Is heart disease painful in cats?

Both acute and chronic pain impact on quality of life however cats may be very adept at hiding signs of pain and therefore careful observation may be required to identify the subtle signs that they show.

We will sometimes use a pain scoring system to assess cats for signs of pain and some of the criteria are:

1. Is cat…

Silent / purring / meowing?         Score = 0

Crying / growling / groaning?      Score = 1

2. Is cat…

Relaxed                                             Score = 0

Licking lips                                       Score = 1

Restless / cowering / withdrawn    Score = 2

Tense / crouched                            Score = 3

Rigid / hunched                               Score = 4

3. Is cat licking any painful area(s)?

No = Score 0

Yes = Score 1

4. We also look at the cat’s ear position and the number below shows the score.

5. We also assess the muzzle shape for signs of tension that result in the lips appearing more tense and drawn.

A higher score makes it more likely that the cat is displaying signs of pain.

So is this cat showing signs of pain?

This cat is opening his mouth to meow (score 0), he appears interested and relaxed (score 0), his ears are pricked (score 0) and his lips / muzzle appears full and relaxed (score 0). So there are no obvious indicators of pain on initial examination.

As some of you may know this is George, the dashingly handsome cat from next door and our self-appointed car park attendant.

What about this cat?

We can’t hear anything but I would guess this cat is silent (score 0) however he does appear to be tense / crouched (score 3), his ears are flattened (score 2) and his lips and muzzle is drawn back and tense (score 2). This gives a total score of 7.

This cat is assumed to be in pain until proven otherwise.

[photo credit:]

Is heart disease painful?

Heart disease in cats may be painful and / or impact on quality of life when:

  1. a clot forms in a limb – this is a very painful complication of heart disease resulting in weakness or paralysis of a limb and requires immediate attention.
  2. fluid accumulates in the chest cavity causing breathing difficulties and anxiety.
  3. inflammation caused by heart failure makes some cats feel lethargic.
  4. sometimes heart medication can exacerbate  kidney dysfunction causing toxins to build up in the body.
  5. there is some evidence that cats are likely to feel angina and some owners will report intermittent behavioural change which may be attributable to angina.

Whilst heart disease can potentially be painful, there are plenty of things that we can do to alleviate this discomfort and optimise quality of life.  If you have any concerns about your cat then please do not hesitate to contact your local veterinary surgeon for advice.  If your vet feels that referral is appropriate then we are very happy to arrange an appointment.

Further reading:Reid, J., Scott, EM., Calvo, G., Nolan, AM.(2017) Definitive Glasgow acute pain scale for cats: validation and intervention levelVeterinary Record 180, 449.

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