This is the Hissing Feline Podcast, a weekly program that is about everything cats. The Hissing Feline features experts and other cat aficionados who share their knowledge and perspectives about dealing with felines. From strays and ferals to adoption, health, and cat psychology. We hope the topics give you helpful and interesting insight into the world of cats. Now, here is the host of the hissing feline, Clark Greer.
SPEAKER_02Cats are notoriously skilled at hiding illness and pain. Determining if your cat is experiencing pain can be difficult. What are the signs? What are different sources of cat pain? And what treatments are available to deal with their discomfort? Those are just some of the questions this episode of the Hissing Feline will address. Returning to the show is Dr. Bruce Cornreich. He's a board certified veterinary cardiologist and director of the Cornell Feline Health Center at Cornell University's College of Veterinary Medicine. Dr. Cornreich, it's great to have you once again on the Hissing Feline today.
SPEAKER_01Oh, it's great to be here again, Clark. Thanks for having me.
SPEAKER_02Do you have an idea of the percentage or the number of cats that experience pain? I understand it it can be pretty high.
SPEAKER_01It can be very high. And you know, we don't know the definitive numbers. Uh we can make some presumptions. You know, um certainly we know that there's a high incidence of injury uh which can be associated with pain. Surgery, of course, post-surgical pain, so cats that uh have different types of surgeries uh experience some degree of pain. So those cats are clear and clearly there are a lot of cats that unfortunately um experience injuries and un and undergo surgeries, whether they're routine or emergent or anything. Um but aside from that, there are we also have some information regarding chronic pain. So those are kind of more acute types of pain, which we'll talk about more in a minute. But for example, you know, up to 85 or 90 percent of cats by the time they're four years of age have some sort of dental disease, whether it's tooth resorption, periodontal disease, and we can presume, um, based upon extrapolation from people and also from their behavior, that in you know, in many, if not most cases, these cats are experiencing discomfort or pain, particularly as the disease advances. Uh then you get into things like osteoarthritis, where we know that, you know, 60 estimates are that about 60 percent of cats by the time they're six years of age have some evidence of osteoarthritis, and as high as ninety percent of cats that are over twelve years of age have osteoarthritis. Um so we can uh presume that the incidence of feline pain is quite high.
SPEAKER_02And we're going to uh spend uh our second segment in a little bit talking specifically about osteoarthritis in relation to, and it's the lead article in the May issue of the uh Cornell Feline Health Center's newsletter. So we're gonna we're gonna get into that a little bit. I think I think it will be a really good uh topic to uh have people understand that specifically as uh discomfort in cats. Do cats have pain that's age-related?
SPEAKER_01That's a good question. I would say that they have pain that is associated with diseases that are age-related that have a higher incidence uh as cats get older. So, for example, osteoarthritis and periodontal disease are great examples. The incidence of these diseases increases as cats get older. In vet school, we were kind of taught this tenant age is not a disease. So it's not the age itself that is causing the di um the discomfort in most cases. It's rather diseases that have a higher prevalence uh in an older population that are causing the discomfort and or the pain.
SPEAKER_02Aaron Ross Powell A little bit ago you were talking about a couple of different types of uh sources of pain in cats, and obviously dental that's that's a that's a really big issue. Are there other things that would cause discomfort in uh felines?
SPEAKER_01Aaron Ross Powell, Jr. The ones we probably know the most about are dental pain and osteoarthritis, but certainly cats that undergo surgery, for example, um any e whether even a routine spay or neuter, it's reasonable to assume that they are experiencing some degree of pain. So that's a common cause. Unfortunately, cats that um have traumatic incidents, whether it's being hit by a car or falling out of a window or having something fall on them or being attacked by other animals, these sorts of things are common sources of pain in cats.
SPEAKER_02What are some signs that cat owners can look for that might tell if the cat is experiencing some kind of pain? Or are there specific things that they can just that they will notice just by looking at their pet?
