Cats are experts at not letting on when something is wrong. This is not stubbornness or indifference — it is a deeply ingrained survival instinct. In the wild, an animal that visibly shows weakness becomes a target.
Domestic cats carry that same wiring, which means that by the time a cat is displaying obvious signs of distress, they have often been in pain for quite a while.
This is one of the most important things cat owners can understand: the absence of obvious suffering does not mean the absence of pain. Knowing what to look for — the quieter, easier-to-miss signals — is one of the most meaningful things you can do for your cat’s wellbeing.
1. Changes in Grooming Habits
Grooming is one of the most reliable windows into a cat’s physical state, and changes in either direction can signal pain.
Over-grooming a specific area — repeatedly licking, chewing, or pulling fur from the same spot — is often a response to localized discomfort. The abdomen, lower back, and base of the tail are common sites.
Cats instinctively groom areas that hurt, in the same way a person might rub a sore muscle. If you notice a thinning patch of fur or irritated skin, it is worth investigating what is underneath.
On the other end of the spectrum, a cat who has stopped grooming, or whose coat has become dull, matted, or unkempt, may be dealing with pain that makes the physical act of grooming difficult — particularly in older cats with joint or mobility issues — or generalized illness that has suppressed their normal routines.
2. Changes in Facial Expression
Cats in pain often show it in their face, though the signals are subtle enough that most owners do not recognize them without knowing what to look for.
Researchers have developed a validated clinical tool called the Feline Grimace Scale to help veterinarians and owners assess pain through facial cues. The indicators include partially closed eyes, ears rotated or flattened outward, whiskers pulled back or bunched together, and a tight or tense muzzle.
A cat who normally greets you with wide, curious eyes but has recently seemed squinty or vacant may not simply be sleepy. Taken alongside other signs, a changed facial expression is worth noting.
3. Withdrawal and Hiding
Most cats have a baseline preference for where they spend their time — a favorite chair, a sunny window, a spot near their owner. A sudden shift in that pattern, particularly toward hiding in unusual or hard-to-reach places, is a meaningful behavioral change.
The key distinction is suddenness. A cat who has always been somewhat private is one thing. A cat who has historically been sociable and begins consistently avoiding contact, retreating under beds, or staying in corners is communicating something.
Withdrawal is one of the most common early signs of both pain and systemic illness in cats, and it is frequently dismissed as a mood or personality quirk until the underlying cause becomes more obvious.
4. Changes in Posture and Movement
A cat in chronic pain often adopts a protective posture — a hunched or rounded back, a tucked abdomen, or a reluctance to stretch out fully when resting. This is distinct from a cat who is simply curled up comfortably; the posture tends to look tense rather than relaxed.
Movement changes are equally telling. Watch for hesitation before jumping onto surfaces your cat used to take in stride, a preference for staying at ground level, stiffness when rising from rest, or an altered gait.
These can be signs of dental pain, abdominal discomfort, urinary issues, or musculoskeletal problems, and they are easy to attribute to aging when they may in fact be treatable conditions.
5. Appetite and Thirst Changes
Pain suppresses appetite. A cat who is eating significantly less than usual, showing disinterest in food they previously enjoyed, or losing weight without an obvious cause may be dealing with discomfort that makes eating unappealing — particularly if oral or dental pain is involved.
Dental disease is extremely common in cats and often goes undetected because cats rarely stop eating entirely, even when their mouths hurt.
Changes in thirst are worth noting in the opposite direction. A cat drinking noticeably more water than usual can be a sign of conditions like kidney disease, diabetes, or hyperthyroidism — all of which can cause internal discomfort alongside their other effects.
Increased thirst in a cat who was previously moderate in their water intake warrants a veterinary conversation.
6. Litter Box Changes
The litter box is one of the most informative health indicators available to cat owners, and pain-related changes are among the most common reasons cats begin avoiding it or behaving differently around it.
A cat who cries out while using the litter box, exits before finishing, makes repeated trips with little output, or begins eliminating outside the box may be experiencing pain when posturing to urinate or defecate. Urinary pain in particular can escalate quickly. A cat straining to urinate with little or no output is a veterinary emergency.
But subtler changes, like a cat who has started going just outside the box or who seems reluctant to step in, are also worth paying attention to. These are not behavioral problems. They are signals.
7. Uncharacteristic Aggression or Irritability
A cat who hisses, growls, swats, or bites in response to being touched in a particular area — especially if that reaction is new or out of character — is often communicating pain rather than temperament. This is one of the signs most likely to be misread as behavioral, when in fact it is a precise and reliable indicator of localized discomfort.
Pay attention to where the reaction occurs. If your cat consistently objects to being touched along the spine, around the abdomen, or near the hindquarters, the location itself is diagnostically useful. A cat who was previously relaxed about handling and has become defensive is telling you something worth listening to.
8. Subtle Vocalizations
The obvious signs of feline pain — loud yowling, crying — are not what most owners should be watching for day to day. Cats in chronic pain rarely make dramatic sounds. The subtler signals are more common and more easily missed.
These include:
- Low, quiet growling when resting
- A new habit of vocalizing in the litter box
- Chirping or chattering that seems disconnected from external stimuli
- Or acat who was previously vocal going unusually quiet
Changes in vocalization pattern — not necessarily volume — are the thing to notice.
Chronic Pain vs. Acute Pain: An Important Distinction
Acute pain — a sudden injury, a urinary blockage, a broken tooth — tends to produce more visible distress and is more likely to prompt an urgent veterinary visit.
Chronic pain is the more insidious problem, because it develops gradually and cats adapt to it incrementally. Owners often look back after a diagnosis and recognize that signs had been present for months, attributed to aging or personality rather than an underlying condition.
Arthritis, dental disease, kidney disease, and gastrointestinal conditions are among the most common sources of chronic pain in cats, and all are manageable when caught and treated. “Getting older” is not an explanation for behavioral change. It is a reason to look more closely.
If any of the signs above sound familiar, trust that instinct. Cats cannot tell us when something hurts, but they do show us, in the ways described here, if we know how to look.
Schedule an appointment with Dr. Nesbitt at Catonsville Cat Clinic and let’s find out what your cat has been trying to tell you.