[Edited on 15 December 2020]
Cats communicate their pain and discomfort in various ways. Unfortunately, it is easy for cat parents to overlook these signals because they are so subtle. Cats are wired to hide any signs that will show their vulnerability to potential predators. It’s a survival instinct that they have inherited from their wild ancestors. But if you spend regular time interacting with your pet, you will notice if something’s off.
Signs Of Pain In Cats
- Cats that have been through surgical procedures or have injuries are assumed to be in pain.
- Avoidance of vertical spaces, such as their favorite spot by the windowsill or the sofa.
- Cats in pain may vocalize more and may be heard meowing and/or howling. There are also instances when a normally vocal cat may suddenly seem quieter than usual
- Won’t climb stairs leading to the next floor or landing
- Sleep more often than usual
- Has a faster heart rate or pulse rate
- May appear restless as they try to settle into a comfortable position
- Inappropriate elimination -- A cat may do their business outside the litter box because it is painful for them to get in and out of the box. This is especially true when the litter box has high walls.
- Withdrawal from the rest of the household, pets, and humans alike. The cat may spend most of the day hiding under the bed or furniture away from everyone.
- Display aggressive behavior when they are handled or approached. There may be resistance when they are picked up. They are quick to scratch, swipe, bite, or hiss.
- The pupils may appear larger.
- A cat may engage in less grooming or stops grooming altogether. This can eventually lead to the formation of mats and tangles. Excessive grooming may occur on a part of the body that is painful
- Panting may be noticeable. Cats that are in pain tend to have shorter and faster breathing. Changes in the movements of the muscles in the cat’s chest or abdomen may also be present
- Mobility difficulties -There is stiffness or limping when walking. Changes in their movement or gait may also be noticeable
- Changes in personality - The cat may react unpredictably when touched.
- Change in appetite and eating patterns. Not eating and/or drinking as much as they used to.
A cat that is in pain or discomfort may exhibit any of these signs and symptoms. A little sleuthing on your part, better yet, a visit to your veterinarian can help identify what is causing your pet’s behavior.
What to do when your cat is in pain?
A call to your veterinarian is an important step in addressing your pet’s dilemma. Prepare to be asked about your pet’s history and to explain or enumerate the symptoms displayed by your cat. Depending on your vet’s assessment, you may be asked to bring your pet in for further examination and laboratory tests.
How Pain Is Treated In Cats
Pain management in cats will depend to a large extent on the cause of pain. If you have concerns about the use of pain medications on your pet, don’t hesitate to talk with your veterinarian. Your veterinarian is the best person who can decide which pain medication is appropriate based on the specific needs of your cat.
What can I give my cat for pain?
While you may be tempted to provide some over the counter pain-relief medications to your cats, it is necessary to let your vets prescribe these pain relief medicine. There is no human medication that is considered safe and licensed for use as a pain relief in cats and many medications intended for dogs are extremely unsafe or indeed life threatening when used in feline patients.
What Do Vets Give Cats For Pain?
There are several different pathways involved in the perception of pain and each category of drug acts to effect a different one.
Non-steroidal Anti-Inflammatory Drugs (NSAIDs)
Cats are extremely sensitive to this class of medications and side effects are much more common and severe when compared to dogs. Considering the serious side effects of NSAID-use in cats, these pain-relieving medications should only be used when safer alternatives for pain relief aren’t as sufficient in the alleviation of symptoms. Guidelines given by the veterinarian regarding the dosing and administration of NSAIDs in cats should always be followed to the letter.
Cats have difficulty eliminating NSAIDs from their system and the build-up can lead to toxicity. The inability of cats to metabolize NSAIDs efficiently is due to the lack of enzymes that are necessary for NSAIDs metabolism and elimination. For this reason, cats are much less tolerant of errors in dosing.
In 2010, The American Association of Feline Practitioners (AAFP) and the International Society of Feline Medicine (ISFM) released important guidelines regarding the use of NSAIDs in cats. These include the following:
- The ‘lowest effective dose’ should be given.
- All cats should also undergo screening before being started on NSAID therapy.
- Close monitoring is very important while a cat is on NSAIDs.
Adverse reactions of NSAIDS use in cats
- Damage to the gastrointestinal tract -- a common example is the formation of ulcers in the stomach lining.
- Blood clotting problems
- Damage to the kidneys
- Loss of appetite
- Fatigue and lethargy
- Brownish urine
- Breathing is shallow or rapid
- Abdomen is swollen and painful
- Swelling in the cat’s face and/or paws
- Gums appear dark in color
- Bluish (cyanotic) gums
If your cat is on any type of NSAID and is showing signs of an adverse reaction, you should stop giving the medication and call your veterinarian.
Pain medications that contain acetaminophen as the active ingredient should NEVER be given to cats. When acetaminophen is broken down in the body, its metabolites cause damage to the cells of the liver and kidneys. There is also the conversion of hemoglobin (the part of the blood that carries oxygen) into methemoglobin, resulting in poor delivery of oxygen to the body cells, tissues, and organs, which may lead to irreversible damage. Tylenol is a popular pain reliever that contains acetaminophen as the active ingredient. It is so toxic that even one tablet of Tylenol (Regular Strength) can kill some cats.
