Is Your Cat Ill or in Pain?

Observing the Hidden Signs

Sharon Graham Ellis

While cats are amazing hunters, they occupy an unusual place on the food chain as mesopredators. Domesticated cats (along with wild animals such as raccoons, foxes, and coyotes) are both hunters and prey. Because they can be a potential meal for a higher-order carnivore or a large omnivore, cats have developed a superb survival skill through their ability to mask signs of illness from predators. While this survival instinct serves cats well in nature, it makes it difficult for owners and those who care for cats to determine when a feline friend needs to visit a veterinarian.

Not all illnesses require immediate veterinary care, so it’s important for cat owners and caretakers to know the difference between an emergency situation and symptoms that require a few days of observation. While both require veterinary care, the difference between them is immediacy of the veterinary visit. According to the American Humane Society, emergency symptoms requiring immediate veterinarian attention are an inability to urinate; serious trauma; excessive bleeding; bloated, hard abdomen; excessive vomiting and diarrhea; seizures; unwillingness to drink fluids; or an inability to stand.¹

Less severe symptoms that don’t subside within 24 to 48 hours also require veterinarian attention. Aside from emergencies, clues that a cat may be ill can be subtle. They can also appear as extremes (for example: not grooming or overgrooming). What follows are some observable behaviors and symptoms that a cat is sending a message that it isn’t feeling well.

Owners are usually the first to notice changes in their cat’s behavior and disposition. If a cat is acting strangely and demonstrates changes in demeanor such as exhibiting sudden aggression, hiding, vocalizing, or engaging in prolonged vacant staring, something is likely amiss. Not all changes in behavior necessitate a veterinarian visit as some of the above behaviors can stem from environmental factors. However, if a cat that is normally interactive takes to hiding, it is usually a sign that stems from a cat’s not feeling well. Other behavioral changes include sleeping more or demonstrating restlessness. Also, the way a cat holds its body can indicate it doesn’t feel well. Cats that are ill or in pain will sit, crouch, or lie down with their tails wrapped around their bodies to announce they feel frightened or defensive, but a wrapped tail position also can be a sign of illness or pain.²

Other behavioral changes include lowered activity levels like not jumping or climbing. Since cats like to observe their surroundings from such high places as cat trees, shelves or windowsills, a cat that used to be active on several heights and suddenly is staying on lower levels, is not taking jumps, or is even missing them may be communicating that the animal is experiencing pain.³ A veterinarian visit is in order to check for signs of chronic pain and/or arthritis.

Sudden changes in appetite are another sign a cat is not feeling well. If a cat that is always ready for treats and for dinner suddenly eschews food, something is most likely up. Conversely, if a cat suddenly starts eating inordinate amounts of chow, there is likely to be something needing to be diagnosed. According to Jennifer Grota, DVM, decreased food intake can indicate “nausea, fever, food aversion, gastrointestinal disease, or pain in the mouth due to dental disease, a mass, a foreign body, or trauma.”² She further addresses how increased appetite can signal “intestinal parasites, hyperthyroidism, diabetes, or a gastrointestinal disease that causes poor nutrient absorption.”³ A veterinarian visit is imperative if a cat is eating more, but is also losing weight. Cats that don’t eat enough over a range of three to five days are at risk of developing fatty liver disease.⁴ Additionally, persistent vomiting and diarrhea can also indicate a number of health issues, so a veterinarian should be consulted.

Strange behavior while eating is another indicator a cat may be feeling unwell. A cat may develop a picky appetite or want to eat canned food exclusively. Red gums, bloody saliva, dropping food while eating, chewing on just one side of the mouth, or having an unexpected and severe reaction to chewing or eating something cold may indicate dental issues.³ Excessive drooling, according to Tufts University, may be caused by nausea or related to dental problems, poisoning, or something being stuck in the cat’s mouth.⁵ Bad breath can be an indicator of dental issues like tartar or abscesses, etc., and can also be a sign of internal illnesses such as diabetes or kidney disease.¹

A cat’s eye can reveal health problems. Cats have three eyelids; the nictitating membrane that forms the third eyelid is visible and helps lubricate and clean the eye surface as well as offering protection. Usually, the membrane rests in the corner of a cat’s eye but can often be seen when cats are relaxed or sometimes when they are sleeping. Concerns arise when the membrane does not move away from the eyeball, protrudes, becomes red or swollen, or has persistent inflammation. Any discharge from the eye is also a warning sign. Catster lists other symptoms that warrant a veterinarian visit, such as the cat squinting, pawing at its face or eyes, demonstrating fatigue or lethargy, or having changes in appetite.⁶

