I know if my cat is in pain?
With obvious injuries or after surgical procedures, you can reasonably assume a cat will experience pain. If you carefully observe your cat’s everyday behaviors, you can often notice pain when it is present, although the signs may be subtle. Most cats experiencing pain alter their behavior in some way. A cat may decline to jump, avoiding the windowsill or the back of the sofa. They may still get to their favorite resting spots, but they take several small jumps to get there. A cat may decide that the stairs are too difficult to navigate and remain on a single level of the home.
Some cats that are in pain will sleep more than usual, while others may be restless and unable to settle into a comfortable position. A cat that begins to soil outside the litter box may in fact be feeling pain and is avoiding the step or jump into a high-walled box.
Arthritic pain is common in older cats and may be manifested in many ways, depending on the area of the body that is affected. It can be difficult for a pet owner to identify the source of such pain without professional help. Observe your cat carefully before visiting your veterinarian so you can accurately report the behavior changes you see.
Other signs of pain include:
- Resistance to handling or being picked up
- Withdrawal from family activity (anti-social)
- Aggression or unexpected reactions when approached or handled
- Decreased grooming and unkempt haircoat (mats, dander, or greasy fur) or increased grooming in specific areas
- Stiffness or limping
- Changes in personality
How is pain treated in cats?
If your cat is undergoing a surgical or dental procedure, ask what pain management will be provided. Most of these procedures require postoperative pain management, though the duration of treatment will vary with the procedure. Generally, your cat will receive pain-relief medications before, during, and after a surgery or dental procedure. Your veterinarian will choose the appropriate drugs based on your pet’s specific needs.
Some common veterinary pain-relief medications include:
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs). These drugs interfere with the body's production of inflammatory molecules that trigger pain and swelling. NSAIDs must be used with caution because there is the potential for liver, kidney, stomach, and/or intestinal problems. NSAIDs are used to treat mild to moderate pain and discomfort. Never give your cat an over-the-counter NSAID, as some can be very dangerous.
Opioids. Opioids are used for more severe pain. This class of pain-relief medication includes morphine, codeine, fentanyl, buprenorphine, and hydromorphone. Opioids are used to treat severe surgical pain and may also be used in advanced cases of cancer or to control severe arthritis pain. Opioids may play a role in maintaining a good quality of life for a cat with severe chronic pain.
Other Options. There are new applications of existing medications that offer additional pain-relief options for cats, such as gabapentin (Neurontin®, Aclonium®, Equipax®, Gantin®, Gabarone®, Gralise®, Neurostil®, Progresse®), tramadol (Ultram®, ConZip®, Durela®, Ralivia®, Rybix®, Ryzolt®, Tridural®, Zytram®), Amantadine, Frunevetmab (Solensia®), and maropitant citrate (Cerenia®).
Cortisone and synthetic cortisone-like drugs, such as prednisone, prednisolone, methylprednisolone, and dexamethasone, are potent anti-inflammatory medications and can have a profound impact on treating pain. However, newer and more effective therapeutics are more commonly used.
Untreated pain is something that no pet should experience. By paying attention to behavior changes that may signal pain and by working with your veterinarian, you can help your cat enjoy a pain-free life.
