Is Your Cat in Pain? Subtle Signs You Might Be Missing

Guest: Amanda Caron, Certified Cat Behavior Consultant, Frisky Feline Behavior Counseling
Host: Amy Castro, The Pet Parent Hotline

Important Disclaimer

The information shared in this episode is for educational purposes only and is not intended to diagnose or treat any medical condition. Behavior changes can have many causes. If you have concerns about your cat's health, pain, or behavior, consult your veterinarian.

Resources

Frisky Feline Behavior Counseling
Amanda Caron provides virtual cat behavior consultations throughout the U.S. as well as in-person services within her Connecticut service area.

Feline Grimace Scale
A validated tool that helps assess acute pain in cats by observing changes in facial expression.

Transcript

00:00 — Teaser

Amy Castro:
Cats are incredibly good at hiding pain, which means the first sign that something's wrong may not look like pain at all. It might look like hiding, being cranky, missing the litter box, or just acting a little off.

Today we're talking about the quiet behavioral changes your cat may be using to tell you something hurts, and how to catch those signals before problems get bigger.

00:24 — Welcome to The Pet Parent Hotline

Amy Castro:
You've reached The Pet Parent Hotline. I'm Amy Castro, and today we're talking about something cats are notoriously good at hiding: pain.

And because the signs can be so subtle, it's easy to assume a cat is just being difficult, being moody, or just doing some weird cat thing when they actually might have something else going on.

Joining me today is Amanda Caron. Amanda is a Certified Cat Behavior Consultant and the founder of Frisky Feline Behavior Counseling, where she helps cat parents understand the why behind their cat's behavior and find compassionate, practical ways to address it.

Whether someone's frustrated, worried, or simply has no idea what the cat's trying to tell them, Amanda helps them move from confusion and conflict to a much happier relationship with their cat.

So Amanda, welcome to the show.

Amanda Caron:
Thank you for having me, Amy. It's a pleasure to be here.

Amy:
I am glad to have you here because cats are an enigma. I don't know. I've got three of them and they still manage to baffle me on a regular basis.

I'm glad we're talking about this particular subject because I do get a lot of people between my rescue work where people are looking to surrender a cat because, let's say, the cat's not using the litter box or something like that. And I always want to know why and what's going on.

My first question is always, “Have you taken your cat to the vet?” No, they haven't.

So this idea of cats and pain and how do we know, because frustratingly they can't tell us, I think is a good subject. Even if you don't have a cat, if you've got a pet that can't talk and tell you what's going on, this is going to be a good episode for you.

Amanda:
Absolutely. I think it's a great topic. I think everyone should know more about it.

As you mentioned, cats really don't show us all the time when their pain is happening unless it's really extreme. So knowing what to look for and what to do about it is really key when engaging with any cats, whether they're your own or working rescue.

02:11 — Why Cats Hide Pain

Amy:
Why is it that cats are so good at keeping it from us, usually until it's super late, like they've been suffering for quite a while by the time we figure it out?

Amanda:
I think in the world of us looking at cats, we don't see their background of being prey and predator. We look at them as our domestic pets in our homes, playing with toys on the couch.

But it's inside them to kind of be guarded and protected over what they're displaying on the outside because, at the end of the day, they are still prey. They are still being predated on from other animals and hunted.

So even in our homes, they still have that kind of, “I need to be safe.” They'll put their guard up and they won't display anything to try to keep themselves safe.

Once they do, it's really hitting a pretty extreme amount of discomfort when they're starting to show those signs very blatantly. So they'll keep their guard up to kind of keep their safety as best as they can.

Amy:
I think that's such an important message for people to hear. I don't think people think of their cats as being prey, like you said.

And so if they showed that weakness easily, like us whining and complaining about “this hurts” or “my tooth hurts” or whatever, they'd quickly be culled from the herd if they didn't watch out.

So it's evolution to survive and hide those kinds of things. And it's unfortunate for our poor cats that they can't tell us.

03:46 — Subtle Changes to Watch For

Amy:
So if our cats are so good at hiding it from an evolutionary standpoint, and I think we're really busy sometimes too and maybe we're not paying as good attention, what kind of things might we be looking for so we can catch a painful condition earlier?

Amanda:
I love that question.

When I look at the average cat in someone's home, I'm really looking at how much the owner knows about the cat to start with. What's normal for them?

