Demystifying feline pain management

Keen observation will provide clues to diagnose pain in cats.
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Mar 01, 2013


Dr. Sheilah Robertson, expert in feline pain management, has some simple advice for diagnosing pain: Look for it, recognize it and measure it.
Cats have an uncanny way of masking their pain and discomfort. They can trick even the most astute pet owner into thinking that a stiff gait is just a normal sign of aging rather than an indication of chronic pain. And they can fool veterinarians into believing that cowering in a cage is simply a sign of fear rather than a signal of acute pain after a recent surgery.

That's why Sheilah Robertson, BVMS, PhD, MCVS, CVA, DACVA, DECVA, former professor of anesthesia and pain management at the University of Florida and current assistant director of the American Veterinary Medical Association's (AVMA) animal welfare division, says it's so important for veterinarians to take time to diagnose pain in cats. And her advice is pretty simple: Look for it, recognize it and measure it.

Currently there's no gold standard for assessing pain in cats, although uniform scales to objectively measure pain are being developed and validated. But in the meantime, it's important for veterinarians to observe feline behavior for clues and to be able to recognize the difference between stress or fear and pain, particularly when it comes to acutely painful conditions.

Robertson states that part of the observation process not only involves keeping an eye out for abnormal feline behavior, such as maintaining a tense, crouched posture or showing difficulty getting into a comfortable position, but also looking for signs of normal behavior, such as stretching or playfully engaging with caregivers. "If a cat is trying to retreat or hide, I'd suspect that cat was in pain and take a closer look," Robertson says.

In general, key indicators of acute pain in cats include changes in posture, position in the cage, activity level, attitude, vocalization, appetite, facial expression and reaction to palpation. Researchers working with mice and rabbits have also identified what can be described as a "pain face," which in cats may include noticeable changes in the eyes, ears and whiskers. Robertson also points out that observing a cat before a painful procedure may yield important clues to the animal's typical demeanor and behaviors, giving the veterinarian a better indication of whether the cat is comfortable after the procedure or if medical intervention is necessary.