Experts are now able to narrow down the list to 25 reliable signs, though for two of the behaviors – straining to urinate and tail flitching – the experts could not come to an agreement on the intensity of pain to which this indicates.
Some of the common indicators include difficulty jumping, playing less, lack of grooming, and a lowered head posture.
Through four rounds of elimination, experts evaluated a total of 91 signs, reaching agreement if at least 80 percent of group reported the same answer on four components of each of the behaviors.
The researchers explain that this list is an assessment tool which covers the sensorial and emotional aspects of pain.
Being able to identify a set of behaviors can help to usually detect pain, rather than looking for a single symptom.
For each of these signs, unless otherwise indicated, the experts are in agreement that they are frequently present in both low and high levels of pain. For the last two signs, experts had varied responses on the intensity of pain the behavior demonstrated.
Here are the 25 signs to look for:
2. Difficulty to jump
3. Abnormal gait
4. Reluctant to move
5. Reaction to palpitation
7. Absence of grooming
8. Playing less
9. Appetite decrease
10. Overall activity decrease
11. Less rubbing toward people
12. General mood
14. Hunched up posture
15. Shifting of weight
16. Licking a particular body region
17. Lower head posture
18. Blepharospasm (involuntary forcible blinking)
19. Change in form of feeding behaviour (rare in low level pain)
20. Avoiding bright areas (rare in low level pain)
21. Growling (rare in low level pain)
22. Groaning (rare in low level pain)
23. Eyes closed (rare in low level pain)
24. Straining to urinate
25. Tail flitching
The properties include the frequency of the behaviors in the presence of pain, the likelihood of its presence with low levels of pain, the reliability of the sign as an indicator of pain, and its presence in acute, chronic, and/or non-painful conditions.
The researchers say that the 25 behaviors cover the sensorial and emotional aspects of pain, and they may be used as a helpful assessment tool to help owners understand when their pets may be suffering.
“Both owners and veterinarians are clearly able to recognize many behavioral changes in cats which relate to pain.
‘However, owners may not always recognize the clinical relevance of what they see,’ said Professor Daniel Mills, Professor of Veterinary Behavioural Medicine at the University of Lincoln’s School of Life Sciences.
‘For example, they may view the changes as an inevitable part of natural ageing and not report them to the vet as a concern, or at least not until the behaviors become quite severe,’ Mills said.
‘We hope that having an agreed list of more objective criteria, which relates to specific signs of pain, could improve the ability of both owners and vets to recognize it.’
Of the 23 signs that were agreed upon across all properties by the experts, nearly all of them were more frequently present in instances of both low level and high level pain.
Only five behaviors were considered rare in low level pain, and only frequent in high level – change in feeding behavior, avoiding bright areas, growling, groaning, and closed eyes.
The team was also able to eliminate many behaviors which they have deemed ‘not sufficient for pain.’ Those eliminated include panting (as this is related to acute conditions), trembling or shivering, and teeth grinding.
While these behaviors alone aren’t to be used as definitive diagnoses, being able to identify a set of behaviors may help to reliably detect pain, rather than looking for a single symptom.
“Cats are notorious for not showing that they are in pain, and the more that we can find out what the signals are, then the sooner we can get them to the vets for diagnosis and treatment,’ said Caroline Fawcett, Chairman of Feline Friends.
“There is a long way still to go before the more subtle signs can be identified, but we are really excited about progress to date.’