How Do Veterinarians Assess Pain in Cats?


Yeow! Uncharacteristically grouchy cats may be in a great deal of pain. By: strecosa

How can you tell when a frightened cat is in pain?

Reach out to stroke an anxious cat, and they’re liable to lash out. If that cat is at the vet, are they lashing out in fear or pain? The cat uses the same actions (growling and lashing out) to express 2 different emotions (anxiety and pain). Tricky!

How do you know which is which, especially when the cat is an inpatient at the vet’s?

Fear-Free Practice

At this point, it’s worth mentioning vets are getting much better at “fear-free” practice. This uses techniques that lower the pet’s anxiety ahead of and during the vet visit.

However, as anyone who dislikes dental visits will know, no amount of plasma TVs on the ceiling or soothing music will totally eradicate drill phobia.

Recognizing Pain Matters

Most feline patients admitted to a vet clinic are out of their comfort zone (and fearful). And these patients may well be due for surgery. So we have the perfect storm: anxious patients who are difficult to assess for pain.

The thing is, vets care a lot about whether their patient is in pain or not. Now more than ever we have an armory of drugs that can give effective pain relief, so there’s no need for cats to suffer discomfort.

However, all drugs have side effects, some more than others. In an ideal world, we want to control pain but avoid unnecessary medication. So with the right tools for the job, vets can control pain in cats — but first you have to recognize there’s a problem.

Several factors go into scoring a cat’s pain using the Glasgow Feline Composite Pain Scale, such as a tense muzzle. By: IceEye

The Conundrum of Cats at the Vet Clinic

People are often told to be alert for changes in their cat’s normal behavior as a sign that something is wrong. An injured or sick cat will hide, so they don’t advertise their vulnerability to predators. Thus, a cat that doesn’t come to greet you as normal may be unwell or in pain.

In the comfort of your own home, a cat in pain will act differently. They may:

  • Hide away.
  • Not come to greet you.
  • Refuse to eat.
  • Be unusually grouchy.

These signs are vital clues that something is wrong. But how do you spot these clues when they’re at the vet’s?

Reducing Stress for Inpatients

No one wants to cause unnecessary stress to their patients, so staff go to great lengths to make their inpatients as stress-free as possible. To reduce the cat’s stress, the vet tech will give the cat a box to hide in. This gives the cat a vital coping strategy, which is to conceal themselves.

Indeed, clinics use strategies to reduce stress such as:

  • Keeping cat and dog inpatients in different wards
  • Using reassuring cat pheromones
  • Playing soothing music
  • Providing boxes for cats to hide in

Clinical staff must also up their game and spot subtle signs of pain.

To do this, many practices now use the Glasgow Feline Composite Pain Scale (GFCPS) method — a bit of a mouthful. This is a method where we look at the bigger picture and give each cat a pain score out of 20. The higher the score, the more discomfort the cat is in.

A cuddly cat may not be in any pain. By: pogo_mm

The Big Picture

In good clinics, the hospital displays a Glasgow chart on the cattery wall, listing each item to be checked. Each cat has a clipboard on their bed where their individual score is recorded. Reviewing the scores helps clinical staff spot trends and when extra pain relief is needed.

Here are some of the factors constantly being checked. Each action has a prescribed “score,” and they’re all added together at the end of the assessment.

1. The Cat in Their Bed

  • Meow or growl: When a cat is left alone, then “stress” noises such as growling, crying or groaning can indicate pain.
  • Relaxed or hunched: If the cat is hunched and miserable, then this can reflect discomfort.
  • Ignoring the wound or licking: Paying attention to a surgical wound may mean something has drawn the cat’s attention to it, such as pain.
  • Pricked or flat ears: Agitated cats flattened their ears. So what caused the agitation? Is it pain?
  • Muzzle shape: A squishy, tense muzzle reflects inner tension — caused by pain, perhaps?

2. Response to a Fuss

Does the cat enjoy a fuss and press in for a rub (good), freeze (not so good) or become aggressive (pain)?

What is the overall impression of the cat on a scale from friendly to depressed and grumpy?

3. Assessing the Sore Place

Is the surgical incision causing the cat pain? This is tested by gently touching the area around the incision and comparing their reaction with touching a non-sore place.

Here’s a little more information about cat pain:

How the Pain Score Is Used

The total pain score helps the vet decide if extra pain relief is required. Then, once the cat has received treatment, we can monitor them to see if it worked and when the effects start to wear off.

All cats are individuals. Some may be hissy and spitty by nature. But the beauty of this scheme allows for the cat to be given a score when admitted. If that score goes up after surgery, it’s likely the cat is in pain. Armed with this information, we can then give pain relief to alleviate their discomfort.

As you see, this is far from an academic exercise because it allows cats to be given the right level of pain relief for them as an individual. All of which goes to show just how far veterinary medicine has come. As a clinician, it’s wonderful to have medications that are safe and effective for cats, which means we’re much better able to manage their pain.


This pet health content was written by a veterinarian, Dr. Pippa Elliott, BVMS, MRCVS. It was last reviewed July 6, 2018.

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