A noticeable increase or decrease in water intake and urination are definite causes for concern and warrant a veterinary visit. Increased thirst can signal diabetes, kidney disease, hyperthyroidism, increased calcium, or endocrine diseases.³ Lowered water consumption can also indicate fever or other problems that need a professional diagnosis. Decreased urination can indicate bladder infections, urine crystals, bladder stones, etc.⁸

One of the most frustrating behavioral indicators of illness in cats is a sudden change in litterbox habits, including not using the litterbox and/or urinating and/or defecating in new places. While people want to anthropomorphize this tendency in cats, the cat is not reproving anyone. According to Catster, cats do not refuse to use the litterbox because they are spiteful or have a desire to punish.⁹ Inappropriate elimination by a cat that faithfully uses the litterbox is a sure sign that something is wrong and the cat needs help. If a cat is eliminating in unusual places or is avoiding the litterbox altogether, seek veterinary advice.

Cats are fastidious caretakers of their coats. Not grooming (as evidenced by poor coat condition that is greasy or matted, skin that is excessively flaky, or evidence of dandruff) is a sign that something is not right. Overgrooming is another sign a cat needs to visit the veterinarian. Overgrooming can show up as bald spots or self-mutilation that manifests as actual wounds.¹⁰

A change in a cat’s vocalization can also be an indicator that the cat isn’t feeling well. It deserves attention if an unusually quiet cat becomes unrelentingly talkative. Other signs of a problem include caterwauling, hissing, or growling. Cats are often believed to be happy or contented when they purr, but purring can also be a sign of pain and anxiety. Cats often self-soothe by purring when they are not feeling well.

Finally, while cats can hear incredibly well and can locate sounds that humans cannot hear, a cat engaging in extended periods of staring can also indicate there’s a problem. Changes in vision or other senses becoming diminished may cause a cat to stare as it tries to get its bearings. Long staring sessions may also indicate the cat is depressed. Neurological and other serious health conditions may be present when cats gaze at nothing, so a veterinary visit is in order.¹¹

Certainly, the physical and behavioral signs of illness may engender doubt in being interpreted accurately. An owner’s instinct is invaluable when deciding whether a cat needs to be seen by a veterinarian. In fact, it may be one of the best informers when considered alongside observation of behaviors and symptoms for how a cat is feeling. Owners typically know their cats well, so a sense that a cat is “just not itself” is often a strong indicator of something more going on. As a loving cat guardian, it’s better to make the trip to the veterinarian and have the diagnosis be a minor issue (or even a non-issue) than to ignore a potentially harmful situation.

 

References

1. American Humane Society. Recognizing and Caring for a Sick Pet. https://www.americanhumane.org/public-education/recognizing-caring-for-a-sick-pet/ [Accessed 10^th April 2025].
2. Gerken, A. How to Read Your Cat’s Tail Language. https://www.petmd.com/cat/behavior/cat-tail-language/ [Accessed 9^th April 2025].
3. Grota, J. How to Tell When a Cat Is Sick. https://www.petmd.com/cat/general-health/how-tell-when-cat-sick [Accessed 10^th April 2025].
4. Wooten, S. 10 Subtle Signs Your Cat May Be Sick. https://cats.com/sick-cat/ [Accessed 10^th April 2025].
5. Tufts University. Why a Cat Drools Depends on the Context. Catnip. 2024 November; 32(11): 1.
6. Chessher, C. Catster. What Is a Cat’s Third Eyelid and What if It’s Showing? Vet Approved Advice. https://www.catster.com/cat-health-care/cat-third-eyelid-showing/?nab=1/ [Accessed 16^th April 2025].
7. Gelatt, K. Disorders of the Eyelids in Cats. https://www.merckvetmanual.com/cat-owners/eye-disorders-of-cats/disorders-of-the-eyelids-in-cats/ [Accessed 16^th April 2025].
8. Gollakner, R. Urine Crystals and Bladder Stones in Cats. https://www.petmd.com/cat/conditions/urinary/urine-crystals-and-bladder-stones-in-cats/ [Accessed 11^th April 2025].
9. Dickenson, P. Catster. Why Is My Cat Peeing Outside of the Litter Box? [Online]. Available from: https://www.catster.com/cat-behavior/do-cats-pee-out-of-spite/ [Accessed 9^th April 2025].
10. Vogelsang, J. How to Tell if a Cat Is in Pain. https://www.petmd.com/cat/symptoms/how-tell-if-cat-pain/ [Accessed 10^th April 2025].
11. Kanowski, K. Why Does My Cat Stare at the Wall? Our Vet Discusses Common Reasons and What to Do. https://www.catster.com/cat-behavior/why-does-my-cat-stare-at-the-wall/ [Accessed 15^th April 2025].