Is a new or missing behavior a sign of feline pain?

Tabitha Kucera, RVT, VTS (Behavior), CCBC, KPA-CTP, FFCP, explains in this video that identifying chronic pain in cats often comes down to recognizing the loss of normal behaviors and the development of new ones. Although feline pain can appear subtle at first, Kucera notes that once professionals and caregivers learn what to look for, the signs become unmistakable. In the video, she also underscores the value of asking clients open-ended questions to uncover these changes earlier.

Below is the interview transcript, which has been lightly edited for improved clarity:

Tabitha Kucera, RVT, VTS (Behavior), CCBC, KPA-CTP, FFCP: So, when it comes to subtle or less-known signs of chronic pain in cats, I kind of like to answer it more broadly because of course, there are very specific things that I tend to see a lot. For example, cats are only scratching on the lower end of the scratcher and aren’t doing those big stretches, or they don’t lay out with limbs away; they kind of sleep like this all the time.

But what I like to focus on is maintenance and loss of normal behavior, and development of new behaviors. So this may be, again of course, house soiling: the cat is missing the litter box [even though] they normally use it. Or, they don’t usually hide, and [now] they’re hiding. Or they’re self-segregating—they’re not spending as much time with you.

Or development of a new behavior could be: all of a sudden, hey, these cats never had tension that the caregiver recognized and now they’re recognizing hissing. And by the time a caregiver is recognizing tension, it’s usually at least moderate because some of those subtler signs of body language aren’t noted, usually.

Or is this cat exhibiting fear-aggressive or pain-induced aggressive behaviors? All of a sudden, they don’t like to be picked up or they don’t like to be brushed. And then you can ask the caregiver: “What does it look like when your cat is brushed?” Not “Does your cat like to be brushed?” Again, those open-ended questions get more of that information.

And then, I know I said the word “subtle” and as far as when I’m describing chronic pain body language in cats, I always like to say that although they’re prey/predator animals and we’re less likely to be able to identify pain in the exam room due to fear and stress causing that pain perception to decrease, it is really important to remember that once we identify the pain, it screams out at you.

So I don’t think it’s very subtle. I think it’s a lot of body language. But once you—I mean, I teach caregivers all the time—once I point it out, they’ll never unsee it. So I’ll be doing a virtual consult, and I watch a cat walk...I'm like, “Whoa. Five observations that that cat is uncomfortable.”

So I think that’s another big thing. It’s not really subtle once you learn it. Just like body language—whether this cat’s fearful or stressed—that can be hard to note sometimes. We notice red, but not yellow or green but once you know them, you’re like, “Oh, I totally understand why this cat escalated,” or “This cat’s yellow, let me adapt my approach or change the environment.”