Wellbeing

    The Feline Grimace Scale: How to Tell If Your Cat Is in Pain

    Cats are masters at hiding pain. This veterinary-validated tool uses subtle facial cues to help you catch suffering before it becomes a crisis.

    7 MIN READ
    UPDATED OCTOBER 2024

    Purrwise guides are educational and do not replace veterinary care for urgent or medical concerns.

    Why Cats Hide Pain

    From an evolutionary standpoint, cats are both predators and prey. In the wild, showing vulnerability or weakness is an invitation to larger predators. This instinct is so deeply ingrained that even your pampered house cat will work tirelessly to mask their discomfort.

    Often, by the time a cat is obviously limping or vocalizing in pain, the underlying condition has reached a severe stage. This is why the Feline Grimace Scale (FGS) is such a revolutionary tool for cat owners—it allows us to see what the cat is trying to hide.

    The Five Facial Indicators

    The FGS focuses on five specific facial features that change when a cat experiences pain. By observing these "action units," you can objectively assess your cat's comfort level.

    IndicatorNormal PresentationPain Presentation
    1. Ear PositionEars are facing forward and upright.Ears rotate outward and flatten (airplane ears).
    2. Orbital TighteningEyes are open and round.Eyes are squinted, narrowed, or closed.
    3. Muzzle TensionMuzzle is relaxed and rounded.Muzzle appears tense, drawn, or flattened.
    4. Whisker PositionWhiskers are loose and curved.Whiskers are bunched, straight, or pushed forward.
    5. Head PositionHead is carried above the shoulders.Head is lowered below the shoulders (hunched).

    Scoring the Scale

    For each of the five indicators, assign a score of 0, 1, or 2:

    • 0:Absent — The indicator looks completely normal.
    • 1:Moderate — There is a noticeable change, but it is not extreme.
    • 2:Obvious — The change is severe and undeniable.

    Add these numbers together for a total score out of 10.

    When to Act

    The clinical threshold for intervention is generally considered 4 out of 10.

    SCORE 1-3

    Monitor closely. Re-evaluate in 2 hours.

    SCORE 4-6

    Call your vet today for an appointment.

    SCORE 7-10

    Seek emergency veterinary care immediately.

    Beyond the Face

    While the face is the most reliable "leak" of pain, other body signals can support your FGS assessment. Look for:

    • Guarding or protecting a specific limb or area
    • Reluctance to jump or difficulty climbing stairs
    • Changes in litter box habits (e.g., missing the box or avoiding it)
    • Over-grooming a specific spot or stopping grooming entirely
    • Hiding in unusual places or social withdrawal

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