Pain in Older Cats: Signs Owners Often Miss

Cats are exceptionally good at hiding pain. A survival instinct means owners often do not realise their cat is suffering until it is quite advanced. Here is what to look for.

Vet guidance: If your cat is showing sudden behaviour changes, signs of pain, or any change in urination, please contact your vet promptly. Do not give any human pain medication to your cat. Paracetamol is fatal to cats. Ibuprofen and aspirin are also toxic.

The subtle signs of chronic pain in older cats

Changes in movement and mobility

• Reluctance to jump, or jumping to lower surfaces than they used to
• Stiffness when getting up from rest, particularly after sleeping
• Slower and more careful movement down stairs or across uneven surfaces
• Changed gait such as a wider stance, shorter stride, or holding a limb differently
• Difficulty getting in and out of the litter tray, which may lead to missing the tray

Changes in grooming

• Licking a specific spot repeatedly, which can indicate localised pain in that area
• Grooming less overall: a cat with arthritis may be unable to reach certain areas comfortably
• Matting in areas the cat can no longer reach such as behind the neck and around the base of the tail

Changes in behaviour and temperament

• Increased aggression or reactivity, particularly when touched in specific areas
• Reduced tolerance of handling they previously accepted without complaint
• Withdrawal: spending more time alone, less interest in interaction
• Reduced play interest: a cat who was moderately active and becomes sedentary may be in pain rather than simply ageing
• Subtle changes in facial expression: researchers have developed a validated Feline Grimace Scale that identifies pain through changes in ear position, orbital tightening, muzzle tension, and whisker position

Changes in appetite and daily habits

• Eating less or showing preference for softer food, which may indicate dental pain
• Not seeking out favourite spots that require effort to reach

What to do

Book a vet appointment and describe the specific changes you have noticed. Be concrete. Saying "she used to jump onto the bed every night and now does not" is more useful than "she seems a bit slowed down." Your vet may palpate joints for pain or swelling, assess gait and mobility, recommend X-rays, check for dental disease, and run blood tests to rule out other causes.

Treatment options

NSAIDs: Non-steroidal anti-inflammatory drugs are available in cat-specific formulations and are highly effective for arthritis pain. They require regular monitoring through blood tests, but when appropriately prescribed they dramatically improve quality of life.

Solensia: A newer monthly injection treatment specifically for feline arthritis pain, with a growing and very promising evidence base.

Gabapentin: Used for nerve pain or when NSAIDs are not appropriate.

Dietary support: Omega-3 fatty acids have anti-inflammatory properties. Prescription joint diets are available from vets.

Environmental modification: Ramps and steps to favourite spots, low-sided litter trays, ground-level sleeping options, and heated beds all make daily life more comfortable for a cat in pain.

Related articles

• Senior Cat Behaviour Changes
• Anxiety in Older Cats
• Signs of Stress in Cats

Frequently asked questions

How do I know if my old cat is in pain?

Common signs include reluctance to jump or jumping less than before, changes in gait or sitting position, grooming less in hard-to-reach areas, changes in temperament such as becoming grumpy or less tolerant of touch, reduced appetite, and changes in facial expression. If you notice several of these together, a vet appointment is warranted.

Is arthritis common in older cats?

Very. Studies suggest over 90 per cent of cats over 12 have radiographic evidence of arthritis, though many do not show obvious lameness. The signs are often subtle and easy to miss. If your senior cat has slowed down, do not assume it is just age. Have them assessed for pain.