Can You Reliably Assess Your Cat’s Pain? Yes.

The Feline Grimace Scale works.


Because cats do not give clear signals when they are in pain, their physical suffering tends to be inadvertently neglected — and therefore under-treated. Research shows that the lack of a reliable pain assessment tool that people can use for cats is one of the main reasons they are not given painkilling drugs often enough when they need relief. But a new study provides evidence that a tool called the Feline Grimace Scale can help people determine when their cats are in enough pain that they need medical treatment.

The Feline Grimace Scale — which assesses acute pain rather than chronic long-term pain — rates a cat’s pain based on scores for each of five parameters, or “action units”: ear position, orbital (eye) tightening, muzzle tension, whiskers orientation, and head position.

The scores allow each parameter for a cat to be categorized into one of three levels – no pain (0), moderate pain (1) or marked pain (2). A total score for all five action units combined that reaches 4 or higher suggests a cat is in enough pain to require administration of analgesics (pain relieving drugs). The pain may be about an illness such as pancreatitis; the after-effects of surgery, including dental surgery; or an injury. 

The study that supports use of the scale

With the help of International Cat Care (, researchers in Canada, Scotland, and Hong Kong were able to see how more than 1,200 people assessed cat pain on the Feline Grimace Scale when looking at 10 different facial images of cats determined by veterinarians to be in varying degrees of pain. Reporting in the Journal of Feline Medicine and Surgery, they found that the responses of the participants — from 66 countries on all six inhabited continents — closely matched those of the veterinarians for every assessment except muzzle tension.

Check out the images from the Training Manual of the Feline Grimace Scale, below, so that you’ll be in a much better position to tell when your own cat is in acute (not chronic) pain. Remember, a total score of at least 4 suggests that a pain reliever is in order.


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