Cats hide pain, so a cat in pain mostly looks like a cat that has changed its habits. Cat Friendly Homes, the owner site of the Feline Veterinary Medical Association, says behavior changes are the main sign of pain in a cat. You compare your cat with its own normal, and you can check five things in its face that vets score.
The order of the steps comes from Tabitha Kucera, a veterinary technician who specializes in behavior, writing in July 2026 for VETgirl, which trains clinic staff. The facts come from the sources named in each step.
The Feline Grimace Scale was built at the Université de Montréal and published in 2019. The researchers filmed 35 pet cats brought to their emergency service and 20 healthy cats, and found five things in the face that change with pain.
| What to look at | Relaxed (score 0) | In pain (score 2) |
|---|---|---|
| Ears | The ears face forward. | The ears are flattened and turned outwards. |
| Eyes | The eyes are open. | The eyes are squinted. |
| Muzzle | The muzzle is relaxed and round. | The muzzle is tense and stretched into an oval. |
| Whiskers | The whiskers are loose and curved. | The whiskers are straight and point forward. |
| Head | The head is above the shoulders. | The head is below the shoulders or tilted down. |
Each of the five scores 0 when the sign is absent, 1 when it is partly there or you are unsure, and 2 when it is obvious, so the top score is 10. The university says 4 or more means the vet should consider pain relief, and that an owner who gets 4 or more should contact the vet. Watch the cat for 30 seconds while it is awake and undisturbed, and wait if it is grooming, eating or meowing. A slow blink from a relaxed cat is something else, and Reading your cat's body explains it.
In a 2021 study, five owners scored 100 pictures and agreed closely with five vets. The scale was tested on sudden pain. For slow pain such as arthritis, the American Animal Hospital Association says the vet depends much more on what the owner sees at home. The same guidelines note that a version for owners is online: Feline Grimace Scale, Université de Montréal. The table is our wording of the 2019 paper, which carries a Creative Commons Attribution 4.0 license, and of the score descriptions on that site.
The checklist uses the four groups Cornell University uses for dogs, with lines from Cat Friendly, the American Animal Hospital Association and the Cornell Feline Health Center.
Print this checklistNone of these signs tells you the cause. Cat Friendly says a change in eating alone can come from a stomach or bowel problem, diabetes or other problems.
Book the visit first. Then tick what you see each day until the appointment, for up to two weeks, with the date beside each tick. Two weeks is our own suggestion, not a figure from the guidelines, and it is not a reason to wait.
Cat Friendly's advice is to note every change in behavior, activity or routine in a notebook, even a minor one. The American Animal Hospital Association says a video from home helps if it shows the whole cat and the whole action in good light. My Pet keeps a dated list of the changes on your own phone and prints it for the vet.
A clinic visit changes how a cat behaves, so the vet watches first: how smoothly the cat moves, its coat, its posture, how it jumps down and how it walks to its carrier. Then the vet presses on each area and bends each joint. The American Animal Hospital Association names the reactions: the cat tenses, its voice changes, or it tries to move away.
For slow joint pain the vet may give you a questionnaire, such as the Feline Musculoskeletal Pain Index, in which you rate how well your cat does everyday actions. The guidelines say an arthritic joint can hurt and look normal on x-rays, or look very abnormal and not hurt.
Do not give your cat a painkiller made for people. The U.S. Food and Drug Administration says cats may be less able than other animals to break down anti-inflammatory painkillers, and that they lack liver enzymes needed to break down acetaminophen safely. The page Ibuprofen and other human painkillers has the rest.
Ask the vet before you buy a joint supplement. The American Animal Hospital Association cites a review that found the strength of evidence low for all of them except omega-3 fatty acids, and that exception was in dogs. The home changes the guidelines name are carpet runners, a ramp or steps, and a resting place within easy reach of the food and the litter box.
Some pain cannot wait for a checklist. Cats: is this an emergency? lists the signs that mean go now, among them a male cat that strains in the litter box and produces nothing, a cat that breathes with its mouth open, and sudden weakness in the back legs with crying. Cat Friendly says a cat that has gone 24 hours or more without food needs a call to the vet immediately. If you are not sure, call a vet.
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Sources read on 2 October 2026; every number is as the source gives it.