SPEAKER_01Sure, great question. You you alluded to the notion that cats are masters at hiding pain, and that's definitely true. They've evolved to hide signs of pain because signs of pain indicate injury and or vulnerability to being preyed upon. Now we know that cats are not only predators, they are also prey in many cases. So depending upon what the issue is, so for example, with dental pain, they their eating habits might change. They may stop eating, they may not want to eat kibble anymore, they may drop food when they eat it, uh, they may salivate, they may take longer to chew, um, they may groom a little bit less, they may become a little bit more irritable, and in some cases they may actually paw at their mouth, um, have bad breath, this sort of thing. So that's an example of what you might see in cats that have dental pain. In terms of something like osteoarthritis, they m their m mobility may change. They may not want to jump up or down on things that they used to. Uh generally speaking, cats across the board, when they're experiencing pain, regardless of its cause, their activity level will go down. They may rest more, they may kind of hide, they may want to interact less, they may groom less, uh, and um in some cases they may object to be uh to being handled by people. Um, and again, generally speaking, they may not want to play, move around, or hunt as much. Uh so these are kind of generic signs uh that cats are um f perhaps experiencing pain.
SPEAKER_02Our calico uh I think it's been a couple of months ago now, she just looked out of sorts. She was going to the basement to sleep, which she does, but she was spending a lot of time away from us. And looking at her eyes, we could tell that there was something going on with this cat. And we we took her to our vet and they did some other blood tests and whatever. They did what they did along with the blood tests, they uh they took some urine from her and they found out that she had a UTI. And uh we would never have sorry to hear that. Yeah, we wouldn't and they we had some antibiotics or whatever, and that uh took care of her. But just paying attention to her expressions uh was really helpful in telling us that there was something wrong with uh with the cat.
SPEAKER_01No, and it's great that you're right on top of that and being very diligent. Uh and it's interesting because this notion of expressions, um, there is uh a s a scale that's called the grimace scale that has been kind of validated by folks who study pain management in cats, and you can actually use things in the facial expression of a cat to determine with reasonable accuracy whether or not that cat is experiencing pain. So whisker position, ear position, position of the head relative to the shoulders, um this sort of thing. Uh you can tell a lot about um how a cat is feeling with respect to pain just by looking at their face. And there's actually um an app available where you can use uh you can uh try to get a good idea of whether a cat is experiencing pain or not just by taking a picture of the face.
SPEAKER_02So technology is really helpful in that instance for people like my wife and I to keep track of what's going on with our cats to make sure that they're not experiencing some kind of pain that they're trying to hide. Trevor Burrus, Jr.
SPEAKER_01Yeah, very important. And it's I'm glad to hear that, and it doesn't surprise me at all to hear that you're diligent that way. Uh because it is true that, you know, cats, uh it's harder to tell when they're uncomfortable than in many other species.
SPEAKER_02Uh earlier you mentioned uh acute versus chronic pain, and those may be terms that are familiar to uh some of our listeners. Uh maybe they've their veterinarian has talked about those kind of things. Would you talk specifically about uh well let's let's define both of those and um and then let's talk specifically about uh acute pain treatment in in this part of the program today.
SPEAKER_01Sure. And generally speaking, acute pain is more sudden onset, short duration. Chronic pain is that that is empirically described as being thr at least three to six months in duration. So that's sort of how you would uh separate those two. You know, acute pain is commonly associated, as we said, with things like um trauma, surgery, like a urinary tract infection, as you said, that can be quite um uncomfortable. Um some diseases certainly can cause um acute pain, uh, but chronic pain is more uh long-lasting.
SPEAKER_02What are some options that that you would suggest or that that you have treated uh cats for that might help with acute pain?
SPEAKER_01Well, and it really depends upon, of course, the situation and the medical status and comorbidities that the cat is experiencing. Uh in terms of short duration acute pain, so for example, for post-surgical pain, there are two FDA-approved non-steroidal anti-inflammatory drugs, uh Robinococcib and Maloxicam. These are for short duration, again, primarily for postoperative pain. Uh that's those are options. Very good pain control can be achieved by opioids, which works centrally in the central nervous system by activating opioid receptors. Uh, those are uh commonly used for acute pain, either non-steroidal anti-inflammatory drugs and or opioids. In some cases, some other kind of off-label usage of things like gabapentin, uh, which is a centrally acting, it's actually a drug that's used for things like seizure disorders, but it can be helpful with pain. Those can be used for acute pain. Most commonly, though, it's probably going to be some combination of non-steroidal anti-inflammatory drugs, uh, opioids, in rare cases, steroids as well. Um, but you know, they all it really depends upon what the cat's medical condition is.
