Cats have an amazing ability to hide their pain. They often don’t show any easily identifiable signs of pain. However, this does not mean that they are not in pain. Pain in cats is often not recognized. Untreated pain can have a significant impact on health and quality of life.
The sensation of pain is a complex combination of sensory stimuli and the mental and emotional perception of this sensation. The intensity of the pain stimuli depends on the extent of the inflammation and the activity of the nerve feedback loops. These factors, together with the perception of pain, make the pain experience unique to each person.
The expression of pain in cats is often subtle; However, there are a number of behaviors that can occur when a cat is in pain. Since these behaviors do not always indicate pain, it is important to investigate the pain and make a clear determination. Symptoms of pain in cats range from more obvious to more subtle. The aching cat may change their sleeping habits or social interactions. The appetite may be reduced. You can no longer use the litter box or you can urinate more often. Personal hygiene can be reduced or exaggerated to the point of self-mutilation. Previously friendly cats can become aggressive. Cats in pain may become restless or immobile and may withdraw. You may not want to jump anymore and avoid being touched or petted. Sometimes they do not carry weight on a limb or have an obvious limp. Using pain scales to assess pain and monitor response to pain management can be important.
One of the challenges of identifying pain in cats is the multitude of signs. Interpretation of signs is made difficult by the fact that many of the pain signs are also signs of other problems. For example, cats with kidney disease may have a decreased appetite even without pain. Cats with age-related cognitive dysfunction may have changes in urination and bowel movements that affect the use of the litter box. Remember that in some situations there is a combination of pain and other health issues. Ideally, if a cat exhibits behaviors or signs consistent with pain, a full exam should be done to rule out other illnesses. A full assessment allows for an appropriate focus on managing pain as well as treating additional health problems.
The options for pain management in cats are much more limited than the options for dogs. Cats are unable to metabolize some drugs effectively or have very delayed elimination times. This means that with some drugs the dosages have to be reduced and there has to be a longer period between dosages. Other drugs must be avoided. Fortunately, there is ongoing research aimed at improving pain medication management for cats.
Given the limited pain management options in cats, it is important to clearly identify the source of pain. This enables a focused approach. For example, treating cancer pain may be different from treating myofascial pain or osteoarthritis or toothache. Common approaches to pain management include nonsteroidal anti-inflammatory drugs like meloxicam, opioids like buprenorphine, and other classes of drugs like gabapentin. Each has its advantages and disadvantages. For example, NSAIDs can cause potential problems for the liver and kidneys. Using drug combinations can help keep individual drug doses lower and reduce the risk of side effects from higher doses.
Non-drug options for pain management include acupuncture, manual therapies such as osteopathy and massage, herbs, homeopathy, and essential oils. Careful selection of the approach or combination of approaches is important and should be based on an analysis of the cause of the pain. As with drug metabolism, cats can slowly metabolize certain herbs and essential oils. This means that some of these products can become toxic if not properly selected and used. Products like glucosamine and chondroitin can help with osteoarthritis problems.
If you think your cat is in pain, contact your veterinarian. You can create a full assessment, diagnosis, and pain management plan tailored to your cat.
Ron Carsten, DVM, PhD, CVA, CCRT was one of the first Colorado veterinarians to adopt the integrative approach, giving numerous lectures to veterinarians, and pioneering the therapeutic use of concentrated feed to treat clinical problems. He is also the founder of Colorado Animal Rescue (CARE). In addition to his doctorate in veterinary medicine, he has a doctorate in cell and molecular biology and is a certified veterinary dupuncturist and certified canine rehabilitation therapist. He practices integrative veterinary medicine in Glenwood Springs.