Are they cats who are really energetic or really engaged with other cats in the home? Are they very social?

The first things you're looking for are going to be changes in that cat's behavior. Anything that seems out of the ordinary should be a flag to you to start monitoring that something could be going on.

Maybe they're pulling away. Maybe they're usually coming to sit with you at dinner time or to watch TV. If they're not there, why?

If they're usually good with other cats in the home and are starting to seem a little bit more irritable or less tolerant, you want to start asking why the dynamics between yourself or the other cats in the home are starting to change.

And maybe it's not anything to do with the way they're behaving in their relationships. Litter-box changes. Maybe they're going more or less, or maybe their eating habits are changing.

When you really pay attention and get to know the normal, you'll start to know when things start to get off from where they should be.

04:47 — Knowing What's Normal

Amy:
I'm glad you brought up the whole idea of normal.

I just did an episode recently where we were talking about noticing behavior changes in your pets. My listeners know I've just gone through a huge, halfway cross-country move. My cats and my dogs have been under a lot of stress, and so they're acting weird just in general.

I think sometimes it can be easy to write that kind of stuff off as just situational, or like you said, changes in relationship, or so-and-so is getting older and is just a grumpy old man.

But then we kind of leave it at that as if that's all we need to say about it. I'm glad you brought that up, that it's really something to hone in on.

Amanda:
Absolutely. Every detail matters.

The more that you pick up on the little things, the closer you can be to figuring out that something may be going on, and then you take your next steps to investigate that further.

The worst-case scenario ends up being nothing, but at least you're staying right on top of things early on.

Amy:
How can we start noticing some of that?

Just using my example of my change, I moved with three cats. One of them has no eyes. Her name is actually Victoria, but we call her Monkey because she will climb to the top of anything even though she can't see where she's going and just be precariously perched. She seems pretty much unfazed by the move.

But then I've got, on the other end of the spectrum, my 15-year-old cat Pickles, who's skinny, she gets sub-Q fluids, she's got kidney issues, and she's always been a little bit... I can't think of a polite way to say it, but she's just a nervous cat.

So how do I know, with Pickles for example, is she just being Pickles and being a nervous cat, or is there something really going on with her?

Amanda:
I think in the sense of a bigger move or when it seems to align with a change in your household, stay on top of things.

Make sure the baseline, eating and using the litter box, is of course firsthand important. If they're not doing those basics, get them to the vet.

But if it seems they're still really processing change after it's been a while, it's always a good idea to ring the vet.

We could give our cats a couple of weeks, maybe a couple of months, for changes, whether that's changes to the household makeup, people in the home, new pets, moves, things like that.

But if it's continuing to go on, I would start asking questions and at least see if the vet has any advice to help them along.

It's always good to get another eye on a situation so you can say, “I did due diligence,” versus waiting it out. Sometimes waiting too long is not always the best.

07:19 — Tracking Changes

Amy:
The unfortunate thing, and I'm just as guilty of it, I'm not pointing any fingers at anybody, but we have a tendency to wait on these things.

Whether it's the hassle of going to the vet for some people or the expense or whatever it might be, we tend to put it off.

But I think it's that combination of putting it off and then not paying attention to it that can cause problems.

Even with Pickles and her kidney issues, to the point where we have to give her these sub-Q fluids on a pretty regular basis, her kidneys were pretty bad by the time I got her in. I hate to admit that, but again, you write it off as Pickles being Pickles. I'm already taking 5,000 animals to the vet every other day, and then you forget about it and now three months have gone by.

I'm sure there are listeners out there who are much more diligent pet parents than I am.

Do you have suggestions as far as how we can track these things so that you can see those patterns of behavior?

Amanda:
Generally, when I'm working with families and we're talking about changes in behavior, the first thing we're keeping track of is frequency.

We're trying to find patterns and time of day. You can put it on your phone or your fridge. Maybe it's odd every Monday, or every day at 6 p.m., or it seems to be occurring more.

When you look at data in a small portion, you may not pick up on anything. If you're tracking for a week or two, you may not pick up on anything. But when I look at data over the course of six to eight weeks, I'm able to go through and highlight patterns in behavior and say, “This is interesting. We're starting to see recurrences here,” or we're seeing increased frequency or decreased frequency.