SPEAKER_02What would you suggest uh at home for cat owners that know that that's been the diagnosis of some type of acute pain, or is there something they can do to help the cat be more comfortable or help the cat through the uh the process of dealing with that pain?
SPEAKER_01Sure. For example, if a cat is experiencing dental pain, something as simple as using wet food rather than kibble might be something that the cat would accept uh more uh easily. Of course, emotional support is very important, making sure that the cat is comfortable, um, that you're monitoring appropriate um uh for for appropriate appetite water intake, making sure that they're eliminating urinating and defecating normally, uh, watching for things like any uh signs of bleeding, respiratory difficulty, these sorts of things. It really depends upon uh the disease, but importantly being vigilant for any change in a cat's behavior, appetite, uh that sort of thing, um, and being emotionally supportive are very important. Of course, when we talk a little bit later about chronic pain with osteoarthritis, there are kind of specific things that owners can do in terms of lifestyle and management that can make things easier for cats that have osteoarthritis, but uh I guess we could talk about that in the second half. The other thing I wanted to add, of course, is always err on the side of being conservative. So what I would say is if there's any concern at all, uh your veterinary team is is trained to to recognize pain, signs of pain that can be difficult for owners to see. So the best option would be if there's any concern at all to contact the veterinarian.
SPEAKER_02And uh just the continued monitoring, I think, is really important uh to make sure that the cat is maybe following a uh medication regimen, checking the results of those types of things. So it does it does take some effort on that part, but uh it's those are important steps to make sure that uh that your cat is gonna be on the road to recovery after something like that. Absolutely. You're listening to the hissing feline. My guest today is Dr. Bruce Cornreich, director of the Cornell Feline Health Center at Cornell University's College of Veterinary Medicine. In the second segment of the show, we'll focus on feline osteoarthritis and chronic pain. Please stay with us.
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SPEAKER_02You're listening to the Hissing Feline Podcast, a show that is about everything cats. I'm your host, Clark Greer. My guest today is Dr. Bruce Cornreich, director of the Cornell Feline Health Center at Cornell University's College of Veterinary Medicine. We've been discussing the topic of feline pain. The lead article in the May 2026 issue of the Feline Health Center's newsletter provides important information about feline osteoarthritis. And that's where we turn our attention for our second segment today. Would you talk a bit about osteoarthritis and where in cats that uh can occur?
SPEAKER_01Sure. Umsteoarthritis, you know, by definition, refers to inflammation of the joints that is caused by usually age-associated degradation of the uh cartilage that protects the joints or where where bones kind of meet one another to prevent bone-on-bone contact, which can be painful. Uh one thing that's pretty become pretty clear is that the incidence of osteoarthritis in cats is significantly higher than was previously believed, so decades ago. So one study, for example, showed that about 90% of cats that are older than 12 years of age have some radiographic sign of osteoarthritis in one or more joints. And these can be hips, knees, elbows, things like this. And you know, any joint in theory can have osteoarthritis, you know, the the carpus and the tarsus, this is the equivalent of the wrist and the ankle in people. Uh but certainly we know that the incidence is higher than we believed it was in the past, so there's been a much more appropriate focus on recognizing it and treating it. Uh the recognition uh can be really difficult in cats. It's such much uh more difficult than it is, for example, in dogs or horses. So, for example, cats may have a limp or they may be lame when they have osteoarthritis, uh, but commonly they they don't. The manifestations of osteoarthritis in cats may be more subtle, decreased activity, uh, inability or unwillingness to run or jump, uh uh a little bit of a, you know, of a uh a change in gait that's not dramatic, uh more time spent resting, less time spent grooming, uh uh reaction to being touched in certain parts of the body that might be uh difficult, uh or uh that might be aggressive or uh or maybe associated with increased vocalization, um and they may play less. So again, subtle findings that it's important for owners to be on the lookout for because then if there is concern, again, reiterating this, whenever you have a concern about your cat, your best source of information is your veterinary team. If you have an index of suspicion that your cat might not be acting quite right or maybe demonstrating some of these behavioral changes, really important to get to the veterinarian so that they can do an appropriate physical exam, neurologic exam, diagnostics like radiography and things like that.
