If you think your cat is in pain, contact your veterinarian. Nothing on this page is a reason to watch and wait. If your cat is breathing hard at rest, can't use its back legs, or is straining without passing urine, that's an emergency — call a clinic now.
"Cats hide pain" is one of the most repeated lines in pet care. It's partly true, and it leaves a lot of owners feeling they couldn't tell even if they tried.
A 2023 study tested that directly, on a large scale — and the results are more encouraging than the saying suggests.
What the study did
Researchers ran an online survey in English and Spanish between March and May 2021, shared through International Cat Care and other channels. Of 3,039 responses, 1,262 were complete, from 66 countries. Participants were adult cat caregivers who were not veterinary professionals.
Each person scored 10 photographs of cats' faces showing different levels of pain, using the Feline Grimace Scale — a structured tool that looks at five parts of the face:
- Ear position
- Orbital tightening (how tight or squinted the eyes are)
- Muzzle tension
- Whiskers change
- Head position
Eight veterinarians scored the same images.
What it found
- Owners' total scores were not significantly different from the vets'. The reliability of those totals was rated good.
- The only feature where owners differed was muzzle tension, which they scored slightly higher than vets.
- Some features were much steadier signals than others:
- Ear position and eye tightening were the most reliable (both in the study's "good" band).
- Muzzle tension was moderate.
- Whiskers and head position were the weakest.
- Age, country and other background details didn't significantly change how people scored.
In plain terms: when owners were given a clear checklist, they read pain in a cat's face about as consistently as vets did — and the ears and eyes were where they were most consistent.
What this doesn't mean
It's worth being honest about the limits, because they matter for how you use this:
- These were unusually engaged owners. People who answer a survey shared by a cat-welfare charity aren't a random sample.
- Photos are easier than real life. A still, well-framed image isn't the same as reading your own cat across a dim room while it hides or reacts to you.
- It measured agreement, not outcomes. It shows people can apply the scale consistently, not that home scoring leads to earlier or better care.
- The scale is for acute pain — sudden, recent pain. Slow, long-term discomfort (like arthritis) is outside what was studied, and often shows up as behaviour changes instead.
So this isn't a home pain test, and it isn't a reason to manage pain yourself. It's a better way to notice and describe.
Where to look, in order
When something seems off, look at the face before you decide "they're just grumpy":
- Ears — held normally, or rotated outward and flattened?
- Eyes — open and relaxed, or tightened and squinted?
- Muzzle — relaxed, or drawn tight around the mouth and nose?
- Head — carried level with the shoulders, or held low?
- Whiskers — note them, but weigh them least.
Then write down:
- When you first noticed it
- Whether it comes and goes or stays
- What else changed — hiding, eating, litter box, jumping, grooming
Take a short video if you can. Facial signs are easy to miss in a single moment and easy to doubt later; a 10–20 second clip is often more useful to your vet than any description.
When not to wait
Contact your vet the same day if your cat's face looks pained and it isn't settling, or if it's paired with not eating, hiding, or a change in toileting. Treat these as emergencies and call a clinic now:
- Breathing hard, fast or open-mouthed while resting
- Sudden pain or weakness in the back legs
- Straining in the litter box with little or no urine
How PAWai helps
PAWai keeps your observations — the ear and eye changes, the dates, the video — together, so what you noticed on a Tuesday is still there, in your own words, at the appointment two weeks later.
PAWai does not score your cat's pain, tell you whether your cat needs pain relief, or administer the Feline Grimace Scale. Pain assessment and treatment decisions belong to your veterinarian. What PAWai does is make sure your observations arrive intact and dated instead of half-remembered.
Read the evidence card: Cat Owners Scored Feline Pain About as Consistently as Veterinarians Did
Related: How to Prepare for a Vet Visit
PAWai organizes information and educates pet owners. PAWai does not diagnose conditions or recommend treatment. Always consult a licensed veterinarian for medical decisions about your pet.
Source: Monteiro, B. P., Lee, N. H. Y., & Steagall, P. V. (2023). Journal of Feline Medicine and Surgery, 25(1). https://doi.org/10.1177/1098612X221145499