You're looking at patterns, time of day, days of the week, frequency. Is there anything that correlates with the behavior, such as going to work or maybe taking the weekend off to travel?

Those are all things that can correlate with behavior. Sharing that with a veterinarian or a behavior person is really valuable to get down to the bottom of what's going on and how you can get back on your feet with your cat.

09:20 — Establishing a Baseline

Amy:
That's good advice. With all of our options that we have available to note-take, there's almost no excuse to do it in some form or fashion.

It doesn't have to be fancy. It doesn't have to be detailed. I've even done it, because I'm lazy and I'm not good at journaling and doing things like that, by just putting the first initial of the pet's name on a calendar entry so I can see at least what days something occurred with that particular pet.

I keep thinking back to you talking about knowing what your pet's normal is. It's very easy for me to blame it on the rescue because I had so many animals to keep an eye on that I maybe didn't engage with my pets on an in-depth basis on a regular day.

But I don't think it's unusual for people to go to the vet and the vet says, “How long has this been going on?” or “Is this normal for your pet?” And people are like, “I don't know.”

How do you begin to gauge what's normal if maybe you haven't done it since birth and now we're starting from today? How do we establish that baseline?

Amanda:
I love that.

Things that are really important that the vet's going to ask include eating habits. How much is your cat eating?

A lot of people are still free feeding, and I'm not here to judge on that conversation, but if they are, how much are the cats taking out of the bowl? How often are you refilling it at the very least?

If they're doing structured meals, do they finish that or do they graze? Does it take them an hour or so to kill that bowl or 10 seconds? That's finding out the normals of feeding.

Then litter-box behavior is the same thing. How big are the urine piles when you're scooping them? How many urine piles? What does the feces look like when you're scooping? Is it a little sticky or is it really hard?

Those are things on a daily basis that you can get in tune with very quickly in just a couple of days.

And then other things, like where does your cat stay to sleep overnight?

Maybe you know they're at the foot of your bed, or maybe you don't know and maybe we want to know and find that out.

Do they play with toys if you engage them? What do they like to do? Sit in the sun?

These are things that I think, just in a week of taking the time to get to know your cat, you can hone in on just by watching.

You don't really have to do too much different. Just do your normal and pay attention more, and you'll get to know your cat more than you thought you did.

11:33 — Multi-Cat Households

Amy:
I would think you could definitely learn a lot doing that.

Now, one sidebar note to that, because my challenge is always that I've got three cats and they tend to share, and trying to keep them separated and keep them away from each other's food is a little bit tricky.

Are there any particular tricks for multi-cat households?

Amanda:
Absolutely.

If you're looking to see if somebody isn't well and you need that data or information, you can separate them for a short time, whether it's a couple of days or a couple of weeks if you need that data.

Or even if it's just mealtime feeding and you're doing it there to make sure that cat is eating because you're not really sure.

I do find that separation can be valuable for getting the appropriate information to the vet in a multi-cat home.

It's really hard to know who's got the runny stools, who's been vomiting, who's not doing this or is doing this.

Sometimes segregation is a tool we need to get help faster. Otherwise, sometimes just saying, “I suspect it's that cat,” could mean you're wasting valuable time taking the wrong cat to the vet, and valuable money too, testing the wrong cat if it's not that cat doing these things.

Segregation can be valuable. Again, it doesn't have to be hard segregation where it's a closed door. You might be able to put up a gate just for a couple of days so you get your answer.

You'll have to talk to the vet depending on exactly what we're looking for, but I think that's a great idea if you need information.

Amy:
That's a good point.

In some cases with Pickles, because even though she's the oldest, she's much more agile than the other one that has a tendency to eat her food, I'll put her food up on my desk and everybody else's food is down on the floor.

If she goes down there, I can see her leave my desk. But when her food's on the desk, I can also see whether she's eating it or whether she's just licking up all the juice, which is kind of what she likes to do.

I've actually adjusted the type of food I buy specifically for her because it seems like she'd rather drink it than eat it. I don't know. She's weird.

But I almost started laughing when you mentioned looking at the litter box and the pee clumps because I spend a lot of time looking and talking about pee and poop.

Sometimes I will get some giant pee clumps in the litter box and I'll actually analyze it from the shape standpoint. Is that two? Did somebody pee on top of somebody else's pee? Or is that just one?