SPEAKER_02There are problems that can actually stem from one type of issue in a cat to another. So it's not just like it's localized, it will it will actually affect some other things. Does does that happen with pain in cats?
SPEAKER_01Uh it certainly can. I mean, well, for example, if a you know, a good example might be, I know we're talking about osteoarthritis, but dental pain. If a cat has dental pain and a cat doesn't eat, then if a cat that doesn't eat can develop a condition called hepatic lipidosis, uh, which can negatively impact liver function. So that's one example. With osteoarthritis, and it's interesting, I actually experienced a little bit a little bit of this myself. Uh if you have uh a change in gait that is an attain uh to compensate for discomfort that you have in the joint that can inappropriately stress other joints, and that can actually cause musculoskeletal problems in other parts of the body. Those are uh two examples.
SPEAKER_02There are some things that older cats will probably experience. That happened with that happened with our uh old cat that lived to be almost 21. I mean, we we got her little pet steps because she could no longer get on the couch, but it became really obvious that she was having difficulty walking uh as she got older.
SPEAKER_01Yeah, not uncommon and and really important to be on the lookout for.
SPEAKER_02Let's talk a bit about pain management plans. Are there specific things that uh as a veterinarian that if a cat has a certain chronic pain, are there plans or are there procedures that a veterinarian might have the cat owner go through with a cat to make sure that uh there is at least not as much discomfort with a chronic pain?
SPEAKER_01Sure. And and generally speaking, it's it's best to take what's known as a multimodal approach, meaning using a combination of uh management or um husbandry changes in the home, as well as uh medications, for example, to control pain. So things that owners can do in the home, for example, as you said, putting ramps so that cats can access places that they used to jump to, if they have osteoarthritis, can't jump up on the bed anymore, for example, putting a ramp. Uh using litter boxes that have lower sides or a cutout that the cat can cross, because if you have a cat that, for example, has osteoarthritis in the hips and you have a high-sided litter box, and the cat can't step over the side of the litter box um without pain, uh that can be distressing and may lead to, for example, inappropriate elimination. So those are examples of what you can do. Uh controlled exercise, so the importance of talking to sports medicine and rehabilitation people. There are um exercises that you can do with your cat to uh improve mobility, strengthen uh muscles. Uh very important, of course, is weight management. We know that many cats are overweight and or or obese. So if a cat is overweight, it's going to be really important to decrease the strain on those joints that may have osteoarthritis by uh achieving an appropriate weight with an appropriate uh feeding plan that can achieve the appropriate weight with veterinary guidance. So those are some examples of things that people can do at home. And then, of course, the use of uh drugs in in uh consultation with veterinarians. The first thing I want to say is uh never give analgesic or pain controlling medication that's meant for people to cats. So, for example, acetaminophen or tylenol, one dose can be fatal to your cat. Ibuprofen can be quite toxic. So very important not to give pain medication that's meant for people to cats without consulting with your veterinarian. Now there are, as I said, you know, different types of drugs that can be used and different interventions that can be used for osteoarthritis. They fall into the categories of these non-steroidal anti-inflammatory drugs, and these drugs, they actually inhibit enzymes that that produce something called prostaglandin, and prostaglandin stimulates uh nerve pain receptors that can cause pain. So non-steroidal anti-inflammatory drugs is one type of uh drug that we can use. Um and again, those are meloxicam and robenacocci are the are the most common ones. Uh there are other drugs that can be used in theory. Uh opioids in some cases, there's one that's called trambidol, that's a weak opioid, that uh in some cases uh can be used in cats. We probably know a little bit more about this use in uh in dogs than in cats, but in theory that's a possibility. Um then there are some other uh centrally acting drugs like gabapentin. So this is commonly used to to for what's called neuropathic pain in humans, but it can centrally, meaning working in the central nervous system, um, inhibit uh no susceptive neurons, which are these are the neurons that detect pain. So those are some kind of drugs that you can use. There