As all cat owners know, cats are NOT small dogs. And when it comes to pain and pain management, this is certainly true. Cats are 
much less likely to show outward signs of pain, especially when they are suffering from chronic (long term) pain. Fortunately for cats and the people who love them, veterinarians have made excellent progress in understanding cat pain and how to manage it.
"Most cats instinctively hide their pain as a
survival mechanism."
Most cats instinctively hide their pain as a survival mechanism. Cats are, by nature, predators, and predators who can no longer hunt become another predator’s next meal. In the past, this led well-meaning experts to presume that cats did not feel pain the same way humans do. Veterinarians know that cats have a nervous system very similar to humans, and we know better how to recognize and manage their pain.
What is pain?
Pain experts define pain as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage."
Pain is very subjective and difficult to measure, and there are as many manifestations of pain as there are injuries, conditions, and individuals. Demonstrations of pain vary widely among pets but are even more elusive in cats. 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, it can be reasonably assumed that a cat will experience pain. Although the signs may be subtle, careful observation of a cat’s everyday behaviors will often reveal pain when it is present. A cat may decline to jump, avoiding the windowsill or the back of the sofa. They may still be able to get to their favorite resting spots, but take several small jumps to get there, for example from a chair to a table to a windowsill. 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 out of the litterbox may in fact be feeling pain and is avoiding the step or jump into a high walled litter box.
Keep in mind that arthritic pain is common in older cats and may be manifested in many different ways depending on the area of the body that is affected, yet it is very difficult for a pet owner to identify the source without professional help. Observe your cat carefully before visiting your veterinarian so you can report accurately the changes in behavior you are seeing.
Some additional signals that a cat could be in pain include (but are not limited to):
- resisting 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, do not be afraid to 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 the surgery or a 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, such as gabapentin (brand names: Neurontin®, Aclonium®, Equipax®, Gantin®, Gabarone®, Gralise®, Neurostil®, Progresse®), tramadol (brand names: Ultram®, ConZip®, Durela®, Ralivia®, Rybix®, Ryzolt®, Tridural®, Zytram®), and maropitant citrate (brand name: Cerenia®) that offer additional pain-relief options for cats.
Pain remains an enormous unmet medical need, for both humans and cats. 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.
