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Frequently asked questions The Feline Grimace Scale (FGS) for cat carers

Note that the FGS does not replace a veterinarian consultation or advice provided by your veterinarian. We do not provide medical consultations or answer questions related to your cat’s health. Any health measurement instrument (e.g. pain scales) has limitations and clinical context should be taken in consideration. We are not liable for any treatment provided by the carer or any decision by your veterinarian.

Do not administer any medication to your cat if you think he/she is painful; some pain killers used in humans may kill your cat or induce serious adverse effects.

01.

How much can I trust the FGS for acute pain assessment? Does it always get it right?

The FGS has gone through a robust scientific validation method used for the most important health measurement scales. It has excellent discriminatory ability (i.e. differentiates painful from non-painful cats). However, like any other instrument, it has limitations based on the observer experience and the effects of drugs; it must be used appropriately.

04.

Is the FGS used to evaluate any type of pain?

No. The FGS has been developed and validated for acute pain assessment. If your cat has a chronic condition, the FGS is not reliable. In this case, other feline chronic pain assessment tools should be used.

06.

The FGS is made for evaluation of acute pain. What does this mean?

Acute pain refers to pain that usually has a function of a ‘warning/alarm signal’. It is a way of the body to indicate that something is not right. In some cases, acute pain is associated with serious conditions and a veterinarian should be consulted. Examples include pain after trauma or surgery, pain related with constipation, urinary obstruction or pancreatitis, and pain related to a wound or abscess.

08.

What are other clinical signs of pain in cats, in addition to changes in facial expression?

Normally, cats with acute pain are quiet and/or depressed and less interested in interacting with the owners or other animals. There are changes in posture, activity and comfort states. They might also have decreased appetite.

10.

Can I score my cat while he/she is grooming, eating or playing?

No. Wait until these activities are finished for FGS scoring.

12.

Is there a phone application for the FGS?

Yes. You may freely download the FGS educational phone application in English, French or Spanish for Apple and (App Store) Android  (Google Play) platforms. It allows the user to learn about the tool, practice his/her skills and helps with FGS scoring in real-time.

13.

Can I use the FGS to evaluate pain in other species?

No. The FGS was validated for use in cats only. Grimace scales for evaluation of pain in other nonhuman mammals are available. See here.

02.

Who can use the FGS?

Studies have shown that veterinarians, veterinary students and technicians/nurse, as well as cat carers can reliably use the FGS.

03.

I suspect my cat has osteoarthritis, should I use the FGS?

No. The FGS has been developed and validated for acute pain assessment. If your cat has a chronic condition, the FGS is not reliable. In this case, other feline chronic pain assessment tools should be used.

05.

Can I score my cat while he/she is sleeping?

No. Do not disturb the cat and wait until he/she is awake for FGS scoring. Make sure the cat is truly sleeping (e.g. in a curled up position) and not showing signs of ‘feign sleep’ due to pain. 

07.

My cat scored 3/10 or 4/10, but I still suspect he/she could be painful

Reassess the cat in 15-20 minutes. Contact your veterinarian if you need any advice related to the health of your cat.

Do not administer any medication to your cat - some pain killers used in humans may kill your cat or induce serious adverse effects.

09.

My scores of my cat are always higher than the scores from my partner. What does this mean?

It is normal for different observers to have differences of 1or 2 points on the total FGS score. If your scores are consistently equal or higher than 4 and you are concerned about your cat, please contact your veterinarian. 

11.

Are there automated means to see if my cat is painful using the FGS? For example, can I take a picture of my cat and automatically know the if he/she is painful?

No. Some companies are advertising the use of the Feline Grimace Scale for automated assessment of cats’ emotions. However, the FGS was scientifically validated for evaluation of acute pain only and it should not be used for evaluation of other emotions (e.g. happiness or sadness). Our laboratory does not have any relationship with these companies and we are currently working on scientifically-sound methods to produce a robust, science-based tool with high specificity, sensibility and precision followed by peer-reviewed publications.