It can get pretty dicey trying to figure that out.

Amanda:
Absolutely. It's very difficult.

Again, that is information if you needed to know if somebody's not going a lot or somebody's going a lot more.

Sometimes segregation with a simple basic setup where you're scooping daily, you could trial that for a week with each cat and then get your information there.

They also have new technologies now, which is really fancy, where it tracks the cat's weight and frequency of them going in.

It's very new technology that I don't know enough about, but I think we're advancing to get information to pet parents without such hassle or such work if they need to.

Amy:
That's an excellent point.

Now, like you said, they've got so many things, like even collars that register when they go in the litter box and you know who's gone in when and what they did. It's amazing and I think it's helpful technology, especially in multi-cat households.

For people who have single cats, it reminds me of my friend Bev because I've never known anybody who knows so much about her cat. But it's just her and the cat living together, so she knows if he didn't finish all of his meal or whatever.

It gets a little easier for her to track. Paying attention to that is important.

15:11 — Cameras and Monitoring

Amanda:
Absolutely.

Another thing that I think can be really helpful for pet parents is, maybe you're not home a lot, having a camera. If you have the Ring doorbell or get a cheap camera online, sometimes what you're not seeing is the ticket.

Sometimes when cats aren't doing well, I will ask families to consider putting a camera up on their cats when they're not around. We learn a lot about how your cat behaves when you're not there.

That's another great tool. If you don't know the answer, sometimes having a camera in a multi-cat home or even a single-cat home is going to show you exactly what you need to know and then provide you with information to send to the vet.

Amy:
That's a good point.

I haven't done it for the cats yet, but I did it one time to try to figure out who was peeing in my dining room. It was a foster dog sneaking in there.

But I used a game camera, which is kind of nice because it only records if there's motion.

If you were trying to catch your cat in the litter box, an inexpensive camera, game camera, whatever that's motion activated, you would see how many times they went in there or if they didn't go in there at all.

That can be super helpful.

16:29 — When to Call the Vet

Amy:
So if pet parents do notice a change in behavior, what's the next step?

Amanda:
My advice to everyone, as soon as you know something's different with your cats, get them to the vet.

Don't question, “Should I contact a behavior specialist first?” Go straight to the vet because you want to check those boxes. There are certain things out there that, should you wait, can become emergencies.

We know the emergency vet is more expensive, and you're talking deeper diagnostics, et cetera. And it's scary, right? You're in the middle of the night driving out to a vet that you don't know.

If you think something's wrong, go to the vet.

Go to the vet first. Let them know your concerns. Get the diagnostics if they're asking for it.

If they're saying, “Do you want us to check deeper?” a lot of things aren't found on the surface. A lot of times they do need to do what they're asking you.

Get those things done. Get a good look at your cat so you can feel reassured going home that you've done your due diligence.

Anytime something's off, get to the vet. Get them in.

Let the vet know when you're calling for an appointment what's going on, because that says urgency.

“Hey, my cat can't urinate.” Okay, that's different than, “Hey, I'm noticing a little less food from the bowl.”

They'll tell you. Those vet techs and receptionists know the right questions to ask and how to relay that to the vet team.

Be sure to share exactly what's going on when you call for that appointment so you get your cat in as soon as possible if it's needed.

Amy:
And for pet parents who are on a tight budget and you're concerned about running to the vet too much, call them and discuss what's going on with your pet.

Your regular vet, who sees your pet on a regular basis, is going to give you a better idea of whether it's, “Hey, keep an eye on this,” or “Try this,” or, “Hey, you really need to come in immediately.”

I think that's why it's so important for people to have an established relationship with a vet and go to their vet on a regular basis.

If you've got a situation and decide to randomly call a vet you haven't seen in two years, they're not going to be able to help you as much over the phone because they've got no recent records of your pet or what their health condition is.

They're going to tell you that you have to come in.

That's just a soapbox moment for seeing your vet on a regular basis.

Amanda:
Absolutely.

Establishing that relationship with your vet means you actually will get more help and feel less isolated.

Especially when you're desperate and want help, calling a vet you maybe saw 10 years ago and saying, “Hey, Chauncey's not doing so well today,” they're thinking, “Chauncey was a kitten when we saw them. Chauncey's 13 now.”

