Cats are masters of hiding pain — a survival instinct that makes them notoriously difficult to read when something’s wrong. In older cats, where joint disease, dental pain, and internal conditions become increasingly common, this stoicism can mean serious problems go unnoticed for months. Here’s what veterinarians actually look for.
Why Cats Hide Pain So Well
In the wild, showing vulnerability attracts predators. That instinct doesn’t switch off in domestic cats. A cat in significant discomfort may continue eating (more slowly), may still groom (with reduced frequency), and may resist obvious signs of distress until pain is severe.
The AAFP (American Association of Feline Practitioners) recognizes this as a genuine clinical challenge — one reason they’ve developed specific feline pain assessment tools for veterinary use. As an owner, you’re looking for deviations from your individual cat’s normal behavior, not dramatic signs of distress.
Behavioral Signs of Pain in Senior Cats
Reluctance to jump or reduced mobility
This is often the first sign of arthritis or joint pain. If a cat that routinely jumped onto the sofa is now taking the long way around, or hesitates at the foot of a step, take note. The WSAVA estimates that 90% of cats over 12 years have some degree of degenerative joint disease on X-ray — most of these cats go undiagnosed until the pain is significant.
Watch for:
- Avoiding stairs or jumping to usual spots
- Stiff gait, especially in the hind legs, most noticeable after rest
- Reluctance to use the litter box if it requires stepping over a high side
- Sitting or lying down with unusual posture (tucked or hunched rather than relaxed)
Changes in grooming
Pain affects where and how much a cat grooms. A cat with back or hip pain may stop grooming their lower back and hindquarters — they can’t comfortably reach those areas. A cat with dental pain may stop grooming their face. An unkempt or matted coat in an older cat that previously self-maintained is a red flag.
The opposite can also happen: cats sometimes over-groom a painful area (compulsive licking at a joint or surgical site).
Withdrawal and reduced social behavior
A cat in chronic pain often withdraws from interactions they previously enjoyed. If your cat used to seek out your lap and now avoids it, if they’ve stopped engaging with toys, or if they’re sleeping in unusual locations (often corners or hiding spots — harder to disturb), pay attention.
This can overlap with cognitive dysfunction syndrome (feline dementia), which also affects older cats — a vet assessment can help distinguish between the two.
Changes in vocalization
Increased yowling, especially at night, is associated with pain in older cats (as well as hyperthyroidism and cognitive changes). Cats in pain may also be uncharacteristically vocal when handled or touched in specific areas. Conversely, a usually talkative cat going quiet can also signal something’s wrong.
Facial expression changes
Veterinary research has produced the Feline Grimace Scale (FGS) — a validated pain assessment tool based on specific facial cues:
- Orbital tightening (squinting or partially closed eyes)
- Flattened or rotated ears
- Whisker tension (pulled back or bunched forward)
- Muzzle tension
- Head position dropped lower than normal
A 2019 study in Scientific Reports validated the FGS as a reliable indicator of acute pain in cats. You’re not expected to run a formal assessment, but knowing that a squinting cat with flattened ears may be communicating pain is useful context.
Physical Signs Worth Watching
- Guarding behavior: Flinching, hissing, or biting when a specific area is touched — even in a normally tolerant cat
- Litter box avoidance: May indicate urinary pain, constipation, or arthritis making it difficult to posture correctly; dental disease can also cause appetite changes and eating difficulties (see our guide to feline dental health and disease prevention)
- Eating more slowly or dropping food: Classic sign of oral pain — watch for it in older cats
- Unexplained weight loss: Rarely nothing in an older cat. Common causes include dental pain, kidney disease, hyperthyroidism, and cancer (our article on early warning signs of kidney disease in cats covers one of the most common culprits)
What to Do If You Suspect Your Cat Is in Pain
Don’t give human pain medications. Ibuprofen and acetaminophen (paracetamol/Tylenol) are toxic to cats. Aspirin can be used at specific doses under veterinary guidance only — never without a prescription. Opioids, NSAIDs, and gabapentin are the primary classes of feline pain medication, and all require veterinary supervision.
Record the behavior. A short video on your phone of the abnormal movement or behavior is extremely useful for your vet — cats often perform normally in clinic environments. The “white coat effect” is real.
Keep a diary before your appointment. Note appetite, mobility, grooming habits, sleeping locations, and social interactions over a week. Patterns matter more than single instances.
Ask specifically about pain management options. Not all vets raise it unless prompted. If your cat has been diagnosed with arthritis, ask about NSAID therapy, gabapentin, and joint supplements — the evidence base for feline pain management has improved substantially in the last decade, and there are good options available.
When to See a Vet
Call same-day if your cat:
- Has stopped eating or drinking
- Can’t walk, is dragging a limb, or has suddenly lost the ability to jump
- Is vocalizing continuously or appears acutely distressed
- Has a visibly swollen joint, face, or abdomen
Schedule a visit within a few days if you notice:
- Gradual decrease in mobility over weeks
- Reduced grooming or a deteriorating coat in a previously well-maintained cat
- Withdrawal from normal interactions
- Unexplained weight loss
Chronic pain in older cats is manageable. The gap between “my cat is just getting old and slowing down” and “my cat is in significant, treatable pain” is smaller than most owners realize. If something has changed, investigate it.
For a broader overview of what to expect as your cat ages — from behavior changes to veterinary needs — the forum’s senior cat care guide covers the full picture.