Opioid medications are often used for severe pain. It’s prescribed by veterinarians as a pain relief, often after surgery. It is also used as pain medication for cats with cancer or severe pain brought by arthritis. These medications should only be used with a vet’s prescription. As with any medication opioids given inappropriately or at an incorrect dose are more likely to have side effects. Even at the correct dosage opioids can cause behavioural changes such as agitation and/ or confusion in cats and also cause pupil dilation, excess salivation and sedation.
Dexamethasone, prednisone, and similar types of corticosteroids have anti-inflammatory properties that can help provide relief from pain and inflammation in cats in some situations, but they are not traditionally used as for their pain relieving qualities alone. These medications are often prescribed for allergies, arthritis, as topical pain relief for cats, and for a variety of other health issues. However, they should be used with caution as they can have potential long-term side effects.
Gabapentin has been traditionally used an anticonvulsant that is used to control epilepsy and seizures. It is also prescribed in cats and dogs for chronic nerve pain treatment. It should never be used in pregnant or lactating pets. The potential side effects of gabapentin in cats include lethargy, loss of balance, digestive upsets (vomiting and diarrhea), swelling of the limbs due to edema, and sedation. Some veterinarians use gabapentin to treat anxiety and provide mild sedation. It can be given to cats before any stressful event, such as travel or visits to the vet. Excess sedation is the most common undesirable sign seen with use of this medication and care should also be taken to ensure that gabapentin is not stopped abruptly when a patient has been on a long term treatment course.
Multi-Modal Approach For Pain Relief
A multi-modal approach is often used when dealing with chronic pain. Remarkable improvements have been observed after the use of a multi-modal approach in treating chronic pain in cats. The components of this treatment strategy include the following:
- Lifestyle changes
One of the major lifestyle changes involves diet and nutrition. The importance of maintaining a normal weight is important in pain management, particularly in cats with osteoarthritis. The excess weight in obese or overweight cats exerts undue stress on weight-supporting joints of the body that may be affected by arthritis. Getting rid of the excess weight has been shown to contribute significantly to pain relief and improve mobility. Work with your veterinarian in creating a complete and balanced diet that can help your pet get rid of the excess weight in a healthy manner. A change in your cat’s diet as recommended by your veterinarian can help provide relief from chronic pain and inflammation.
Cats that are suffering from chronic pain can also benefit from some controlled physical activity or exercise to keep their muscles and joints moving. Strong joints and muscles can help cats become less vulnerable to pain.
- Environmental changes
Making certain changes in your pet’s environment, such as adding steps or ramps, providing a larger litter box with low sides for easy access, and a well-padded bed can help improve comfort and accessibility to cats that are in pain.
- Alternative therapies
These include massage therapy, underwater treadmill activity, passive joint manipulation and stretching, acupuncture, and other forms of homeopathic therapies which can be beneficial in reducing chronic pain and providing natural pain relief for cats with arthritis and other painful conditions.
These are defined as food that has reported health and/or medical benefits and helps boost protection against chronic disease. Glucosamine and chondroitin are popular joint supplements that have been shown to have a positive effect on the health and structure of the joint cartilage, as well as help, alleviate joint pain and inflammation. Microlactin, a milk protein that is extracted from cow’s milk has also been shown to inhibit inflammation.
Omega-3 fatty acids can help reduce inflammation in the joints and the accompanying pain and discomfort. One of the best sources of omega-3 fatty acids for cats is fish oils, as derived from salmon. Senior cats benefit from omega-3 supplementation to ease joint inflammation brought about by aging.
Why human pain medications should NOT be given to cats?
Humans and cats are mammals, which means there are similarities in our metabolism and organ systems. However, there are many instances when cats and humans differ greatly in the way they metabolize certain substances or chemicals. This is true with NSAIDs. Cat parents should always remember that over-the-counter human-grade medications should NOT be given to cats as they are extremely sensitive to the side effects.
Can Cannabidiol (CBD) Provide Pain Relief For Cats?
Currently Cannabidiol products for cats are not legal or licensed in Singapore.
Research studies have been able to demonstrate the pain-relieving properties of CBD. However, CBD may react with other medications that cats are taking and may only lead to further complications. You should seek advice from your veterinarian to avoid any problems.
Edited by: Dr. James Blanshard
BVM&S GPcertEM&S MRCVS
James graduated in 2003 from the University of Edinburgh, R(D)SVS. He has worked in a range of veterinary settings from 1st opinion clinics to specialist hospitals in the UK, Canada, Hong Kong and Singapore. He has completed an in-residence, postgraduate training position run jointly by The Calgary Zoo and the University of Calgary, Canada in zoological medicine (exotic/non domestic species) and is also the holder of an ISVPS certificate in Emergency Medicine and Surgery (GPcert EM&S). By working at Perrovet James hopes to provide our pets and pet parents with high quality 1st opinion veterinary services and the personable and caring service that you deserve.