Ace lived 17 years. He was healthy for most of his life, and his last year was his hardest: cancer, trouble with his eyes, and care that took real attention every single day.

If you’re caring for an older or sick pet, there is one question that sits underneath all the others. Are they hurting?

Animals rarely tell us the way we expect. Dogs can mask pain, and cats often don’t show it in obvious ways at all. The signs are often quiet changes in how they move and behave, not only crying out or limping.

Signs of pain in dogs

• Slower on walks, or not wanting to go

• Trouble with stairs, sitting down or getting up after resting

• Stiffness or limping

• Restlessness, pacing, or not being able to settle

• Panting a lot, even at rest

• Licking or chewing at one spot

• Eating less

• Hiding, or needing more attention than usual

• Snapping or growling, when that isn’t like them

• Lying down more, an arched back, or the head carried low

• Whimpering, yelping or groaning

• Accidents in the house

Signs of pain in cats

• Hiding more, or spending less time with the family

• Jumping up to favorite spots less, or hesitating first

• Grooming less, especially along the back and hips

• Trouble using the litter box, or going outside it

• Being more sensitive when handled

• Playing less

• Eating less

Litter box changes can also be a sign of a urinary problem, which is another reason to call your veterinarian.

A cat’s face can tell you a lot, too. Researchers at the Université de Montréal developed the Feline Grimace Scale, which looks at five things: the position of the ears, tightness around the eyes, tension in the muzzle, the position of the whiskers and the position of the head. It was built to spot sudden pain, and there is a version for cat owners online and as an app.

It might not be just old age

Arthritis is one of the most common causes of long-term pain in dogs and cats, and it is often mistaken for getting old. The changes tend to come on slowly, over weeks or months, which is why they can be hard to spot. In one study of cats over 12, X-rays showed joint changes in 90 percent of them.

Slowing down can be a sign of pain that your veterinarian can help with, not just a sign of age.

What you can do at home

• Know their normal. Owners know their pets’ everyday behavior better than anyone, and a change from that normal is worth noting.

• Write it down. What you saw, when it happens, and whether it’s getting better or worse.

• Take a short video. Pets, cats especially, may hide pain at the clinic, so a clip of the limp or the pause before a jump helps your veterinarian see what you see. Try to get the whole animal in the frame, in good light.

Don’t reach for human pain relievers

Ibuprofen, naproxen and aspirin should not be given to pets unless your veterinarian tells you to, and acetaminophen should never be given to a cat, because it can be fatal. Ibuprofen and naproxen can cause stomach ulcers and kidney damage. If your pet seems to be hurting, call your veterinarian first.

When to call

Call your veterinarian or an emergency clinic right away for:

• Severe or constant pain

• Trouble breathing

• Not being able to stand or walk normally, or sudden, severe limping

• In dogs, a swollen or bloated belly, especially with retching that brings nothing up

• In cats, especially male cats, straining in the litter box with little or no urine

• Not eating or drinking for a full day

Call within a day for a sudden change in behavior, limping that lasts more than a day, sleeping more and not wanting to play, or eating less with no other signs of illness.

Pain is treatable

Veterinarians have many ways to manage pain, with medicine and without it, and treating it early tends to make it easier to manage. Asking early is never overreacting. Noticing is part of caring for them, and you are the one who notices.

Ace’s story is where all of this began for us. You can read it in It Started with Ace.

If you’re watching for these signs every day, you don’t have to do it alone. Care Circle is a free place to talk with other people caring for an older or sick pet, and the NurturedPet app is the companion we built after caring for Ace. It’s in free beta now.

Sources

We’re arranging a veterinary review of this article. Until it’s done, here are the sources behind it.

• American Animal Hospital Association: 2022 AAHA Pain Management Guidelines for Dogs and Cats

• World Small Animal Veterinary Association: Guidelines for Recognition, Assessment and Treatment of Pain (2014)

• Cornell Riney Canine Health Center: Recognizing pain in dogs

• Cornell Riney Canine Health Center: Osteoarthritis

• Cornell Riney Canine Health Center: Gastric dilatation-volvulus (GDV) or bloat

• Cornell Feline Health Center: Is Your Cat Slowing Down?

• Cornell Feline Health Center: Feline Lower Urinary Tract Disease

• NC State Comparative Pain Research and Education Center: Osteoarthritis in Cats

• Evangelista MC et al. Facial expressions of pain in cats: the development and validation of a Feline Grimace Scale. Scientific Reports, 2019

• Merola I, Mills DS. Behavioural signs of pain in cats: an expert consensus. PLoS One, 2016

• Hardie EM et al. Journal of the American Veterinary Medical Association, 2002 (degenerative joint disease in cats over 12)

• U.S. Food and Drug Administration: Get the Facts about Pain Relievers for Pets

• Merck Veterinary Manual: Poisoning from Human Over-the-Counter Drugs

• Merck Veterinary Manual: Recognizing and Assessing Pain in Animals

• Merck Veterinary Manual: When to See a Veterinarian

• Tufts Cummings School of Veterinary Medicine: Difficulty Breathing (Dyspnea)

This article shares general information from veterinary sources. It isn’t a substitute for advice from your own veterinarian, who knows your pet.