A lot changes, just like us. We're not the same people we were when we were kids. Our bodies change. Maybe the household has changed.

They need all the information. It's not anything they can take over a three-minute call.

Having regular visits and getting ahead of things is why screenings are important to avoid big emergencies.

I agree with you wholeheartedly. Having a regular relationship with your vet is great. And finding a vet you love is great too.

19:42 — When Behavior Could Actually Be Pain

Amy:
That can be a challenge and it's a process for sure, but there are a lot of fantastic vets out there.

So to bring this conversation together a little bit, what do you wish pet parents knew more when it comes to pain and their cat?

Amanda:
I think in my experience a lot of cats demonstrate pain, but you really have to get past the behavioral side of things and question, “Why are you behaving that way?”

Many times cats will be sensitive to touch and people are like, “You're just grouchy. You're just an old cat.”

Question that.

Why is that cat biting you? Why is the cat swatting you? Why is the cat dropping their food or being a messy eater?

They're not humans. They're not leaving a mess for you purposely and they don't want to be grumpy.

Start to question those things.

When you really pause and take a breath from your busy day, look at them and think about those behaviors that can frustrate us.

Why are you peeing outside of the box? Why are you biting me when I touch you?

Sometimes when you really stop and look at them, look in their eyes and watch the way they navigate their environment, you start to think, “Maybe you're not as comfortable as I thought,” or, “Maybe something is wrong.”

I think it takes a moment because our lives are just so busy with work or families or extracurriculars. We come home, we feed, we sleep.

But when the question becomes, “Why does your cat do that?” many people say, “I don't know. I just assumed they were old,” or “I assumed they were grumpy,” or that they were dominant or whatever.

Those are the simplest answers that come to mind as humans.

But when I start asking questions and dig deeper and say, “Why do they only bite when you touch their back end? Did they always bite? Or was it only when they got older? When did the eating habits start? When was the last time they had their teeth checked?”

Things start to get puzzle-pieced together where they're like, “Boy, I should probably call the vet.”

Slow down and think about when things started. What triggers those behaviors? Your cat's aging. What happened when that behavior started?

I think a lot of times when we slow down, we can really be more empathetic for our pets because we know what it's like to be uncomfortable, to have a backache, a toothache, a headache. We can be grumpy too.

But because cats can play during the day or they'll eat, a lot of times it's, “They're eating and using the bathroom. They're okay.”

Really look deeper than that.

If there are any behaviors going on that you don't understand with your cat, just take a moment and take it in and really put together those puzzle pieces.

If you can't do that, seek help from someone, whether that's your vet or a behavior professional, and say, “I don't understand it, but I'm a little concerned that something could be going on.”

That's where people like myself come in to say, “Let's figure the puzzle out because it's not making sense. I want to help you, and let's help your cat.”

Amy:
I think you hit on something that I like to stress, even though I'm just as guilty as anybody else of saying, “You're just doing that to aggravate me.”

I say that, but in reality I know that. That's actually one of the things I like about animals. Your neighbor will do something with malicious intent, right? Or your ex or whatever the case may be.

Animals don't have motive.

So to assign motive, they're angry because I'm going to work or because we went on vacation or because of this or because of that, and then just write that off, I think we need to stop doing that and start with the assumption, at least, that it could be something physically wrong.

Get that investigated, and then you can go from there to start assessing it from a behavioral standpoint.

I think that's an important thing for people to hear.

Amanda:
Yes. Always medical checks first and then behavioral.

Many of the cases that come to seek help from me end up back at the vet because they just need someone to help them with, like we talked about, the tracking or just understanding the bigger piece of the puzzle.

Many times behavior is resolved when the cat is feeling better.

That's a wide variety of behaviors, from biting, inter-cat conflict, house soiling, you name it.

Cats don't feel good, they don't act good, just like people.

Definitely always a medical check, and then there are behavior professionals if that all checks out and you still need help.

24:07 — The Feline Grimace Scale

Amy:
Amanda, this has been a lot of really helpful information, but we know there's a plethora of information out there in the universe on a variety of things.

Are there any particular resources that you would recommend if pet parents are in the process of investigating this?

Maybe they haven't gotten results back from their vet or they haven't had that appointment yet. Is there something they could look at and maybe get started with finding out what's going on with their cat?

