How to tell when felines aren't feeling fine

Researchers reveal the 25 signs that could mean your cat is in pain

• Researchers determined 25 behaviours that sufficiently reveal cat is in pain
• Through four elimination rounds, researchers narrowed down list from 91
• Some signs of pain include difficulty jumping, hunched posture, less play 

By Cheyenne Macdonald For Dailymail.com

Published: 26 February 2016

Cat owners learn to develop a shared language with their pets; they can discern the meanings of different meows and will return a 'slow blink' when graced with one.

But, cats are notorious for hiding pain, so figuring out if a cat is suffering is a much more difficult process.

A new study has collected insight from international experts to reach a consensus on the tell-tale signs of a cat in pain.

Cat owners learn to develop a shared language with their pets; they can discern the meanings of different meows and will return a 'slow blink' when graced with one. But, cats are notorious for hiding pain, so figuring out if a cat is suffering is a much more difficult process

From reluctance to move, to avoidance of light, the researchers have compiled a list of the 25 behaviours that reveal your cat is in pain.

To determine which cat behaviours are good indicators of pain, and which behaviours are not, the authors recruited 19 experts, ranging from private clinicians to academic staff.

The results were published in the journal PLOS One, titled Behavioural Signs of Pain in Cats: An Expert Consensus.

Experts were able to narrow down the list to 25 reliable signs, though for two of the behaviours – straining to urinate and tail flitching – the experts could not come to an agreement on the intensity of pain to which this indicates.

Some of these signs include difficulty jumping, playing less, lack of grooming, and a lowered head posture.

Through four rounds of elimination, experts evaluated a total of 91 signs, reaching agreement if at least 80 percent of group reported the same answer on four components of each behaviour.

THE 25 SIGNS THAT ARE 'SUFFICIENT' INDICATORS OF PAIN IN CATS

The researchers explain that the list is an assessment tool which covers the sensorial and emotional aspects of pain.

Being able to identify a set of behaviours can help to reliably detect pain, rather than looking for a single symptom. 

For each of these signs, unless otherwise indicated, the experts agreed that they are frequently present in both low and high levels of pain. For the last two signs, experts had varied responses on the intensity of pain the behaviour indicated. 

1. Lameness

2. Difficulty to jump

3. Abnormal gait

4. Reluctant to move

5. Reaction to palpitation

6. Withdraw/hiding

7. Absence of grooming

8. Playing less

9. Appetite decrease

10. Overall activity decrease

11. Less rubbing toward people

12. General mood

13. Temperament

 14. Hunched up posture

15. Shifting of weight

16. Licking a particular body region

17. Lower head posture

18. Blepharospasm (involuntary forcible blinking)

19. Change in form of feeding behaviour (rare in low level pain)

20. Avoiding bright areas (rare in low level pain)

21. Growling (rare in low level pain)

22. Groaning (rare in low level pain)

23. Eyes closed (rare in low level pain) 

24. Straining to urinate 

25. Tail flitching

These properties include the frequency of the behaviours in the presence of pain, the likelihood of its presence with low levels of pain, the reliability of the sign as an indicator of pain, and its presence in acute, chronic, and/or non-painful conditions.

The researchers say that the 25 behaviours cover the sensorial and emotional aspects of pain, and they can be used as a helpful assessment tool to help owners understand when their pets may be suffering.

'Both owners and veterinarians are clearly able to recognise many behavioural changes in cats which relate to pain. 

'However, owners may not always recognize the clinical relevance of what they see,' said Professor Daniel Mills, Professor of Veterinary Behavioural Medicine at the University of Lincoln's School of Life Sciences.

'For example, they may view the changes as an inevitable part of natural ageing and not report them to the vet as a concern, or at least not until the behaviours become quite severe,' Mills said.

'We hope that having an agreed list of more objective criteria, which relates to specific signs of pain, could improve the ability of both owners and vets to recognize it.'

From reluctance to move, to avoidance of light, the researchers have compiled a list of the 25 behaviours that reveal your cat is in pain. The signs also include difficulty jumping, playing less, lack of grooming, and a lowered head posture

Of the 23 signs that were agreed upon across all properties by the experts, nearly all of them were frequently present in instances of both low level and high level pain.

Just five behaviours were considered rare in low level pain, and only frequent in high level – change in feeding behaviour, avoiding bright areas, growling, groaning, and closed eyes.

The team was also able to eliminate many behaviours which they have deemed 'not sufficient for pain,' including panting (as this is related to acute conditions), trembling or shivering, and teeth grinding.

While these behaviours alone aren't to be used as definitive diagnoses, being able to identify a set of behaviours can help to reliably detect pain, rather than looking for a single symptom.

'Cats are notorious for not showing that they are in pain, and the more that we can find out what the signals are, then the sooner we can get them to the vets for diagnosis and treatment,' said Caroline Fawcett, Chairman of Feline Friends.

'There is a long way still to go before the more subtle signs can be identified, but we are really excited about progress to date.'

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