Additional resources

Diagnosing pain

When a dog or cat is brought to your clinic, either for a regular check-up or because their owner has identified that something is wrong, having a pain assessment protocol in place will save you time and aid in consistency from exam to exam of the same animal. Consider incorporating a standardized pain scoring system into your overall patient assessment, treatment, and reassessment protocols.

Diagnosing pain in cats

Pain behaviours in cats can be quite subtle. Careful questioning of the owner about the cat's past and present "normal" behaviours will be helpful, especially in the case of a chronic condition.

Acute pain in cats

Cats react to painful stimulus in several potential ways:

Behaviour changes — flinching, crying, or becoming aggressive.
Facial expressions — dilated pupils or squinting eyes.
Vocalisation — growling, hissing, moaning, excessive purring, or atypical silence.
Sensitivity to affected area — hiding or protecting a specific area or licking or biting a specific area.
Activity levels — less interest in play or reduced activity (often lying still).
Attitude — hiding, avoiding other animals or people, acting aggressively, or excessive comfort seeking.
Appetite — reduced appetite.
Grooming — failure to groom.

Chronic pain in cats

Some conditions that are well-known in dogs, such as osteoarthritis, are also common in older cats. The symptoms in cats, however, are more likely to be attributed to "old age."¹

Identifying chronic pain can be more difficult than acute pain. Unlike acute pain that usually stems from an identifiable source, chronic pain develops over time. Because there are few signs of chronic pain in cats and they usually appear alongside natural long-term changes in a cat's behaviour, knowing what to look for can be difficult.

Typical signs include:

Decreased grooming.
Reluctance to jump up on favourite places.
More (or less) time spent sleeping.
Inappropriate urination/defecation.
Poor coat.
Less interest in playing/climbing/interacting with owner.

Diagnosing pain in dogs

Fortunately, it is usually easier to detect pain in dogs than in cats. Unfortunately, by the time the most obvious signs of chronic pain appear, such as lameness or limping, the dog has likely been in pain for some time.

Pain in dogs

With pain from an injury or surgery, a dog may react naturally by barking, howling, or yelping. But not all pain behaviours are vocal and obvious — especially when the pain is chronic. Some signs of a dog in pain include:

Facial expressions — Dull eyes, staring into space, drooping of head and ears, and panting.
Awareness of affected area — Licking, scratching, chewing, and even looking at a particular area.
Change in activity levels — Restlessness or a reluctantance to move, disturbed sleep, a preference to lying somewhere quietly, less interest in interacting with people or other animals.
Attitude — Aggressiveness, withdrawal, or anxiety. A weak tail wag and a poor response to owner or other loved ones.
Appetite — Reduced appetite, picky with food.
Grooming — Reduced amount of grooming, loss of coat condition.

1. Hellyer P, Rodan I, Brunt J, et al. J Feline Med Surg. 2007 Dec;9(6):466-80.