Amanda:
One of the best tools that I utilize in my everyday work, and veterinarians are also using, is something called the Feline Grimace Scale.

What it is is a tool that we can utilize to assess cats' body language and really get a sense for if they're feeling well.

It looks at things like muzzle tension, whisker position, ear position, orbital tightening, their body position, where their head is placed.

When you look over what the entire program looks like and compare it to your cat, it really is insightful.

That's something I'll show pet parents and they're really intrigued. They're like, “Wow, this is incredible.”

Using that to score your cat on what signs you're seeing and then bringing that to the vet to say, “I'm not saying my cat's painful, but I did utilize this tool and I'd like to present to you what I came across.”

There's actually an app now. I believe you can upload photos and it will help you identify potential things to talk about with your vet.

So it's not diagnosing pain. It's diagnosing talk points with your vet.

Understandably, certain breeds have characteristics that we have to be careful of. Scottish Folds, for example, those ears are different. Certain cats have the shorter face.

We really want to be careful about looking at that scale and missing something because it's a breed characteristic.

We don't want to say it's diagnostic in the sense of saying, “Yes, your cat has pain,” but it is enough to say, “Hey, doctor, I utilized this resource and I'd love to present to you what I think I'm looking at.”

I use that as a tool in my work, and I encourage families to look up that tool if you're headed to the vet and questioning, “Could my cat be in pain?”

That's not to say your cat will show those signs, but if they are, it's definitely a talking point for the vet when you head in.

Amy:
Something to get started with.

And I think that is an excellent point. Don't suddenly decide you've gone to vet school and you can correctly diagnose and treat and everything else.

But it gives you a starting point to discuss, so that's important.

26:31 — Getting Behavioral Help

Amy:
Let's say that my cat has gotten a clean bill of health but I am still experiencing some behavior issues that I would want to discuss.

Can people reach out to you? Do you work with people in person? Tell us a little bit more about what you do in your practice.

Amanda:
Absolutely.

I encourage any families in the U.S. to reach out. I'm happy to consult with you virtually over Zoom.

For an area of Connecticut around where I go, the Farmington Valley and a little bit of upper state as well, you can always reach out and see if you're within my service area. That's available on my website as well.

We do in-home visits, but the interesting thing about the work I do is that I can get a sense for everything I can get a sense for in your home virtually as well.

I have families record specific videos so I can get a sense.

If you're not able to have me in your home, record a video of your house so I can see the layout. Where is your cat eliminating? Show me your cat jumping off things or moving around.

I want to get the insights you want me to see, but sometimes an in-home visit just isn't plausible.

And what if your cat is uneasy with new people? I don't want to make your cat uneasy.

We can have a lot more success by making sure everybody's comfortable and still getting me that data.

The work I do is really with the family.

I tell people, if you're having troubles, reach out. I actually offer a free 10-minute call on my website where people can call me and see what the process is like.

I generally don't do a consultation during that call. We want to get the full information. But I think it's important that people are able to talk to a real person and just get heard.

That's really important.

If I feel like I'm not the right resource, I'll point you in the right direction. Maybe head to your vet or a veterinary behaviorist or perhaps another consultant in your area who's certified.

I like to help families any way I can.

That call is a great way for us to say, “Is this the right pathway for you or not?”

28:34 — Final Takeaway

Amy:
Awesome. That's great.

We'll definitely put the links in the show notes to your website and to the Feline Grimace Scale app and information so that people have access to that.

Amanda, I really appreciate you being on the show today.

As I have been trying to do, paying more attention to my pets and what's going on with them, this has been really helpful for me.

I know it will be very helpful to listeners to hear more about how they can get better at being detectives when it comes to their cat's behavior and possible pain.

I really appreciate that information.

Amanda:
Thanks, Amy, for having me. I enjoyed it so very much, and I hope to be back again.

Amy:
I think the big takeaway for me is that we don't necessarily need to become experts at diagnosing pain.

We just need to be really good at knowing our own cats and noticing when something changes.

Because sometimes it really is just your cat being weird, but sometimes it's information that's really worth paying attention to.

Thanks for listening to The Pet Parent Hotline. If you enjoyed the show, text a friend right now and tell them, “I've got a show that you need to hear.”

And remember, your pet's best life starts with you living yours.