are also things like supplements, so essential fatty acids, icosopentenoic acid. These have a lot of omega-3 fatty acids, which can help slow down cartilage destruction. Uh we probably know a little bit more um about them in dogs than in cats. Uh glucosamine and chondroitin sulfate uh can help build extracellular matrix or cartilage in cats, and these supplementations may help. Um in some cases, um things like acupuncture, uh laser therapy, these are uh what are called nontraditional means of addressing this discomfort associated with osteoarthritis. And what pr we don't know as much about them with respect to scientific validation, but we're learning more and more. And these things are reasonable uh sort of adjuncts to therapy. Now, more recently, an interesting uh it's kind of considered to be an emerging therapy, these are called monoclodal antibodies to something called nerve growth factor. And nerve growth factor is important uh in the transmission of uh pain sensation. And unlike non-steroidal anti-inflammatories, which work by chemically inhibiting the production of compounds that stimulate the nerves, this is kind of a pretty cool idea. These are actually antibodies that are made to neutralize some this nerve growth factor that's important for pain transmission. So uh this that's this uh the drug that's been approved is called Fru NovetMab. Some people uh the the brand name is uh silentia. So this is an anti-nerve growth factor, what we call monoclonal antibody that's approved in the United States. Um you know, we are learning, you know, any of these drugs and or interventions uh where you're talking about giving medications, um, they can have side effects. So we're learning more and more about side effects of all of these, including uh this new celentia. Um and then uh there's uh uh uh something called glycosamina glycans, something called adiquan, which can be used to decrease uh the activity of what are called catabolic enzymes or enzymes that break down cartilage in joints. And again, uh we know more about this in dogs than in cats, but these are given less frequently and they may hold promise for the management of osteoarthritis pain in cats in the future.
SPEAKER_02Right. And once again, questions whether a cat has uh chronic or acute pain essential that that the cat owner sees their veterinarian to have a visit about this, as well as potential treatments for that, and you were mentioning side effects and those things, and and the person's veterinarian would go over over all those things. So I think that's really, really good advice, Doctor.
SPEAKER_01Yes, absolutely. And again, consult with your veterinarian. There's a lot that we can do, and again, very important that you involve both the owner doing things like, you know, the thing with the litter box, making sure there are ramps, making sure things are easily accessible, uh, making sure that you have the everything that the cat needs on the same floor of your home, for example, so that they don't have to walk up or downstairs to go to the bathroom to eat, to drink water, in combination with uh your veterinarian to provide the appropriate medical therapy as needed, and also rehabilitation.
SPEAKER_02I want to thank Dr. Bruce Cornrice, director of the Cornell Feline Health Center at Cornell University's College of Veterinary Medicine for joining me on this podcast today. Very informative material, Doctor, and I know that the listeners will appreciate knowing about cat pain and some things that uh veterinarians in their area can can do to help with that.
SPEAKER_01It's my pleasure, Clark, and uh nice to be with you today.
SPEAKER_02Tell your friends about the Hissing Feline podcast and leave a review of the show where you listen to the program. Also let me know about topics you want to hear on the podcast and questions you have about cat topics. The podcast's email address is the Hissing Feeline at DerechoCatMedia.com. Derecho is spelled D-E-R-E-C-H-O. I want to especially thank Adam Allington with Cornell Media Relations for helping to make this episode possible. Join me for the next episode of the Hissing Feline when the topic will be CAT training. Until then, remember to keep purring.
SPEAKER_00Content on the Hissing Feline Podcast is for information and entertainment purposes only, and is not intended to provide medical, veterinary, or legal advice. Please consult your veterinarian and local and state authorities before dealing with feral and stray cats. Opinions expressed are those of the hosts and guests and not necessarily those of Duracho Cat Media LLC. References to products or services do not imply an endorsement. The Hissing Feline podcast is a production of Duracho Cat Media LLC and has been blessed by our rescue cats, Bridget and Maddie. All content is used with permission or under fair use.